Studies Of Posttraumatic Stress Disorder Research Articles

Transdisciplinary method for exploration and visualization of neuroimaging papers and databases: Application to PTSD

A major improvement in MRI techniques has led to an exponential increase in data acquisition and, consequently, in the number of published articles reporting brain impairments and cognitive deficits underlying a disorder. Meta-analysis offers a means of synthesizing the available literature, testing existing models in the light of scientific advances, and revealing unexpected information. However, article selection, author specialization and top-down hypotheses can mask some results and introduce bias into interpretations. LinkRdata is a platform for automated, data-driven, meta-analytical methods suitable for processing large numbers of MRI articles, that can reduce selection and interpretation biases, thereby allowing scientists to review neurocognitive correlates of disorders in relation to their own corpus of articles. To validate our method, we applied it to fMRI studies of post-traumatic stress disorder. Results confirmed LinkRdata's power to uncover findings hidden by the top-down hypothesis approach.

Testing Quantitative and Qualitative Sex Effects in a National Swedish Twin-Sibling Study of Posttraumatic Stress Disorder.

Twin studies have demonstrated that posttraumatic stress disorder (PTSD) is moderately heritable, and the pattern of findings across studies suggests higher heritability in females compared with males. Formal testing of sex differences has yet to be done in twin studies of PTSD. The authors sought to estimate the genetic and environmental contributions to PTSD, and to formally test for sex differences, in the largest sample to date of both sexes, among twins and siblings. Using the Swedish National Registries, the authors performed structural equation modeling to decompose genetic and environmental variance for PTSD and to formally test for quantitative and qualitative sex differences in twins (16,242 pairs) and in full siblings within 2 years of age of each other (376,093 pairs), using diagnostic codes from medical registries. The best-fit model suggested that additive genetic and unique environmental effects contributed to PTSD. Evidence for a quantitative sex effect was found, such that heritability was significantly greater in females (35.4%) than males (28.6%). Evidence of a qualitative sex effect was found, such that the genetic correlation was high but less than complete (rg=0.81, 95% CI=0.73-0.89). No evidence of shared environment or special twin environment was found. This is the first demonstration of quantitative and qualitative sex effects for PTSD. The results suggest that unique environmental effects, but not the shared environment, contributed to PTSD and that genetic influences for the disorder are stronger in females compared with males. Although the heritability is highly correlated, it is not at unity between the sexes.

Systems biology dissection of PTSD and MDD across brain regions, cell types, and blood.

The molecular pathology of stress-related disorders remains elusive. Our brain multiregion, multiomic study of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) included the central nucleus of the amygdala, hippocampal dentate gyrus, and medial prefrontal cortex (mPFC). Genes and exons within the mPFC carried most disease signals replicated across two independent cohorts. Pathways pointed to immune function, neuronal and synaptic regulation, and stress hormones. Multiomic factor and gene network analyses provided the underlying genomic structure. Single nucleus RNA sequencing in dorsolateral PFC revealed dysregulated (stress-related) signals in neuronal and non-neuronal cell types. Analyses of brain-blood intersections in >50,000 UK Biobank participants were conducted along with fine-mapping of the results of PTSD and MDD genome-wide association studies to distinguish risk from disease processes. Our data suggest shared and distinct molecular pathology in both disorders and propose potential therapeutic targets and biomarkers.

Do traumatic events and substance use co-occur during adolescence? Testing three causal etiologic hypotheses.

