Posttraumatic Research Articles

Centering prayer in the treatment of Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event. A significant proportion of sexual assault survivors develop PTSD. Research indicates that 75% of sexual assault survivors meet the criteria for PTSD one month after the assault. PTSD treatment combines psychotherapy, medication, hypnosis, meditation, and emerging therapies to help individuals manage trauma-related symptoms and regain control over their lives. Nonetheless, despite advances in PTSD treatments, there remains a pressing need for new approaches to address gaps in current care. We recently demonstrated that centering praying (CP) is useful in treating Parkinson’s disease. Objective: To treat female patients complaining of PTSD due to sexual abuse or rape with CP. Methods: We will develop a randomized controlled trial studying five females from 18 to 35 years old who complain of PTSD due to sexual abuse or rape. Five women paired in an age without any neurological, psychiatric, or systemic disorder will be the control group. Patients will be randomly selected blindly according to the DSM-5 criteria by two neurologists. Comorbid major psychiatric disorders, substance abuse, or severe medical conditions will be excluded. Each patient and the control subjects will be studied by computer tomography to exclude any neurological condition. Outcome Measures will be the PTSD Checklist for DSM-5 (PCL-5) and the quantitative computer tomography (QEEGt). Secondary outcomes will be the PHQ-9 (Patient Health Questionnaire-9) to assess depression specifically, Results: Demographic data showed a significant improvement in patients’ clinical condition assessed by PLC-5 and PHQ-9 after CP treatment. QEEGt records demonstrated a stable pattern in all five patients: an increase of theta activity (4–8 Hz) in the left parietal-temporal-occipital areas of PTSD patients. Figure 3 shows a grand average of the five patients, demonstrating an important augmentation of theta activity in this region. Z-values in the QEEGt map show a progressive decrement of the statistically significant Theta increment above our normative data as long as the CP treatment progresses. Conclusion: We conclude that CP appears to offer a distinct and accessible pathway for managing PTSD, promoting emotional regulation, resilience, and a sense of inner peace rooted in spirituality.

The Mediating Role of Difficulties in Emotion Regulation and Earthquake Stress Coping in the Relationship Between Posttraumatic Cognitive Attribution and Posttraumatic Stress Disorder in Türkiye 2023 Earthquake Survivors.

Natural disasters such as earthquakes leave deep psychological effects on individuals that can lead to posttraumatic stress disorder, and understanding these effects is vital to support psychological recovery processes after trauma. In this context, the aim of this study was to examine the mediating role of emotion regulation difficulties, religious coping, positive reappraisal and seeking social support in the relationship between posttraumatic cognitive attributions and posttraumatic stress disorder in 2023 Kahramanmaraş Pazarcık, Elbistan and Hatay Yayladağı earthquake survivors (N = 408). The findings from the multiple mediation analysis showed the indirect effect of posttraumatic cognitive attribution on PTSD through difficulties in emotion regulation, religious coping, positive reappraisal, and seeking social support. Therefore, difficulties in emotion regulation may be a risk factor for PTSD, while religious coping, positive reappraisal and seeking social support may be protective factors. Strategies to reduce difficulties in emotion regulation and to improve religious coping, positive reappraisal and social support seeking in earthquake survivors may be necessary to reduce PTSD that may be caused by the earthquake.

Causal associations between immune cells and psychiatric disorders: a bidirectional mendelian randomization analysis.

