PTSD

*COMMUNITY SUPPORT -- VETERAN'S RESOURCES

K9s For Warriors - Because Together We Stand

Scott Smith
Sep 14, 2018

Soldier, take me from this shelter’s cage.
Give me back my life. In return, I’ll cover your back.
I’ll be your canine warrior, your sixth sense.
I’ll stand guard into the night and chase the demons away,
the uninvited, cloaked in night sweats and darkness. 

I will help you open your cage of solitude
then walk tall by your side into the light of day. 
Together, our faith will rise as tall as your soldier’s pride. 
We are now family in this post-911 world. 
Because together, we stand.

-Bridget Cassidy

MEET JAMES AND DUNKIN

James Rutland is a 12-year Army veteran who served a tour of duty in Iraq in 2004, followed by two more tours in South Korea. He left the military in 2014, suffering from multiple medical conditions related to his service, including mild traumatic brain injury (TBI), sleep apnea, and hearing loss, to name a few.

Most importantly, he suffered from depression and often thought about suicide. Thinking he could do it alone, Rutland tried healing from the trauma on his own. That wasn’t working. “If you do what you’ve always done, you’ll get what you always got,” says Rutland.

What Life Without Dunkin?

  - James Rutland of K9s For Warriors 

In 2016, Rutland finally rounded the bend of recovery when he was paired with his service dog, Dunkin. “I started focusing on "we instead of "me”, says Rutland. 

He has a semi-colon tattoo on his right wrist, a known symbol of taking a pause when thinking about suicide. Unlike a “period” which ends a sentence, the semicolon creates a pause, for the reader, then continues the story. Rutland wears it proudly. "It's a great conversation starter," Rutland says. 

He goes on to explain that breathing, family, friends, and the program that gave him Dunkin are what keeps him going.

THE PROGRAM: K9S FOR WARRIORS

K9s For Warriors is a BBB accredited charity organization located in Ponte Vedra, Florida, that has been pairing rescue dogs with traumatized soldiers since 2011. The dogs are trained to be service dogs, specifically performing tasks to quiet the symptoms of war trauma disabilities in soldiers. 

“The skillsets our dogs learn help these warriors with anxiety, isolation, depression, and nightmares,” says Shari Duval, the founder of K9s For Warriors. “So, the warriors can function again in public.”

Specifically, the dogs are trained to deal with symptoms of Post-traumatic Stress Disorder (PTSD), traumatic brain injury (TBI), or military sexual trauma (MST), as a result of military service on or after 9/11.

K9s For Warriors sees it as two battles: fighting the past of the dog and fighting the past of the warrior. We’re saving two lives here. 

-Brett Simon 

K9s For Warriors veterans walking with their service dogs

Duval started the program after watching her son Brett Simon suffer from PTSD after he returned from Iraq. Simon did two tours, developing PTSD during the first one. Watching her son suffer from the debilitating condition motivated Duval to research alternative treatments to the standard talk therapy and medication, neither of which worked for her son.

“On average, soldiers take 14 meds a day to treat PTSD, TBI, or MST,” says Duval. If treatment is not working, she says veterans are prescribed more and more drugs. “I even knew one soldier who was taking 44 meds per day.”

After two years of researching alternative PTSD treatments, Duval came upon a program that paired service dogs to alleviate their PTSD symptoms in veterans. 

According to Simon, “Mom was the one that suggested I use a service dog to deal with my PTSD when nothing else worked.” Duval saw her son’s symptoms begin to improve. She then wanted to help other veterans do the same.

Thus, the K9s For Warrior program was born. With her son’s background in training dogs, including 13 years as a canine police officer, Duval convinced Simon to start the nonprofit together.

To date, the program has rescued more than 850 dogs and 440 military service members, with an astounding 99% program success rate.

Based on a recent Purdue study, the organization’s mission seems to be making a difference in the lives of warriors.

WHAT IS PTSD?
PTSD is classified as a mental disorder that develops after a person experiences severe trauma as a result of a traumatic event such as warfare, sexual assault, auto accident, or other severely traumatic events. PTSD symptoms are re-experiencing, avoidance, arousal, and negative changes in beliefs and feelings. The disability manifests itself in depression, anxiety, night terrors, and social embarrassment resulting in isolation. Many individuals have initial symptoms while others can worsen, requiring treatment.

According to the Department of Veterans Affairs (VA), it is common to have reactions such as upsetting memories of an event, increased anxiety, or trouble sleeping after experiencing a traumatic event. If these reactions do not go away or worsen, then the individual may have PTSD.

Along with TBI and MST, PTSD is recognized under the American Veterans Aid (AVA), the Department of Justice through the American Disabilities Act (ADA), and the Veteran’s Association of America (VA). The Department of Defense (DoD) is also strongly committed to providing service members and families with access to quality mental health care and resources for all mental health conditions including PTSD. 

I appreciated the willingness of K9s for Warriors to open their doors to research and science.