Why do potentially traumatic events (PTEs) and substance use (SU) so commonly co-occur during adolescence? Causal hypotheses developed from the study of posttraumatic stress disorder (PTSD) and substance use disorder (SUD) among adults have not yet been subject to rigorous theoretical analysis or empirical tests among adolescents with the precursors to these disorders: PTEs and SU. Establishing causality demands accounting for various factors (e.g. genetics, parent education, race/ethnicity) that distinguish youth endorsing PTEs and SU from those who do not, a step often overlooked in previous research. We leveraged nationwide data from a sociodemographically diverse sample of youth (N = 11,468) in the Adolescent Brain and Cognitive Development Study. PTEs and substance use prevalence were assessed annually. To account for the many pre-existing differences between youth with and without PTE/SU (i.e. confounding bias) and provide rigorous tests of causal hypotheses, we linked within-person changes in PTEs and SU (alcohol, cannabis, nicotine) across repeated measurements and adjusted for time-varying factors (e.g. age, internalizing symptoms, externalizing symptoms, and friends' use of substances). Before adjusting for confounding using within-person modeling, PTEs and SU exhibited significant concurrent associations (βs = .46-1.26, ps < .05) and PTEs prospectively predicted greater SU (βs = .55-1.43, ps < .05) but not vice versa. After adjustment for confounding, the PTEs exhibited significant concurrent associations for alcohol (βs = .14-.23, ps < .05) and nicotine(βs = .16, ps < .05) but not cannabis (βs = -.01, ps > .05) and PTEs prospectively predicted greater SU (βs = .28-.55, ps > .05) but not vice versa. When tested rigorously in a nationwide sample of adolescents, we find support for a model in which PTEs are followed by SU but not for a model in which SU is followed by PTEs. Explanations for why PTSD and SUD co-occur in adults may need further theoretical analysis and adaptation before extension to adolescents.

Post-Traumatic Stress Disorder: Administration, Clinical and Pharmacological, Organizational and Legal, Pharmaceutical Management, Recent Case Studies

Administered post-traumatic stress disorder based on ICD-11. The organizational and legal management of post-traumatic stress disorder’s pharmacotherapy based on evidence-based medicine and evidence-based pharmacy was studied. The use of medications to reduce post-traumatic stress disorder’s symptoms is indicated. Analgesics, anxiolytics, antidepressants, anticonvulsants, and drugs from other clinical-pharmacological groups can be used for analgesia, mood improvement, anxiety reduction, and control of hypergaining. Areas of professional reintegration (support in job search, skills training, education, employment, and adaptation to civilian life) have been determined. Legal support in the system of legal relations "doctor-patient-pharmacist-lawyer" indicated in order to achieve a comprehensive and multidimensional approach to the medical and pharmaceutical care of patients with post-traumatic stress disorder. Clinical and pharmacological management in the pharmacotherapy of post-traumatic stress disorder was studied. The further pharmaceutical development of the composition of the new drug based on the known active pharmaceutical ingredients of an analgesic and an antipsychotic is substantiated. Mentioned about the organizational and legal management of social patient-oriented pharmacotherapy, recent case studies of post-traumatic stress disorder in conflict conditions.

A comparative study of posttraumatic stress disorder in two post-conflict communities in Benue state Nigeria.

The attendant long-term mental health consequence of the conflict of various kinds in Nigeria is yet to be thoroughly investigated. The Tiv-Fulani farmer-herdsmen crisis is one such conflict that occurred in 2013/2014 in Guma local government in Benue state. This study seeks to find out some years after the crisis, the prevalence difference in posttraumatic stress disorder (PTSD) between a community (Uikpiam) with direct exposure to the conflict and another (Daudu) with indirect exposure, the pattern of distribution of PTSD symptoms and the associate factors of PTSD. It is a cross-sectional one that employed a multi-stage cluster sampling method to select 413 participants; 135 from Uikpiam and 278 from Daudu. The study instruments administered included a questionnaire with some socio-demographic variables and an extract from the PTSD module of the Composite International Diagnostic Interview. The prevalence rate of PTSD was higher in Uikpiam (16.3%) when compared to Daudu (4.3%). A high proportion of sub-threshold symptoms of PTSD was recorded in both communities. An association was found between a lower educational qualification and PTSD (χ2 = 8.373; p = 0.039). PTSD can be a prolonged mental ill-effect of crisis and proximity to trauma sites increases vulnerability including lower education. This study looked at PTSD only as an outcome of this crisis, but mental health adverse outcomes of the crisis may not be limited to this alone, hence the need for further investigations for relevant stakeholders to act.