Extensive researches illuminate a potential interplay between immune traits and psychiatric disorders. However, whether there is the causal relationship between the two remains an unresolved question. We conducted a two-sample bidirectional mendelian randomization by utilizing summary data of 731 immune cell traits from genome-wide association studies (GCST90001391-GCST90002121)) and 11 psychiatric disorders including attention deficit/hyperactivity disorder (ADHD), anxiety disorder, autism spectrum disorder (ASD), bipolar disorder (BIP), anorexia nervosa (AN), major depressive disorder (MDD), obsessive-compulsive disorder (OCD), Tourette syndrome (TS), post-traumatic stress disorder (PTSD), schizophrenia (SCZ), and substance use disorders (cannabis) (SUD) from the Psychiatric Genomics Consortium (PGC). A total of four types of immune signatures (median fluorescence intensities [MFI], relative cell [RC], absolute cell [AC], and morphological parameters [MP]) were included. Effect estimates were obtained by using the inverse-variance-weighted (IVW), weighted median method, Mendelian randomization (MR)-Egger, and corrected by false discovery rate. Outliers were evaluated through the leave-one-out technique. Horizontal pleiotropy was assessed using the MR pleiotropy residual sum and outlier (MR-PRESSO) and MR-Egger intercept tests. MR analysis results suggested several immune cell subtypes were casually associated with psychiatric disorders. It was found that CD33br HLA DR + CD14 - AC (Myeloid cell, AC) may contribute to decreasing the risk of BIP (odds ratio [OR] = 0.9179, confidence interval [CI] = 0.8829-0.9542, PFDR = 7.06 × 10-3), and likewise, CD38 on transitional (B cell, MFI) also showed negative causal effect on SCZ risk (OR = 0.9551, CI = 0.9330-0.9776, PFDR = 0.0441). While IgD - CD27 - %lymphocyte (B cell, RC) has causal effect on increasing BIP risk (OR = 1.0184, CI = 1.0079-1.0291, PFDR = 0.0201). In addition, HLA DR + + monocyte %monocyte (TBNK, RC) is likely to increase AN onset (OR = 1.0746, CI = 1.0324-1.1186, PFDR = 0.0506), and CCR2 on CD14 - CD16 + monocyte (Monocyte, MFI) may contribute to PTSD (OR = 1.0591, CI = 1.0275-1.0917, PFDR = 0.0369). Sensitivity analysis revealed consistency of results. Our research elucidates there may be causal links between immune traits and the onset of psychiatric disorders, which established a groundwork for the prospective clinical utilization of immune cells as markers for the diagnosis and early intervention of psychiatric disorders.

Preliminary effectiveness of a trauma-informed mind-body intervention for survivors of human trafficking in the Philippines

ABSTRACT Human trafficking survivors report high rates of depression, anxiety, and post-traumatic stress disorder. Despite growing attention to the mental health needs of this population, there is a dearth of evidence-based mental health interventions and reintegration support programs for survivors in low-resource settings. We report findings from a pilot study exploring the preliminary effectiveness of a trauma-informed, mind-body intervention for survivors in Cebu, Philippines. Data were analyzed using linear mixed-effects models. Findings show significant reductions in symptoms of depression, anxiety, and PTSD among survivors over time. Findings demonstrate the promise of culturally-responsive, low-technology mind-body interventions to address survivors’ mental health needs.

Neurobehavioral Symptoms Partially Mediate the Effects of Depression and PTSD on Participation for Veterans With Mild Traumatic Brain Injury: A Cross-Sectional Study.

To examine whether neurobehavioral symptoms mediate the relationship between comorbid mental health conditions (major depressive disorder [MDD] and/or posttraumatic stress disorder [PTSD]) and participation restriction among Veterans with mild traumatic brain injury (mTBI). Veterans Health Administration (VHA). National sample of Veterans with mTBI who received VHA outpatient care between 2012 and 2020. Secondary data analysis of VHA clinical data. We specified a latent variable path model to estimate relationships between: (1) comorbid mental health conditions and 3 latent indicators of neurobehavioral symptoms (vestibular-sensory; mood-behavioral; cognitive); (2) latent indicators of neurobehavioral symptoms and 2 latent indicators of participation restriction (social and community participation; productivity); and (3) comorbid mental health conditions and participation restriction. International Classification of Diseases codes, Neurobehavioral Symptom Inventory, and Mayo-Portland Adaptability Inventory Participation Index to measure mental health conditions, neurobehavioral symptoms, and participation restrictions, respectively. Indirect effect estimates indicated that comorbid MDD and/or PTSD was associated with greater social and community participation restrictions, as mediated by mood-behavioral (β=.22-.33; 99% CI 0.18-0.4; small to medium effect) and cognitive symptoms (β=.08-.13; 99% CI 0.05-0.18; small effect), and with greater productivity restrictions, as mediated by vestibular-sensory (β=.06-.11; 99% CI 0.04-0.15; small effect) and cognitive symptoms (β=.08-.13; 99% CI 0.05-0.18; small effect). Direct effect estimates indicated that comorbid MDD and/or PTSD was associated with greater challenges with both social and community participation (β=.19-.40; 99% CI 0.12-0.49; small to medium effect) and productivity (β=.08-.44; 99% CI-0.02 to 0.55; small to medium effect). Neurobehavioral symptoms partially mediated the impact of MDD and/or PTSD on participation restrictions among Veterans with mTBI. These findings advance the understanding of explanatory mechanisms underlying participation challenges among Veterans with comorbid mTBI and mental health challenges, thereby informing the development of tailored intervention strategies.