-Dr. Maggie O'Haire

PILOT STUDY AFFIRMS ANTICIPATED OUTCOME

K9s For Warriors recently partnered with Purdue University College of Veterinary Medicine on a pilot study testing the effectiveness of service dogs as a complementary treatment for military members and veterans who suffer from PTSD. Dr. Maggie O'Haire, assistant professor of human-animal interaction, along with Kerri E. Rodriguez, research assistant, conducted the study and published the findings earlier this year.

The study had a total of 141 participants from the K9s For Warriors’ program or individuals on the program’s waiting list. Half of the program's participants had service dogs; the other half did not.

The study found that PTSD symptoms were significantly lower in veterans with service dogs, demonstrating that service dogs are associated with lower PTSD symptoms among war veterans. “The initial findings showed lower depression, lower PTSD symptoms, lower levels of anxiety, and lower absenteeism from work due to health issues,” says Dr. O'Haire.

Each morning, she measured levels of cortisol - a stress hormone, in each participant; an increase of the hormone in the morning is indicative of a healthy level or curve. We tend to see a rise in cortisol immediately after waking up. “We call it the morning rise”, says Dr. O'Haire. 

Dr. Anantha Shekhar, Director of Indiana Clinical and Translational Sciences Institute, and professor at Indiana University School of Medicine was the lead researcher on the grant at the university. "Service dogs are a great resource for veterans to modulate their own reactions and to cope better with symptoms of PTSD,” says Dr. Shekhar.

Dr. Timothy Hsiao, a Yale graduate, as well as the Program Director of the National Center for Advancing Translational Sciences (NCATS) at the National Institute of Health (NIH) awarded the NCATS award to Dr. O’Haire as a KL2 Scholar under the CTSA Career Development Award.

“This is an innovative approach to a serious medical issue,” said Dr. Hsiao. “This study highlights the unique skills that the CTSA Program Hubs and their KL2 Scholars bring to address difficult conditions like PTSD.”

Other key findings (in a related study) included a significant reduction in suicidal thoughts, required medication (not suggested by K9s For Warriors),  night terrors, and an increase of three to four more hours of sleep per night. That is, in part, due to the fact that the service dogs are trained to wake up the warriors when experiencing night terrors. Purdue University is currently studying this behavior and although it hasn't been substantiated scientifically, it has been reported by K9s For Warriors anecdotally. 

Dr. O’Haire has been granted additional funding from NIH to perform a large-scale study on the efficacy of service dogs as a complementary treatment of PTSD symptoms in military members and veterans. The study is scheduled to be completed in 2019.

THEY RESCUED EACH OTHER

Her senses were always up, in a constant state of fight or flight, ever since that day in May of 2012. Tiffany Baker, an Army National Guard soldier, was traveling in a Mine-Resistant Ambush Protected (MRAP) vehicle while stationed in Afghanistan when it hit a 250-pound IED. The bomb was so powerful, it rolled the heavily-enforced vehicle.

Baker sustained major physical injuries, requiring four hip surgeries the next year. She also suffered a traumatic brain injury because of the attack. “I was taking 17 medications between being overseas and then coming back,” says Baker. She was frequently going to the VA, seeing a counselor, psychiatrists, and psychologists. “They were constantly giving me medications.” She was feeling more and more isolated.

In February 2015, Baker medically retired, saying goodbye to her unit, the 1157 Transportation Company. That same year, she met Buddy through K9s For Warriors.

Buddy had been badly abused and neglected by his owner. Before being rescued, he was found tied to a tree without any food or water. “K9s For Warriors is great at pairing the dog with veterans,” says Baker. She explains that Buddy always covers her back. He’s "got her 6", and he creates a safe barrier between her and other people, allowing her to function in public.

Just as Buddy is my service dog, I am Buddy's service human.

-Tiffany Baker, K9s For Warrior graduate and advocate 

Baker was so taken with Buddy and the K9s For Warriors program that she got involved in supporting the PAWS (Puppies Assisting Wounded Service Members) Act of 2017 that got the VA on board with service dogs helping veterans. The bill directs the VA to carry out a five-year pilot program, providing grant funding to qualifying nonprofits that provide service dogs to military members or veterans who suffer from PTSD after they finalize other traditional treatments. 

Baker actually spoke at a press conference in support of the act. “Going into the public was very difficult,” says Baker. “I’m always watching over my back.”

But Buddy has helped Baker to get back out into the public. Tiffany graduated this past May from Waukesha County Technical College with a degree in business management, and an emphasis in social media marketing.  As Baker puts it, she is like every other broken person whose service dog keeps them going. She says, “I need to get out of bed to take care of him.”

The two rescued each other.

Service dog gazing up at veteran

WAR TRAUMA: THE MONSTER IN THE ROOM

Seventeen years at war with a volunteer military has resulted in U.S. soldiers being deployed multiple times more than any other time in modern history. According to a recent Rand Corporation report, 2.77 million service members have been deployed on 5.4 million deployments since 9/11, with around 225,000 Army soldiers having been deployed at least three times or more.