White matter predictors of PTSD: Testing different machine learning models in a sample of Black American women

BackgroundMachine learning neuroimaging studies of posttraumatic stress disorder (PTSD) show promise for identifying neurobiological signatures of PTSD. However, studies to date, have largely evaluated a single machine learning approach, and few studies have examined white matter microstructure as a predictor of PTSD. Further, individuals from minoritized racial groups, specifically, Black individuals, who experience disproportionate trauma frequency, and have relatively higher rates of PTSD, have been underrepresented in these studies. We used four different machine learning models to test white matter microstructure classifiers of PTSD in a sample of trauma-exposed Black American women with and without PTSD. MethodParticipants included 45 Black women with PTSD and 89 trauma-exposed controls recruited from an ongoing trauma study. Current PTSD presence was estimated using the Clinician-Administered PTSD Scale. Average fractional anisotropy of 53 white matter tracts served as input features. Additional exploratory analysis incorporated estimates of interpersonal and structural racism exposure. Classification models included linear support vector machine, radial basis function support vector machine, multilayer perceptron, and random forest. ResultsPerformance varied notably between models. With white matter features along, linear support vector machine demonstrated the best model fit and reached an average AUC = 0.643. Inclusion of estimates of exposure to racism increased linear support vector machine performance (AUC = 0.808). ConclusionsWhite matter microstructure had limited ability to predict PTSD presence in this sample. These results may indicate that the relationship between white matter microstructure and PTSD may be nuanced across race and gender spectrums.

Totes and trauma 3: a schematic for trauma persistence

PurposeThe purpose of this conceptual paper is to demonstrate how memes perpetuate trauma with a schematic. This conceptual paper uses the “begin with the end in mind” meme to format the presentation of the necessary components for the schematic of how trauma persists across generations. It is the third paper in a series of applications of the recursive, test-operate-test schematic to the systemic effects of the information processes involved in trauma. The schematic presented permits evaluations of solutions to interrupt the generational trauma cycle.Design/methodology/approachThe required schematic components are described. Trauma (actual or perceived threat to survival) will be briefly discussed. Evolutionary processes that create the psychophysiology necessary to support nominal social expectations (NSEs) memes and metaphors will be summarized. The development of NSEs will be discussed. Metaphors and memes necessary for the creation of the schematic and esoteric events at level Learning IV will be briefly described. Finally, Figure 3, which illustrates the maintenance of NSEs and attempts to prevent their violation, will be explained.FindingsIt is asserted that functional human social behavior requires NSEs. Trauma is found to persist through the presence of anti-nominal NSE memes that are transduced by the individual into anti-nominal metaphors, which then damage grid, place and dentate gyrus cell (GPDG) neurophysiology. The damaged neurocircuits allow the use of anti-nominal NSE metaphors within our individual neurophysiology. Furthermore, anti-NSE memes interfere with the self-organized criticalities (SOCs) of genetic-epigenetic processes necessary for the intergenerational transfer of functional social behavior. When anti-NSE nominal metaphors are transduced back into anti-NSEs, social niche memes, the trauma process is reiterated. Anti-NSE memes and metaphors are found to be inappropriate criteria central to the maintenance of persistent trauma. Therefore, anti-NSE memes have hijacked our epigenetics and our social niches. Solutions are available because during our evolution, the Homo clade developed esoteric capabilities and the ability to bring back what information we can from those encounters. This physiology operates around the 5HT2A neural receptors that process hallucinogens, such as psilocybin. Accessing this resource system, either through naturally occurring altered states of consciousness or through micro-dose pharmaceutical psilocybin and related neurotransmitters, produces a significant structural change in the GPDG system to reset the NSE system illustrated in the schematic to its nominal status so that we can maintain nominal NSE relationships within our meme niche(s).Research limitations/implicationsThe source of persistent trauma in our social niche(s), the means by which the trauma is maintained and the means to mitigate and perhaps eliminate persistent trauma are identified. Based on these three conclusions, it is difficult to make decisions regarding corrective actions because of ubiquitous anti-NSE memes and because of the limitations of our ordinary consciousness.Practical implicationsIf we wish to survive as a species, we will need to discover the criteria necessary to maintain our niche(s) congruent SOCs and use them instead of tyrannical memes described by Dawkins (1989) to make decisions about ourselves and our niche(s).Social implicationsSignificant courage is required to identify the memes that maintain trauma because many of them are culturally sacred cows. Unfortunately, we have known since Bremner's (1995) MRI study of posttraumatic stress disorder that trauma causes brain damage. Fortunately, our NSE genes compel us to pursue restitution of the memes that maintain our trauma-inducing cultures.Originality/valueSeveral original assertions are presented. While the Homo clade ancestors began the creation of the social niche(s) that led to Homo sapiens sapiens, it is asserted that the australopiths created the NSE memes which are the foundation behaviors that permit our social niche(s). Furthermore, NSEs were produced by enhanced intentionality skills and NSEs were created by both genetic and memetic processes. The evolution of intentionality-NSE neural networks is asserted as the source of intentional material manipulation. While anti-NSE memes are claimed as the source of persistent trauma, the practice of esoteric technologies is presented as a solution to persistent trauma.