Engagement With an Internet-Administered, Guided, Low-Intensity Cognitive Behavioral Therapy Intervention for Parents of Children Treated for Cancer: Analysis of Log-Data From the ENGAGE Feasibility Trial.

Parents of children treated for cancer may experience psychological difficulties including depression, anxiety, and posttraumatic stress. Digital interventions, such as internet-administered cognitive behavioral therapy, offer an accessible and flexible means to support parents. However, engagement with and adherence to digital interventions remain a significant challenge, potentially limiting efficacy. Understanding factors influencing user engagement and adherence is crucial for enhancing the acceptability, feasibility, and efficacy of these interventions. We developed an internet-administered, guided, low-intensity cognitive behavioral therapy (LICBT)-based self-help intervention for parents of children treated for cancer, (EJDeR [internetbaserad självhjälp för föräldrar till barn som avslutat en behandling mot cancer or internet-based self-help for parents of children who have completed cancer treatment]). EJDeR included 2 LICBT techniques-behavioral activation and worry management. Subsequently, we conducted the ENGAGE feasibility trial and EJDeR was found to be acceptable and feasible. However, intervention adherence rates were marginally under progression criteria. This study aimed to (1) describe user engagement with the EJDeR intervention and examine whether (2) sociodemographic characteristics differed between adherers and nonadherers, (3) depression and anxiety scores differed between adherers and nonadherers at baseline, (4) user engagement differed between adherers and nonadherers, and (5) user engagement differed between fathers and mothers. We performed a secondary analysis of ENGAGE data, including 71 participants. User engagement data were collected through log-data tracking, for example, communication with e-therapists, homework submissions, log-ins, minutes working with EJDeR, and modules completed. Chi-square tests examined differences between adherers and nonadherers and fathers and mothers concerning categorical data. Independent-samples t tests examined differences regarding continuous variables. Module completion rates were higher among those who worked with behavioral activation as their first LICBT module versus worry management. Of the 20 nonadherers who opened the first LICBT module allocated, 30% (n=6) opened behavioral activation and 70% (n=14) opened worry management. No significant differences in sociodemographic characteristics were found. Nonadherers who opened behavioral activation as the first LICBT module allocated had a significantly higher level of depression symptoms at baseline than adherers. No other differences in depression and anxiety scores between adherers and nonadherers were found. Minutes working with EJDeR, number of log-ins, days using EJDeR, number of written messages sent to e-therapists, number of written messages sent to participants, and total number of homework exercises submitted were significantly higher among adherers than among nonadherers. There were no significant differences between fathers and mothers regarding user engagement variables. Straightforward techniques, such as behavioral activation, may be well-suited for digital delivery, and more complex techniques, such as worry management, may require modifications to improve user engagement. User engagement was measured behaviorally, for example, through log-data tracking, and future research should measure emotional and cognitive components of engagement. ISRCTN Registry 57233429; https://doi.org/10.1186/ISRCTN57233429.

Perinatal Mental Health Disorders and Resilience in Patients with Fetal Anomalies.

Pregnant women face heightened vulnerability to mental health disorders (MHDs). There remains a lack of data during the antenatal period, particularly for high-risk subpopulations such as those with fetal anomalies. Understanding the psychological impact of women receiving a fetal anomaly diagnosis is crucial, as it can lead to MHDs. Additionally, maternal stress due to such diagnoses can have adverse effects on short- and long-term health outcomes for both the mother and the child. This study aimed to address the gap in knowledge regarding prenatal MHDs in women with fetal anomalies by characterizing maternal peripartum psychological health and identifying factors related to MHDs. Women diagnosed with fetal anomalies (N = 110) were recruited from a tertiary fetal care center and completed surveys assessing resilience, anxiety, depression, and posttraumatic stress symptoms (PTSs). Demographic characteristics were also collected and analyzed. Multiple regression analyses were conducted to explore associations between demographic variables and mental health outcomes. Participants endorsed elevated depressive symptoms (45%), anxiety (43%), and PTSs (39%). Private insurance and relationship status were positively associated, and resilience was negatively associated, with depression and anxiety levels. Maternal perception of diagnostic severity correlated with increased depressive symptoms and PTSs, whereas physician ratings of diagnostic severity did not. The findings underscore the prevalence of MHD among pregnant women with fetal anomalies and emphasize the importance of assessing maternal perception of severity in predicting mental health outcomes. Identifying risk factors like insurance status and relationship status suggests avenues for targeted screening and intervention. Multidisciplinary collaboration is essential for implementing effective strategies to address peripartum psychopathology related to fetal anomalies and improve overall maternal and fetal health. · Pregnant women with fetal anomalies face poor mental health.. · Resilience is negatively related to poor mental health.. · Perception of severity impacts mental health symptoms..