The DoD reported that between 2000 and September 2017, about 173,000 active-duty service members were diagnosed with PTSD in the military health system, with about 139,000 of those being diagnosed following a deployment of 30 days or more.

According to the DoD, PTSD is treatable, and many service members will recover with appropriate treatment. However, many do not.

It is invisible and causes panic attacks, survivor guilt, anger, etc.

-Brett Simon 

Dr. Andrea Roberts, Research Scientist with the T.H. Chan School of Public Health at Harvard University says PTSD is common in civilian life. “Most PTSD goes untreated,” says Roberts. “Individuals suffering from PTSD have higher tendencies for cardiovascular disease, high-blood pressure, and autoimmune disease (Lupus).”

Roberts went on to explain there are effective treatments for PTSD, including talk therapy or exposure therapy (where a patient is led through the trauma to understand that the event is part of the past and not in the present). Another treatment is prescription medication on its own or in combination with talk or psychotherapy.

HOW K9S FOR WARRIORS IS SAVING LIVES

Take Me from the Shelter’s Cage

According to the American Society for the Prevention of Cruelty to Animals (ASPCA), 670,000 dogs are euthanized each year in the United States. “We take shelter or rescue dogs and turn them into warriors,” says Duval. K9s For Warriors rescues dogs from animal shelters across the United States, particularly local ones including the Alachua County Humane Society, Putnam County Shelter, and Lake City County Shelter.

It takes K9s For Warrior six months to train a dog. They train a total of 120 dogs per year. They rescue most breeds except full-bred Pitbulls, Dobermans, Chow Chows, Rottweilers, or Dalmatians due to insurance restrictions or state sanctions. The service dogs have full public access (with papers) but are not emotional support dogs or pets.

Once the dogs are fully trained, they are ready to be paired with their warrior. As Duval says, “When the dog's healthy, the warrior is healthy.”

As of May 2018, K9s has rescued 870 dogs with 434 dogs becoming service dogs, and the remaining rescues placed for adoption with loving families.

I Got Your 6

The K9s For Warriors program trains rescue or shelter dogs to perform four specific tasks: averting panic attacks, waking warriors from nightmares, creating personal space comfort zones in public situations by standing in front of the veteran (barrier) and reminding warriors to take their medications.

Dogs also learn two other commands: brace and cover. Many warriors suffer physical disabilities as well, so the brace command prepares the dog to assist the warrior with standing, sitting or kneeling. The cover command is used to cover the warrior’s back.

Many soldiers with PTSD do not like people coming up from behind them. In the field, soldiers say to one another, “I got your back” or “I got your 6.” The cover command does just that. The service dog literally becomes the warrior’s sixth sense, by sitting and facing the opposite way the warrior is facing. When someone approaches from behind, the dog wags its tail.

According to Moira Smith of the ASPCA, service animals can also boost the handler’s social and emotional life, in addition to providing safety and autonomy in public. “The dog acts as a bridge for social interaction,” says Smith. She explains that most Americans can’t relate to war experiences, but they are familiar with taking care of a dog as a pet. “It also adds another dimension to their identity.”

Dogs and Warriors Together: Let the Healing Begin

The three-week program is open to veterans or military members who became disabled while serving in the U.S. Armed Forces on or after 9/11. The program costs $27,000 per participant but at no cost to the warrior. If one cannot cover travel costs, K9s pays for travel to and from the facility. To Duval, every military member or veteran who walks through her door is family and is treated with honor and respect. “We bring the warrior home to heal, to a place to regroup, to hit the reset button,” says Duval.

To qualify, a warrior must submit an application and have a verified clinical diagnosis of PTSD, TBI, or MST. All applications go through a full vetting process that takes 2-4 weeks to complete. During that time, a trained service dog is identified that matches the applicant’s specific situation and needs. The organization stays in constant contact with applicants throughout the entire application process, including after approval or while a warrior is put on the waiting list. The waiting period is currently one year.

The dog doesn’t know or care about their diagnoses - they love the handler unconditionally. 

-Moira Smith of the ASPCA

If accepted into the program, the warrior must reside at Camp K9, the organization’s Florida facility, for three weeks. There is one program per month with 12 warriors in attendance. Warriors arrive on a Sunday and are introduced to their canine warriors within 24 hours. “After that, you go nowhere without your dog,” says Simon.

K9s For Warriors believes their program is unique. In addition to matching warriors with service dogs and providing training, certifications, seminars, legal instruction, and housing, they also offer what Duval calls “wrap-around services.” These include lifelong health care and food for the service dogs and ongoing unconditional love and support of the warrior pair.

The program includes grooming, health care, and command classes, among others. Public access classes take warriors out in public with their dogs, to Costco, to the Jacksonville Zoo, to downtown St. Augustine or a restaurant. “They go to places in a high-stress environment to force them to use their dogs,” says Simon. At the end of the program, warriors and their dogs go to a local park and practice all the commands. Before graduating, the pairs take a Public Access test regulated by the Assistance Dogs International (ADI).