Single-Nucleus Transcriptome Profiling of Dorsolateral Prefrontal Cortex: Mechanistic Roles for Neuronal Gene Expression, Including the 17q21.31 Locus, in PTSD Stress Response.

Multidisciplinary studies of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) implicate the dorsolateral prefrontal cortex (DLPFC) in disease risk and pathophysiology. Postmortem brain studies have relied on bulk-tissue RNA sequencing (RNA-seq), but single-cell RNA-seq is needed to dissect cell-type-specific mechanisms. The authors conducted the first single-nucleus RNA-seq postmortem brain study in PTSD to elucidate disease transcriptomic pathology with cell-type-specific resolution. Profiling of 32 DLPFC samples from 11 individuals with PTSD, 10 with MDD, and 11 control subjects was conducted (∼415K nuclei; >13K cells per sample). A replication sample included 15 DLPFC samples (∼160K nuclei; >11K cells per sample). Differential gene expression analyses identified significant single-nucleus RNA-seq differentially expressed genes (snDEGs) in excitatory (EX) and inhibitory (IN) neurons and astrocytes, but not in other cell types or bulk tissue. MDD samples had more false discovery rate-corrected significant snDEGs, and PTSD samples had a greater replication rate. In EX and IN neurons, biological pathways that were differentially enriched in PTSD compared with MDD included glucocorticoid signaling. Furthermore, glucocorticoid signaling in induced pluripotent stem cell (iPSC)-derived cortical neurons demonstrated greater relevance in PTSD and opposite direction of regulation compared with MDD, especially in EX neurons. Many snDEGs were from the 17q21.31 locus and are particularly interesting given causal roles in disease pathogenesis and DLPFC-based neuroimaging (PTSD: ARL17B, LINC02210-CRHR1, and LRRC37A2; MDD: LRRC37A and LRP4), while others were regulated by glucocorticoids in iPSC-derived neurons (PTSD: SLC16A6, TAF1C; MDD: CDH3). The study findings point to cell-type-specific mechanisms of brain stress response in PTSD and MDD, highlighting the importance of examining cell-type-specific gene expression and indicating promising novel biomarkers and therapeutic targets.