Physiology mechanisms of exercise for PTSD: a narrative review

In at-risk societies, the population of post-traumatic stress disorder (PTSD) incidence is gradually expanding from veterans to the general public. In the face of the high incidence of PTSD, exercise therapy, as an economical and maneuverable treatment, has not received the attention it deserves. In this paper, the literature on PTSD symptom improvement through comb-climbing exercise interventions found that performing long-term exercise can achieve significant improvement in PTSD symptoms by modulating the central nervous system, autonomic nervous system, and immune system at the physiological level. Aerobic exercise (running, walking) is beneficial to the central nervous system and immune system; anaerobic exercise positively affects the autonomic nervous system, including resistance or strength endurance training; yoga, which focuses on flexibility and balance training, has a positive effect on the immune system. Future research should explore the neutral and negative effects and mechanisms of exercise on PTSD interventions. Expand more empirical studies in special occupational populations. And implement longitudinal intervention studies with PTSD patients to gain an in-depth understanding of PTSD intervention effects.

Cannabis Use Characteristics and PTSD-Related Outcomes Among Canadian Veterans With Chronic Pain

Previous research on the relationship between cannabis and posttraumatic stress disorder (PTSD) has produced equivocal results. One explanation is that differences in cannabis use characteristics (e.g., medicinal vs. recreational use, route of administration, THC to CBD ratio, and grams per day) are associated with differences in PTSD severity. Using data from a previous cross-sectional study, we performed a series of MANOVAs to examine how cannabis use, cannabis use characteristics, sex, and talk therapy attendance are associated with PTSD severity, psychological distress (i.e., depression and anxiety), and insomnia in a sample of Canadian veterans with chronic pain and a history of trauma (N = 513). We also performed descriptive analysis on participants’ demographics, military history, and cannabis use. Participants with a cannabis prescription and/or who attended talk therapy tended to have higher PTSD severity than those who did not. Cannabis use, sex, route of administration, THC to CBD ratio, and grams per day, were not significantly correlated with PTSD-related outcomes. However, descriptive analysis showed that the majority of those who used cannabis reported that it benefited their mental health. We speculate that veterans with more severe PTSD are more likely to seek out treatment in the form of prescribed cannabis or talk therapy; and that the perceived effect of cannabis on PTSD differs from the measured effect due to cannabis only causing a short-term reduction in PTSD symptoms.

High Prevalence of Posttraumatic Stress Disorder Symptoms Found in Well-Treated People with HIV after the Introduction of Patient-Reported Outcome Measures.

People with HIV (PWH) are at greater risk of experiencing mental health problems, such as depression and post-traumatic stress disorder (PTSD). The purpose of our study was to determine the prevalence of posttraumatic stress disorder PTSD in PWH. PWH in care Amsterdam University Medical center (Amsterdam UMC) with access to the electronic patient portal were offered patient-reported outcome measures (PROMs) between May 2022 and May 2023, including the PC-PTSD-5 screen for PTSD as part of routine clinical care. Risk factors for a clinically relevant PC-PTSD-5 score were determined using univariate and multiple logistic regression analyses. Of 2476 PWH included, 1384 (55.9%) had access to the electronic patient portal of whom 474 (34.2%) completed the PC-PTSD-5. PWH without access to the patient portal were more often female, born in low- and middle-income countries, acquired HIV more often via heterosexual contact, and had worse HIV-related outcomes compared to those with access. Of 474 PWH who completed the PC-PTSD-5 screening question, 62 (13.1%) reached the threshold for clinically relevant PTSD. Age less than 50 years (OR 2.29, 95% CI: 1.21-4.35), and having originated from low- or middle-income countries (OR 2.02, 95% CI: 1.09-3.76) were associated with PTSD. Our findings show that 13% of PWH with a well-controlled HIV infection with access to the electronic patient portal at Amsterdam UMC experienced clinically relevant PTSD complaints.