ADI sets the standards for training guide, hearing, and service dogs. Sheila O’Brien, the President of the North America Chapter, says, “This is a rigorous process, holding organizations to the highest standards.” According to O’Brien, the committee was formed (with ADI) nine years ago to look at programs that are placing dogs with vets and persons with PTSD to develop best practices.

She went on to explain that the initial purpose of ADI was to meet the physical needs of veterans. “After speaking with vets, we understood they could handle the physical disabilities, but it was the PTSD that was with them 24/7, and that’s where the service dogs provided the most value.”

There are now 72 ADI-accredited programs throughout North America with a total of 17,502 service dog teams formed from accredited programs. Each team must be recertified every five years.

We Are Family

Duval is all about family and serving those she vehemently sees as our nation’s greatest asset: our country’s military members.

Each month, a new family is formed when a warrior takes his or her first step onto the grounds at Camp K9 in Florida. In addition to meeting their dog and dog trainer, warriors meet the “Housemoms,” volunteers who stay in the facility day and night and talk with the warriors about everyday things instead of their military service.

The Housemoms run errands, grocery shop, and take warriors on outings. After graduation, Housemoms continue to stay in touch with the warriors by phone and on social media.

Apart from the Housemoms, K9s For Warriors relies heavily on its volunteers, local businesses, and support from Florida's veteran community. Many of the meals donated to the program come from local restaurants, neighbors, and organizations. Whether it be offering emotional aid to our veterans or helping with kennel enrichment, K9s is readily available to accept new Volunteer Ambassadors.

Service dogs are prescriptions on four legs

-Shari Duval 

At the start, K9s For Warriors operated out of two houses with the dogs in the garages and vets sleeping on couches. "Then our humble beginnings were transformed by Summit Contracting. They believed in our program and built us a beautiful 17,000 square foot facility on nine acres. It was the most incredible gift in the world" said Simon. 

In 2017, Steve Gold and family, gifted The Gold Family Campus to K9s For Warriors. The campus is a 67-acre property featuring a 9-bedroom and 7-bath house. It will be powered by solar panels (worth $1 million), making the campus energy-independent. The facility is currently under construction and will be operational in 2019.

It will allow four more veterans to attend each monthly program, bringing the total number of warriors graduating per month to 16. The campus will also function as the primary facility for female military members and veterans.

An additional facility means more space for Duval and Simon to save lives.

STANDING TOGETHER FOR A BETTER TOMORROW

There are good things in K9s For Warriors’ future.

As previously stated, Dr. O’Haire is partnering again with K9s For Warriors on a more extensive study funded by NIH. The findings will be published in 2019.

The VA is also running a Congressionally-mandated PTSD service dog study that will be completed in 2019. A total of 180 veterans have received either a service dog or an emotional support dog as part of the study. According to a VA spokesperson, after peer reviews, the VA will submit the study and results to the National Academy of Sciences for review, as required by the authorizing legislation (Section 1077 of the 2010 National Defense Authorization Act).

On the legislative side, Simon is working to secure public access identification from Service Dog Credentials, so K9s For Warriors’ service dogs will be recognized by airlines, hotels, and restaurants, bypassing the need for the warriors to provide paperwork or visit the disability office.

The future for K9s For Warriors looks promising as Duval and Simon continue to fight to save lives, both of soldiers and their canine warriors.

Because together, they stand.

https://www.consumersadvocate.org/features/k9s-for-warriors

--------------------------------------------

For more information on PTSD treatment options, visit the U.S. Department of Veterans Affairs, PTSD: National Center for PTSD or the DoD, which encourages service members to ask for help by affirming that seeking help is actually a sign of strength.

Co-Author Bridget Cassidy, Associated Editor

Is your stress changing my brain?

Stress isn't just contagious; it alters the brain on a cellular level

March 8, 2018

Science Daily/University of Calgary

Scientists have discovered that stress transmitted from others can change the brain in the same way as a real stress does.

 

In a new study in Nature Neuroscience, Jaideep Bains, PhD, and his team at the Cumming School of Medicine's Hotchkiss Brain Institute (HBI), at the University of Calgary have discovered that stress transmitted from others can change the brain in the same way as a real stress does. The study, in mice, also shows that the effects of stress on the brain are reversed in female mice following a social interaction. This was not true for male mice.

 

"Brain changes associated with stress underpin many mental illnesses including PTSD, anxiety disorders and depression," says Bains, professor in the Department of Physiology and Pharmacology and member of the HBI. "Recent studies indicate that stress and emotions can be 'contagious'. Whether this has lasting consequences for the brain is not known."

 

The Bains research team studied the effects of stress in pairs of male or female mice. They removed one mouse from each pair and exposed it to a mild stress before returning it to its partner. They then examined the responses of a specific population of cells, specifically CRH neurons which control the brain's response to stress, in each mouse, which revealed that networks in the brains of both the stressed mouse and naïve partner were altered in the same way.