A novel treatment program for adolescents with post traumatic stress disorder with virtual reality technology

Recent advancements in the study of posttraumatic stress disorder (PTSD) have led to the discovery of innovative improvements to therapies that have already received empirical validation. The purpose of this paper is to investigate the theoretical feasibility and expected effects of a new treatment approach for the adolescent PTSD patient population that combines VR virtual reality technology with traditional treatment modalities by referring to relevant studies, literature, and survey feedback from the relevant groups. The main focus is on the use of virtual reality technology to address the reluctance of the adolescent patient population to accept treatment and to explore other possibilities for the development of a relevant target population. The limitations and drawbacks of current VR systems in the treatment of psychological disorders are also discussed, but theoretical solutions are also given. The specific role of the senses in the theoretical model and the role and usefulness for patients, physicians, and others, respectively, are also given.

Посттравматичний стресовий розлад у дітей: раннє розпізнавання та координація надання медичної допомоги в умовах воєнного часу

At the current stage, when military operations continue and there is possible development of various manifestations of psychotraumatic stress disorders in children, the acuteness and urgency of solving the problem determines the need for early recognition of the symptoms of post-traumatic stress disorder, due to its frequency and high risk and indicators of negative consequences. Purpose - to improve the quality of life of children in wartime conditions by early recognition of symptoms of the risk of developing post-traumatic stress disorder and increasing the awareness of primary care physicians about this condition and coordination of medical and psychological care. Materials and methods. Practical guidelines on the early recognition of symptoms of the risk of developing post-traumatic stress disorder in children are presented in the national Adapted clinical guideline based on evidence (2016), Unified clinical protocol (primary, secondary (specialized) and tertiary highly specialized medical care) (2019), as well as the guidelines of the National Institute for Health and Clinical Improvement of Great Britain (NICE, 2018) and information from PubMed databases, UpTo Date. For determining these recommendations the new version of the International Classification of Diseases (ICD-11) was taken into account. Results. An analysis of clinical guidelines and scientific literature related to the study of post-traumatic stress disorder in children, in particular, its early recognition by primary care physicians, was carried out. The question of the peculiarities of the clinical course of psychotraumatic disorders depending on the time of their appearance after a traumatic event and the age of children is highlighted. In the context of the time that has passed since the traumatic event and the age of the children, a screening program for the early recognition of symptoms of the risk of developing post-traumatic stress disorder, which require immediate response by primary care workers, is presented. Special attention was paid to children from war zones, geographically remote regions, displaced persons, refugees. Conclusions. Early conducting of a short screening assessment of the risk of developing post-traumatic stress disorder in children, a timely decision on the provision of medical and psychological assistance, will contribute to the improvement of their quality of life in wartime conditions. No conflict or interests was declared by the authors.

Inverse Probability Weighting Estimation in Completely Randomized Experiments

In addition to treatment assignments and observed outcomes, covariate information is often available prior to randomization in completely randomized experiments that compare an active treatment versus control. The analysis of covariance (ANCOVA) method is commonly applied to adjust for baseline covariates in order to improve precision. We focus on making propensity score-based adjustment to covariates under the completely randomized design in a finite population of experimental units with two treatment groups. We study inverse probability weighting (IPW) estimation of the finite-population average treatment effect for a general class of working propensity score models, which includes generalized linear models for binary data. We provide randomization-based asymptotic analysis of the propensity score approach and explore the finite-population asymptotic behaviors of two IPW estimators of the average treatment effect. We identify a condition under which propensity score-based covariate adjustment is asymptotically equivalent to an ANCOVA-based covariate adjustment and improves precision compared with a simple unadjusted comparison between treatment and control arms. In particular, when the working propensity score is fitted by a generalized linear model for binary data with an intercept term, the asymptotic variance of the IPW estimators is the same for any link function, including identity link, logit link, probit link, and complementary log-log link. We demonstrate these methods using an HIV clinical trial and a post-traumatic stress disorder study. Finally, we present a simulation study comparing the finite-sample performance of IPW and other methods for both continuous and binary outcomes. Supplementary materials for this article are available online.