Mental health of volunteers: origin of psychosomatic disorders in PTSD conditions

Background. Numerous studies in various scientific areas deal with to the problem of mental health of Ukrainians: the theory and practice of psychological and pedagogical research, psychophysiological concepts and theories, a systematic approach in psychology, the psychophysiological aspect of the emotional background, as well as psychosomatic features of optimal personality functioning. Preservation of mental health has become a priority of the state policy of Ukraine to support the country’s stability and fighting capacity. The study of the impact of psychoemotional factors on the functional state of the body for the restoration and optimization of life support among volunteers who provide free psychological assistance and support the mental health of the population is relevant. The research was aimed at studying the origin of psychosomatic disorders in volunteers with post-traumatic stress disorder (PTSD), as well as determining the impact of these disorders on their mental health and psychosocial status. Materials and methods. The following psychodiagnostic tools were used: emotional burnout diagnosis method according to V. Boyko, NEWS questionnaire, PCL-5 questionnaire and post-traumatic growth questionnaire. According to the results of the study, it was found that emotional burnout in volunteers manifests itself in three phases: tension, resistance, and exhaustion according to indicators of a high level of stress and severe depression in respondents with signs of PTSD (23.9 %). Results. Mental disorders such as asthenic, anxiety-phobic, hysteroform and depressive syndromes are observed in all groups. Conclusions. The psychosomatic mechanism of the relationship between mental activity and behavior in PTSD includes the influence of a traumatic psycho-emotional factor that causes a constant feeling of danger, panic attacks or fear of repeating the situation, a feeling of hopelessness, low mood, apathy, loss of interest in usual activities, aggression, irritability, frequent conflicts and anger outbursts, feelings of detachment, social isolation, relationship problems and guilt for experiencing PTSD symptoms.

Cyber abuse and posttraumatic stress disorder among racially diverse women who have resided in domestic violence shelters: A longitudinal approach.

The present study presents a longitudinal examination of the impact of cyber abuse (CA) on posttraumatic stress disorder (PTSD) severity among a racially diverse sample of women with intimate partner violence (IPV). Using data collected from a completed randomized control trial with women who sought safety in a domestic violence shelter (W-DVS; N = 172), we conducted a secondary data analysis. Participants completed measures of CA, PTSD severity, and other types of IPV at each time point. To examine predictors of the latent change factor, we estimated the influence of CA on each latent change factor while controlling for other (i.e., noncyber abuse) types of IPV and treatment condition across time. Initial results suggested that CA has a negative impact on PTSD severity over time for W-DVS, as CA predicted changes in PTSD severity across five time points when controlling for treatment condition and PTSD symptom severity at the previous time points. However, CA did not predict a change in symptom severity when controlling for other forms of (noncyber abuse) IPV. Although more CA is associated with more severe PTSD symptoms from the time women are in shelter to postshelter, 3, 9, and 15 months postshelter, this is no longer the case when overall IPV is considered. This study extends our understanding of how CA can exacerbate psychological health consequences, including PTSD severity, of W-DVS, suggesting that cyber abuse should be assessed in tandem with other IPV types rather than as a separate phenomenon. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Examining Intervention Programs for Perpetrators and Victims of Intimate Partner Violence: A Review of Contemporary Approaches

A systematic review of the effectiveness of intervention programs for perpetrators and victims of intimate partner violence (IPV) was conducted. Inclusion criteria for studies included publication in a peer-reviewed journal, a representative, community, or clinical sample, written in English, and conducted in the United States. A total of 40 articles were included. Comparisons to a prior review highlight developments in research in the past 10 years. Studies into batterer intervention programs, the predominant form of abuser intervention in the United States, found mixed support for their effectiveness at reducing IPV. Issues with program completion remain a problem. Research into victim–survivor programs proved more promising in both reducing IPV and ameliorating adverse mental health outcomes (i.e., depression and posttraumatic stress disorder). Recommendations for intervention and policy with future directions for IPV research are discussed.

Maternal mental health matters: Indicators for perinatal mental health-A scoping review.