 

The study's lead author, Toni-Lee Sterley, a postdoctoral associate in Bains' lab said, "What was remarkable was that CRH neurons from the partners, who were not themselves exposed to an actual stress, showed changes that were identical to those we measured in the stressed mice."

 

Next, the team used optogenetic approaches to engineer these neurons so that they could either turn them on or off with light. When the team silenced these neurons during stress, they prevented changes in the brain that would normally take place after stress. When they silenced the neurons in the partner during its interaction with a stressed individual, the stress did not transfer to the partner. Remarkably, when they activated these neurons using light in one mouse, even in the absence of stress, the brain of the mouse receiving light and that of the partner were changed just as they would be after a real stress.

 

The team discovered that the activation of these CRH neurons causes the release of a chemical signal, an 'alarm pheromone', from the mouse that alerts the partner. The partner who detects the signal can in turn alert additional members of the group. This propagation of stress signals reveals a key mechanism for transmission of information that may be critical in the formation of social networks in various species.

 

Another advantage of social networks is their ability to buffer the effects of adverse events. The Bains team also found evidence for buffering of stress, but this was selective. They noticed that in females the residual effects of stress on CRH neurons were cut almost in half following time with unstressed partners. The same was not true for males.

 

Bains suggests that these findings may also be present in humans. "We readily communicate our stress to others, sometimes without even knowing it. There is even evidence that some symptoms of stress can persist in family and loved ones of individuals who suffer from PTSD. On the flip side, the ability to sense another's emotional state is a key part of creating and building social bonds."

 

This research from the Bains lab indicates that stress and social interactions are intricately linked. The consequences of these interactions can be long-lasting and may influence behaviours at a later time.

https://www.sciencedaily.com/releases/2018/03/180308143212.htm

What's really going on in PTSD brains? Experts suggest new theory

October 7, 2016

Science Daily/University of Michigan Health System

PTSD experts agree that the condition has its roots in very real, physical processes within the brain – and not some sort of psychological “weakness”. But no clear consensus has emerged about what exactly has gone “wrong” in the brain. A new theory that integrates decades of research focuses on a key function called context processing.

 

For decades, neuroscientists and physicians have tried to get to the bottom of the age-old mystery of post-traumatic stress disorder, to explain why only some people are vulnerable and why they experience so many symptoms and so much disability.

 

All experts in the field now agree that PTSD indeed has its roots in very real, physical processes within the brain -- and not in some sort of psychological "weakness." But no clear consensus has emerged about what exactly has gone "wrong" in the brain.

 

In a Perspective article published this week in Neuron, a pair of University of Michigan Medical School professors -- who have studied PTSD from many angles for many years -- put forth a theory of PTSD that draws from and integrates decades of prior research. They hope to stimulate interest in the theory and invite others in the field to test it.

 

The bottom line, they say, is that people with PTSD appear to suffer from disrupted context processing. That's a core brain function that allows people and animals to recognize that a particular stimulus may require different responses depending on the context in which it is encountered. It's what allows us to call upon the "right" emotional or physical response to the current encounter.

 

A simple example, they write, is recognizing that a mountain lion seen in the zoo does not require a fear or "flight" response, while the same lion unexpectedly encountered in the backyard probably does.

 

For someone with PTSD, a stimulus associated with the trauma they previously experienced -- such as a loud noise or a particular smell -- triggers a fear response even when the context is very safe. That's why they react even if the noise came from the front door being slammed, or the smell comes from dinner being accidentally burned on the stove.

 

Context processing involves a brain region called the hippocampus, and its connections to two other regions called the prefrontal cortex and the amygdala. Research has shown that activity in these brain areas is disrupted in PTSD patients. The U-M team thinks their theory can unify wide-ranging evidence by showing how a disruption in this circuit can interfere with context processing and can explain most of the symptoms and much of the biology of PTSD.

 

"We hope to put some order to all the information that's been gathered about PTSD from studies of human patients, and of animal models of the condition," says Israel Liberzon, M.D., a professor of psychiatry at U-M and a researcher at the VA Ann Arbor Healthcare System who also treats veterans with PTSD. "We hope to create a testable hypothesis, which isn't as common in mental health research as it should be. If this hypothesis proves true, maybe we can unravel some of the underlying pathophysiological processes, and offer better treatments."

 

Liberzon and his colleague, James Abelson, M.D., Ph.D., describe in their piece models of PTSD that have emerged in recent years, and lay out the evidence for each. The problem, they say, is that none of these models sufficiently explains the various symptoms seen in patients, nor all of the complex neurobiological changes seen in PTSD and in animal models of this disorder.

 

The first model, abnormal fear learning, is rooted in the amygdala -- the brain's 'fight or flight' center that focuses on response to threats or safe environments. This model emerged from work on fear conditioning, fear extinction and fear generalization.

 

The second, exaggerated threat detection, is rooted in the brain regions that figure out what signals from the environment are "salient," or important to take note of and react to. This model focuses on vigilance and disproportionate responses to perceived threats.