A study of post-traumatic stress disorder in schizophrenic patients 35 years after experiencing the Tangshan earthquake.

This study aimed to investigate the relationship between dissociative experiences, post-traumatic stress disorder (PTSD), and psychiatric symptoms exhibited byschizophrenic patients 35 years after the Tangshan earthquake. Seventy-one schizophrenic patients who had experienced the Tangshan earthquake were selected and evaluated by the Post-traumatic DissociativeExperience Questionnaire (PDEQ), thPTSD Checklist-Civilian Version (PCL-C), and the Positive and Negative Symptom Scale (PANSS). The score of Group B (re-experiencing symptoms) in PCL-C was significantly positively correlated with age and significantly negatively correlated with the course of schizophrenia. Both gender and marriage were significantly positively correlated with the score of PCL-C Group D (irritability symptoms caused by hyperarousal). The PDEQ score was negatively correlated with thecourse of schizophrenia and positively correlated with the presence of sleep difficulties. Significant differences were foundbetween the PCL-C scores of the positive and negative symptoms of the three core symptom groups; the positive rate of Group B was significantly higher than that of Group D, and the positive rate of Group C was significantly higher than that of Group D. The PCL-C total score was positively correlated with the negative symptom factor score of PANSS; Group C's symptoms were significantly negativelycorrelated with the positive factor score of PNASS; andGroup D's' symptoms were significantly negatively correlated with the PANSS total score and thepositive factor score. When consiering patients with schizophrenia post the Tangshan earthquake, age, gender, and marital status were all positively correlated with PTSD. The course of schizophrenia was negatively associated with PTSD and dissociative experiences. PTSD was positively correlated with the negative symptoms of schizophrenia and negatively correlated with the positive symptoms of schizophrenia. Thus, the conditions and symptoms of PTSD may interact with those of schizophrenia.

The effectiveness of extinction training in male rats: Temporal considerations and brain mechanisms

The extinction of conditioned fear is frequently used in laboratories as a model for human exposure therapy and is crucial for studies of posttraumatic stress disorder (PTSD). However, the efficacy of specific protocols can vary greatly, and the underlying brain mechanisms are not sufficiently clarified. To address this issue, variable starting time (one or twenty-eight days after fear conditioning) and extinction protocols were used, and the efficacy and durability of fear extinction were also studied. Changes in the behavior, stress hormone levels and neuronal activation patterns of stressed rats were analyzed. Conditioned fear was rapidly and efficiently extinguished by all the protocols investigated. However, when these extinction protocols were initiated one day after fear training, conditioned fear relapsed spontaneously four weeks later. In contrast, when extinction trials were started 28 days after conditioning, no relapse occurred. Hormone measurements taken by the end of extinction trials indicated that adrenocorticotropin, but not corticosterone responses reflected behavioral extinction without any sign of relapse. The last extinction training increased the activation of the medial prefrontal cortex and decreased the activation of the central and medial amygdala when extinction began one day after fear conditioning. By contrast, the activation of the basolateral amygdala and the entire hippocampus decreased by the last training session when extinction started 28 days after fear conditioning. Our findings show that extinction training can extinguish remote fear memories more effectively than recent ones, and that the brain mechanisms underlying remote and recent fear memory extinction differ. Laboratory models should also focus on a later time point to increase their translational value.

A Prevalence Study of Post-Traumatic Stress Disorder and Its Sociobiological Determinants During Second Wave of COVID-19 Pandemic Among General Population of National Capital Territory of Delhi

A Prevalence Study of Post-Traumatic Stress Disorder and Its Sociobiological Determinants During Second Wave of COVID-19 Pandemic Among General Population of National Capital Territory of Delhi

Tensor response quantile regression with neuroimaging data.