Perinatal mental health disorders are a significant contributor to morbidity and mortality in childbearing women. The World Health Organization recommends all women be screened for mental health disorders postnatally and have diagnostic and management services available. There are, however, currently no global indicators in use which measure the status and progress of perinatal mental health. The aim of this scoping review was to identify existing perinatal mental health indicators and propose a core set which could be used at a global level. We used the Global Perinatal Mental Health Theory of Change as the conceptual framework. We found 25 indicators for PMH aligned with the Global Perinatal Mental Health Theory of Change, which were condensed to form a core set of nine indicators These core indicators include the proportion of women with depression, anxiety, post-traumatic stress disorder, psychosis, or adjustment disorders in the perinatal period; the proportion of women screened for these services; the proportion who have access to services following a positive diagnosis; and, the proportion of healthcare providers trained to provide mental health care. This review forms part of the foundational work for the development of a global monitoring framework which would be able to monitor progress towards the provision of universal high quality perinatal mental health care.

"To Whom Should I Refer Her?" Factors Contributing to Religious Informal Helpers' Referral Decisions for Women with Mental Illness and At-Risk Women: The Case of Israeli Balaniyot.

Religious informal helpers may play a crucial role in recognizing and providing referrals to mental health professional for at-risk individuals, including those with mental illness, especially since members of religious communities tend to conceal their difficulties and to view religious leaders as a sole source of assistance. This quantitative study aimed to explore Jewish bathhouse attendants ("balaniyot") who assist women in their monthly immersion, a unique situation in which mental health symptoms (e.g. obsessive-compulsive disorder, postpartum depression, post-traumatic stress disorder, eating disorders) and intimate partner violence may come to light. The Health Belief Model (HBM) which suggests factors explaining the likelihood of seeking or referring to professional help for physical and/or mental illness guided the selection of the variables. Israeli Balaniyot (N = 166) completed self-report questionnaires assessing factors deriving from HBM: religious affiliation, mastery, spirituality at work, knowledge of mental health, and tendency to assist IPV victims. Binary regression analysis examined the contribution of variables to choice of referral source (professional vs. spiritual/rabbinical). The findings indicated that most participants (69%) tended to refer at-risk women to professional help. Predictive factors included religious affiliation (with a higher tendency among Orthodox balaniyot), weekly workdays, mental health knowledge, a focus on protecting women's safety and family integrity, and high mastery conditioned by low spirituality at work. The findings validate the HBM and its application among religious informal helpers and suggest the need to increase balaniyot's knowledge of mental health issues and trust in professional figures and to respect their religious beliefs.

Post-Traumatic Stress Disorder in Scabies Patients: The Overlooked Part of a Global Outbreak

Post-Traumatic Stress Disorder in Scabies Patients: The Overlooked Part of a Global Outbreak

Associations between death anxiety and probable posttraumatic stress disorder and clinical depression and anxiety in older Israeli adults during wartime.

The outbreak of the Israel-Hamas war on October 7, 2023, has presented unprecedented challenges to older adults' mental health, including increased posttraumatic stress, anxiety, and depression. The current study examined potential war- and age-related factors associated with probable posttraumatic stress disorder (PTSD), clinical depression (probable depression), and generalized anxiety disorder (probable anxiety) among older adults during the ongoing war. Moreover, due to the continued threat of death, we examined whether death anxiety is an additional contributing factor to older adults' probable PTSD, depression, and anxiety. Data were collected January-March 2024 from 554 community-dwelling older adults (Mage = 73.90 years, SD = 7.35, range: 61-96 years) who completed online scales assessing sociodemographic variables, war exposure (distance from the Gaza Strip, exposure to terror attacks/blasts), and age-related constructs (assistance in daily activities [ADL], cognitive decline, physical illnesses, death anxiety). Increased ADL was associated with probable depression, B = 0.62, OR = 1.87, and anxiety, B = 0.42, OR = 1.53, and cognitive decline was associated with probable depression, B = 1.52, OR = 4.56. Older adults with high levels of death anxiety were almost 3 times as likely to meet the criteria for probable PTSD, B = 1.05, OR = 2.85, and more than 1.5 as likely to meet the criteria for probable depression, B = 0.54, OR = 1.71, and anxiety, B = 0.50, OR = 1.65. The importance of death anxiety as a potential risk factor for negative psychological outcomes among older adults during war is discussed.