 

The third, involving executive function and regulation of emotions, is mainly rooted in the prefrontal cortex -- the brain's center for keeping emotions in check and planning or switching between tasks.

 

By focusing only on the evidence bolstering one of these theories, researchers may be "searching under the streetlight," says Liberzon. "But if we look at all of it in the light of context processing disruption, we can explain why different teams have seen different things. They're not mutually exclusive."

 

The main thing, says Liberzon, is that "context is not only information about your surroundings -- it's pulling out the correct emotion and memories for the context you are in."

 

A deficit in context processing would lead PTSD patients to feel "unmoored" from the world around them, unable to shape their responses to fit their current contexts. Instead, their brains would impose an "internalized context" -- one that always expects danger -- on every situation.

 

This type of deficit, arising in the brain from a combination of genetics and life experiences, may create vulnerability to PTSD in the first place, they say. After trauma, this would generate symptoms of hypervigilance, sleeplessness, intrusive thoughts and dreams, and inappropriate emotional and physical outbursts.

 

Liberzon and Abelson think that testing the context processing theory will enhance understanding of PTSD, even if all of its details are not verified. They hope the PTSD community will help them pursue the needed research, in PTSD patients and in animal models. They put forth specific ideas in the Neuron paper to encourage that, and are embarking on such research themselves.

 

The U-M/VA team is currently recruiting people with PTSD -- whether veterans or not -- for studies involving brain imaging and other tests.

 

In the meantime, they note that there is a growing set of therapeutic tools that can help patients with PTSD, such as cognitive behavioral therapy mindfulness training and pharmacological approaches. These may work by helping to anchor PTSD patients in their current environment, and may prove more effective as researchers learn how to specifically strengthen context processing capacities in the brain.

https://www.sciencedaily.com/releases/2016/10/161007123407.htm

What the New York Times gets wrong about PTSD

May 19, 2016

Science Daily/Drexel University

In analyzing the articles the New York Times has written about post-traumatic stress disorder over the last 35 years, researchers found some troubling trends in the influential paper's coverage.

 

Believe it or not, both the public and policy-makers often get their ideas from the media. When those ideas are formed about something as serious and impactful as posttraumatic stress disorder, it's important for the media to tell the story in the right way.

 

With that in mind, Drexel researchers examined how the country's most influential paper, the New York Times, portrayed posttraumatic stress disorder (PTSD) from the year it was first added to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (1980) to present day (2015).

 

"Mass media shape public awareness about mental health issues and affect mental illness problem recognition, management, and treatment-seeking by providing information about risk factors, symptoms, coping strategies, and treatment options," said Jonathan Purtle, DrPH, assistant professor in Drexel's Dornsife School of Public Health and the study's principle investigator. "Mass media also influence community attitudes about mental illness and educate policymakers about whether and how to address them."

 

Between 1980 and 2015, 871 news articles mentioned PTSD. In their American Journal of Orthopsychiatry paper, Purtle and his co-authors, Katherine Lynn and Marshal Malik, pointed out three specific issues in the Times' coverage that could have negative consequences.

 

"New York Times portrayals of populations affected by PTSD do not reflect the epidemiology of the disorder."

 

The Drexel team found that 50.6 percent of the Times' articles focused on military cases of PTSD, including 63.5 percent of the articles published in the last 10 years.

 

In actuality, Purtle's past research showed that most PTSD cases are related to noncombat traumas in civilians. The number of civilians affected by PTSD is 13 times larger than the number of military personnel affected by the disorder.

 

Occurrences are also much more likely in those who survive non-combat traumas, which include sexual assault (30-80 percent of survivors develop PTSD), nonsexual assault (23-39 percent develop it), disasters (30-40 percent) and car crashes (25-33 percent), among other causes. Veterans of the wars in Afghanistan and Iraq have just a 20 percent occurrence of PTSD.

 

However, coverage like that in the Times leads the general public to believe that a PTSD diagnosis requires some military component. And 91.4 percent of all legislative proposals involving PTSD between 1989 and 2009 focused only on military populations, with 81.7 percent focusing on combat as a cause (the next highest cause was sexual assault, at 5.5 percent).

 

"PTSD was negatively framed in many articles."

 

Self-stigma attached to PTSD has been identified as a strong barrier to seeking treatment.

 

As such, with fewer and fewer articles over the years mentioning treatment options (decreasing from 19.4 percent of all PTSD-focused articles in 1980-1995 to just 5.7 percent in 2005-2015), it is particularly harmful when articles focused on negative portrayals of those with PTSD.

 

Purtle and his researchers found that 16.6 percent of the articles were about court cases in which the defendant potentially had PTSD, while 11.5 percent of other articles talked about substance abuse.

 

"These negative themes could create misconceptions that people who have PTSD are dangerous and discourage employers from hiring prospective employees with the disorder," Purtle said.

 

"Most themes in the New York Times PTSD articles pertained to proximal causes and consequences of the disorder."