Collecting neuroimaging data in the form of tensors (i.e. multidimensional arrays) has become more common in mental health studies, driven by an increasing interest in studying the associations between neuroimaging phenotypes and clinical disease manifestation. Motivated by a neuroimaging study of post-traumatic stress disorder (PTSD) from the Grady Trauma Project, we study a tensor response quantile regression framework, which enables novel analyses that confer a detailed view of the potentially heterogeneous association between a neuroimaging phenotype and relevant clinical predictors. We adopt a sensible low-rank structure to represent the association of interest, and propose a simple two-step estimation procedure which is easy to implement with existing software. We provide rigorous theoretical justifications for the intuitive two-step procedure. Simulation studies demonstrate good performance of the proposed method with realistic sample sizes in neuroimaging studies. We conduct the proposed tensor response quantile regression analysis of the motivating PTSD study to investigate the association between fMRI resting-state functional connectivity and PTSD symptom severity. Our results uncover non-homogeneous effects of PTSD symptoms on brain functional connectivity, which cannot be captured by existing tensor responsemethods.

Studying Higher Education within Armed Conflict Areas of Thailand: a Study of Post-Traumatic Stress Disorder

Objectives: To compare the prevalence of post-traumatic stress disorder (PTSD) symptoms and examine the associated factors between students who studied at campuses located within the areas affected by Southern Thailand’s insurgency, and those in a nearby province.Material and Methods: This study was of a cross-sectional designed, conducted by self-administered questionnaires; using the Thai version of the PTSD checklist. The subject groups were Prince of Songkla University students who studied at the Pattani Campuses, which are located within the restive areas of Southern Thailand’s insurgency, and Hat Yai Campus, which is in a nearby province. Results: Of all 897 university students, 454 university students studied in Pattani. The prevalence of PTSD symptoms was 30.8%; which is statistically significant, compared with 17.6% of those who studied in Hat Yai (p-value&lt;0.001). The associated factors, in both groups, were perception of stress from the violence due to the insurgency. Moreover, domicile and intention to resign were significantly associated with PTSD symptoms in the Pattani Campus group. However, gender, religion and satisfaction of university teaching were associated factors among university students at the Hat Yai Campus. Conclusion: Difference of PTSD symptoms among university students, who studied at the campus located in restive areas and a nearby province, was statistically significant. Both groups reported that perception of stress from the violence due to the insurgency was associated with their PTSD symptoms.

Genome-wide association study of posttraumatic stress disorder among childhood cancer survivors: results from the Childhood Cancer Survivor Study and the St. Jude Lifetime Cohort

Genetic influence shapes who develops posttraumatic stress disorder (PTSD) after traumatic events. However, the genetic variants identified for PTSD may in fact be associated with traumatic exposures (e.g., interpersonal violence), which appear heritable as well. Childhood cancer survivors (CCS) are at risk for PTSD, but genetic influences affecting cancer are unlikely to overlap with those affecting PTSD. This offers a unique opportunity to identify variants specific to PTSD risk. In a genome-wide association study (GWAS), 3984 5-year survivors of childhood cancer of European-ancestry from the Childhood Cancer Survivor Study (CCSS) were evaluated for discovery and 1467 survivors from the St. Jude Lifetime (SJLIFE) cohort for replication. Childhood cancer-related PTSD symptoms were assessed using the Posttraumatic Stress Diagnostic Scale in CCSS. GWAS was performed in CCSS using logistic regression and lead markers were replicated/meta-analyzed using SJLIFE. Cross-associations of identified loci were examined between CCS and the general population. PTSD criteria were met for 671 participants in CCSS and 161 in SJLIFE. Locus 10q26.3 was significantly associated with PTSD (rs34713356, functionally mapped to ECHS1, P = 1.36 × 10–8, OR 1.57), and was replicated in SJLIFE (P = 0.047, OR 1.37). Variants in locus 6q24.3-q25.1 reached marginal significance (rs9390543, SASH1, P = 3.56 × 10–6, OR 0.75) in CCSS and significance when meta-analyzing with SJLIFE (P = 2.02 × 10–8, OR 0.75). Both loci were exclusively associated with PTSD in CCS rather than PTSD/stress-related disorders in general population (P-for-heterogeneity < 5 × 10–6). Our CCS findings support the role of genetic variation in PTSD development and may provide implications for understanding PTSD heterogeneity.