Genetic and peripheral biomarkers of comorbid posttraumatic stress disorder and traumatic brain injury: a systematic review

BackgroundPosttraumatic stress disorder (PTSD) commonly cooccurs with traumatic brain injury (TBI) in military populations and is a significant predictor of poor long-term outcomes; however, it is unclear to what extent specific biological variables are associated with comorbidity. This PROSPERO-registered systematic review evaluates the current body of literature on genetic and peripheral biomarkers associated with comorbid TBI and PTSD.MethodsSearches were conducted in four databases (PubMed, PsycInfo, PTSDPubs, Scopus). We included published studies examining differences in peripheral biomarkers among civilian, military, and veteran participants with both TBI and PTSD compared to those with TBI alone as well as, in some cases, PTSD alone and healthy controls. Data were extracted from included studies and evidence quality was assessed.ResultsOur final analysis included 16 studies, the majority of which were based on data from active duty military and veteran participants. The results suggest that multiple gene variants are likely to contribute to the cumulative risk of PTSD comorbid with TBI. An elevated circulating level of the pro-inflammatory cytokine IL-6 was the most consistently replicated blood-based indicator of comorbid illness, compared to mTBI alone.ConclusionSeveral genetic and protein markers of cellular injury and inflammation appear to be promising indicators of chronic pathology in comorbid TBI and PTSD. Additional research is needed to determine how such factors indicate, predict, and contribute to comorbidity and to what extent they represent viable targets for the development of novel diagnostic tools and therapeutic interventions.

Common Elements and Differences Among Treatment Approaches to Complex Post-Traumatic Stress Disorder: A Commentary on Five Case Studies.

Treating people who have experienced deep and prolonged developmental trauma, that is, complex post-traumatic stress disorder (cPTSD), can be challenging given the complexity and severity of their presentations. The main features of complex post-traumatic stress disorder, that is, affective and behavioral dysregulation, altered self-experience and identity disturbances, relational difficulties, negative self-concepts, and negative pathogenic beliefs, are, at the same time, therapeutic goals and obstacles to treatment. Therefore, clinicians must be aware of these difficulties in order to identify them and be ready to treat them when they arise during therapy with the same client. For this reason, the clinical cases presented in this issue of the Journal of Clinical Psychology: In Session provide a very useful overview of how to deal with these manifestations from the perspective of different models of psychotherapy. This commentary, after briefly reviewing the clinical features and therapeutic difficulties of these clients, offers a critical summary of the commonalities and differences between the various approaches presented by the clinical cases in this special issue. The purpose is to help the reader navigate the key aspects of treating the pathogenetic processes involved in cPTSD and to identify the different therapeutic tools that may be applicable to the different clinical presentations.

Functional independence trajectories over 5 years in older veterans with traumatic brain injury: A model systems study.

Research on older adults who sustain a traumatic brain injury (TBI) has predominantly been on civilian, nonveteran populations. Military populations experience higher rates of TBI and often experience the additive effects of TBI and other comorbid disorders, including posttraumatic stress disorder and/or substance use that may increase disability over time. To investigate predictors of functional independence trajectories over the 5 years after TBI in veterans 55 years or older at injury. Five Veterans Affairs (VA) polytrauma rehabilitation center (PRC) inpatient rehabilitation programs. Veterans who experienced their TBI at 55 years or older and had completed one or more Functional Independence Measure (FIM) Motor and Cognitive measure at 1, 2, or 5 years after TBI (n = 184) from the VA TBI Model Systems national database. Retrospective analysis of observational data using hierarchical linear models. FIM Motor and Cognitive scores at 1, 2, and 5 years after TBI. Motor and cognitive functioning decreased over time. Lower FIM Motor trajectories occurred in participants who had pre-TBI functional limitations in going out of the home and with longer posttraumatic amnesia (PTA). FIM Motor scores decreased over time, and the decrease was steeper for those with a moderate or severe injury. Lower FIM Cognitive trajectories occurred in participants who had problematic substance use at baseline and among those with longer PTA. FIM Cognitive scores decreased at a steeper rate for participants with greater injury severity. Similar to previously published studies in civilian populations, older veterans with TBI may be at risk for functional and cognitive decline. This study's findings increase the field's understanding of functional trajectories after TBI in older adults and may help identifty those who are at risk for lower functional outcomes.