 

Most articles in the study's 35-year focus centered on the traumatic exposure that led to PTSD, as well as the symptoms that result from the disorder. They rarely told stories of survivors and prevention.

 

Although nearly three quarters of articles mentioned a traumatic cause of PTSD, concepts such as risk/protective factors or prevention were barely mentioned. Risk/protective factors were only mentioned in 2.6 percent of articles and prevention was only mentioned in 2.5 percent.

 

Almost a third of the articles reviewed discussed some kind of symptom -- nightmares (13.1 percent of the time), depression (12.3 percent) and flashbacks (11.7 percent) being most common.

 

"This narrow focus could inhibit awareness about PTSD resilience and recovery and constrain discourse about the social determinants of traumatic stress, which is needed to garner political support for policy interventions," the Drexel team wrote.

 

What Can Be Done?

 

Purtle, Lynn and Malik believe that broadening the discourse on PTSD can lead to better outcomes. Some ways that that can be achieved are focusing on survivor narratives that discussing resiliency and recovery, or talking about research that doesn't wholly focus on the military causes of the disorder.

https://www.sciencedaily.com/releases/2016/05/160519121152.htm

Posttraumatic stress disorder reveals an imbalance between signalling systems in the brain

December 1, 2015

Science Daily/Uppsala University

Experiencing a traumatic event can cause life-long anxiety problems, called posttraumatic stress disorder. Researchers now show that people with posttraumatic stress disorder have an imbalance between two neurochemical systems in the brain, serotonin and substance P. The greater the imbalance, the more serious the symptoms patients have.

 

Many people experience traumatic events in life, e.g. robbery, warfare, a serious accident or sexual assault. Approximately 10 percent of people subjected to trauma suffer long-lasting symptoms in the form of disturbing flashbacks, insomnia, hyperarousal and anxiety. If these problems lead to impairment, the person is said to suffer from posttraumatic stress disorder, PTSD.

 

It has previously been shown that people with PTSD have altered brain anatomy and function. A new study by researchers from the Department of Psychology at Uppsala University and Clinical Neuroscience at Karolinska Institutet shows that people with PTSD have an imbalance between two neurochemical signalling systems of the brain, serotonin and substance P. Professors Mats Fredrikson and Tomas Furmark led the study using a so-called PET scanner to measure the relationship between these systems.

 

The study, which has been published in the scientific journal Molecular Psychiatry, shows that it is the imbalance between the two signalling systems which determines the severity of the symptoms suffered by the individual rather than the degree of change in a single system. Others have previously speculated that the biological basis of psychiatric disorders such as PTSD includes a shift in the balance between different signalling systems in the brain but none has yet proved it. The results of the study are a great leap forward in our understanding of PTSD. It will contribute new knowledge which can be used to design improved treatments for traumatised individuals.

 

"At present, PTSD is often treated with selective serotonin re-uptake inhibitors (SSRIs) which have a direct effect on the serotonin system. SSRI drugs provide relief for many but do not help everybody. Restoring the balance between the serotonin and substance P systems could become a new treatment strategy for individuals suffering from traumatic incidents," says lead author Andreas Frick, researcher at the Department of Psychology, Uppsala University.

http://www.sciencedaily.com/releases/2015/12/151201093515.htm

PTSD, traumatic experiences may raise heart attack, stroke risk in women

June 29, 2015

Science Daily/American Heart Association

Women with severe PTSD or traumatic events may have a 60 percent higher lifetime risk of cardiovascular disease. The study is the first to examine trauma exposure, PTSD, and onset of cardiovascular disease exclusively in women. Researchers suggest physicians ask women about traumatic events and PTSD symptoms and then monitor them for cardiovascular issues.

 

In the first major study of PTSD and onset of cardiovascular disease (both heart attacks and strokes) exclusively in women, researchers examined about 50,000 participants in the Nurses' Health Study II over 20 years.

 

PTSD occurs in some people after traumatic events (such as a natural disaster, unwanted sexual contact or physical assault). Patients may experience flashbacks of the trauma, insomnia, fatigue, trouble remembering or concentrating, and emotional numbing. Other symptoms include nightmares, irritability or being startled easily. PTSD is twice as common in women as in men.

 

In the study:

 

Women with four or more PTSD symptoms had 60 percent higher rates of cardiovascular disease compared to women who weren't exposed to traumatic events.

 

Women with no PTSD symptoms but who reported traumatic events had 45 percent higher rates of cardiovascular disease. Almost half of the association between elevated PTSD symptoms and cardiovascular disease was accounted for by unhealthy behaviors like smoking, obesity, lack of exercise and medical factors such as high blood pressure. "PTSD is generally considered a psychological problem, but the take-home message from our findings is that it also has a profound impact on physical health, especially cardiovascular risk," said Jennifer Sumner, Ph.D., lead author and an Epidemiology Merit Fellow at Columbia University's Mailman School of Public Health in New York City and a Visiting Scientist at the Harvard T.H. Chan School of Public Health in Boston. "This is not exclusively a mental problem -- it's a potentially deadly problem of the body as well."