A multi-institutional study of post-traumatic stress disorder and its risk factors in Ethiopian pediatric patients with physical trauma

IntroductionPost Traumatic Stress Disorder (PTSD) was more common in children who had suffered physical trauma than in adults. Despite its prevalence, the prevalence and factors associated with PTSD in pediatric patients with physical trauma are unknown in Ethiopia. As a result, the purpose of this study was to determine the prevalence of PTSD and associated factors among pediatric patients with physical trauma who attended Northwest Amhara referral hospitals.MethodsAn institutional-based cross-sectional study design was used in 422 pediatric patients with physical trauma aged 8–18 years from March 15 to May 15/2021. Using a systematic random sampling technique, data were collected from a sample of selected trauma patients via interviews and chart review. A standardized, pre-tested Child PTSD Symptom Scale was used to assess the severity of PTSD. Epidata 4.6 was used to enter the data, and Stata 14.0 was used to analyze it. Bivariable and multivariable binary logistic regression models were used to identify PTSD determinants.ResultThe study included 422 paediatric patients who had suffered physical trauma, with a response rate of 97.87 percent. PTSD was found in 22.03 percent of paediatric patients with physical trauma in Northwest Amhara referral hospitals. The study discovered that female gender (AOR = 3.04, 95 percent CI: 1.58–5.84), age of 8 to 10 years old (AOR = 3.70, 95 percent CI: 1.39–9.87), having a chronic medical illness (AOR = 5.99, 95 percent CI: 2.60–13.77), having severe pain (AOR = 3.17, 95 percent CI: 1.12–8.99), low social support (AOR = 8.97, 95 percent CI: 4.04–19 were associated with PTSD.Conclusion and recommendationThe prevalence of PTSD was found to be high among pediatric patients who had experienced physical trauma. Special attention should be given to female patients, aged 8 to 10 years old, who have a chronic illness, for those who complain of severe pain and engaging others to provide good social support systems, are strongly recommended to alleviate PTSD in this segment of population.

Epigenome-wide association study of posttraumatic stress disorder identifies novel loci in U.S. military veterans

Posttraumatic stress disorder (PTSD) is a chronic and disabling psychiatric disorder prevalent in military veterans. Epigenetic mechanisms have been implicated in the etiology of PTSD, with DNA methylation being the most studied to identify novel molecular biomarkers associated with this disorder. We performed one of the largest single-sample epigenome-wide association studies (EWAS) of PTSD to date. Our sample included 1135 male European–American U.S. veterans who participated in the National Health and Resilience in Veterans Study (NHRVS). DNA was collected from saliva samples and the Illumina HumanMethylation EPIC BeadChip was used for the methylation analysis. PTSD was assessed using the PTSD Checklist. An EWAS was conducted using linear regression adjusted for age, cell-type proportions, first 10 principal components, and smoking status. After Bonferroni correction, we identified six genome-wide significant (GWS) CpG sites associated with past-month PTSD and three CpGs with lifetime PTSD (prange = 10−10–10−8). These CpG sites map to genes involved in immune function, transcription regulation, axonal guidance, cell signaling, and protein binding. Among these, SENP7, which is involved in transcription regulation and has been linked to risk-taking behavior and alcohol consumption in genome-wide association studies, replicated in an independent veteran cohort and was downregulated in medial orbitofrontal cortex of PTSD postmortem brain tissue. These findings suggest potential epigenetic biomarkers of PTSD that may help inform the pathophysiology of this disorder in veterans and other trauma-affected populations.