 

Most studies of cardiovascular disease risk in PTSD patients have been conducted in men who have served in the military or among disaster survivors.

 

The current study, conducted by a team of researchers at Columbia and Harvard-Chan, is unique in that it examined women from the community who were exposed to a variety of traumatic events.

 

Our results provide further evidence that PTSD increases the risk of chronic disease," said. Karestan C. Koenen, the study's senior author and Professor of Epidemiology at Columbia University Mailman School of Public Health and Harvard T. H. Chan School of Public Health. "The medical system needs to stop treating the mind and the body as if they are separate. Patients need access to integrated mental and physical healthcare."

 

Researchers used a questionnaire to evaluate different types of traumatic experiences and PTSD symptoms. They also considered cardiovascular disease risk factors such as obesity, lack of exercise, diabetes, cigarette smoking, high blood pressure, and other contributors to cardiovascular health such as excessive alcohol use, and hormone replacement use.

 

PTSD emerged as a risk factor for cardiovascular disease in a sample of women under the age of 65. Physicians should be aware of this link and screen for cardiovascular disease risk, as well as monitor related health conditions and behaviors, including encouraging changes in lifestyle factors that may increase this risk, Sumner said.

 

More than half of the people in the United States who suffer from PTSD don't get treatment, especially minorities. Women need to get mental healthcare to treat symptoms as well as be monitored for signs of cardiovascular problems, she said.

http://www.sciencedaily.com/releases/2015/06/150629175956.htm

 

Poor sleep quality linked to reduced resilience among veterans

June 8, 2015

Science Daily/American Academy of Sleep Medicine

Poor sleep quality is associated with reduced resilience among veterans and returning military personnel, a new study suggests. Findings suggest that appraisal of sleep quality may contribute to resilience scores more than self-reported sleep efficiency.

 

Results show that 63 percent of participants endorsed poor sleep quality, which was negatively associated with resilience. Longer sleep onset, lower sleep efficiency, shorter sleep duration, worse sleep quality, and greater daytime disturbance were each associated with lower resilience. Findings suggest that appraisal of sleep quality may contribute to resilience scores more than self-reported sleep efficiency.

 

'To our knowledge, this study is the first to examine the relationship between resilience, defined here as positive stress-coping ability, and self-reported sleep quality among veterans and active duty service-members of the Iraq and Afghanistan conflicts,' said lead author Jaime M. Hughes, MPH, MSW, research affiliate at Durham VA Medical Center and doctoral student at the University of North Carolina-Chapel Hill.

 

The research abstract was published recently in an online supplement of the journal Sleep and will be presented June 8 in Seattle, Wash., at SLEEP 2015, the 29th annual meeting of the Associated Professional Sleep Societies LLC.

 

The study group comprised 2,597 Iraq and Afghanistan military veterans. Eighty percent were male with a mean age of 37 years. An in-person assessment captured resilience (Connor-Davidson Resilience Scale), Post-Traumatic Stress Disorder (Davidson Trauma Scale), sleep quality (Pittsburgh Sleep Quality Index), and combat exposure (Combat Exposure Scale).

'These results support the need for additional research to better understand resilience as it relates sleep behaviors and sleep quality. Such findings may contribute to a better understanding of how chronic sleep disturbance impacts an individual's adaptive and functional capacities upon reintegration, and can help to inform the development of novel sleep interventions,' said Hughes.

http://www.sciencedaily.com/releases/2015/06/150608213115.htm

PTSD doubles diabetes risk in women

January 7, 2015

Science Daily/Columbia University's Mailman School of Public Health

Women with post-traumatic stress disorder are nearly twice as likely to develop type 2 diabetes compared with women who don't have PTSD, according to new research. The longitudinal cohort study provides the strongest evidence to date of a causal relationship between PTSD and type 2 diabetes.

 

The longitudinal cohort study provides the strongest evidence to date of a causal relationship between PTSD and type 2 diabetes. Results are published online in the journal JAMA Psychiatry.

 

The researchers analyzed survey data collected between 1989 and 2011 from 49,739 women enrolled in the Nurses Health Study II and found a dose-response relationship: the greater the number and severity of PTSD symptoms, the greater a woman's risk of type 2 diabetes. Four percent of the nurses reported the highest number of PTSD symptoms. By age 60, nearly 12 percent of women with the highest number of PTSD symptoms had developed type 2 diabetes, whereas fewer than 7 percent of women with no trauma exposure had diabetes.

 

Antidepressant use and elevated body mass index accounted for nearly half of the increased risk of type 2 diabetes, or 34 and 14 percent, respectively. On the other hand, smoking, diet quality, alcohol intake, and physical activity did not explain the association.

 

One in nine women will have PTSD at sometime over the course of her lifetime--twice the rate of men. Women are also more likely to experience extreme traumatic events like rape that carry a high risk for the disorder.

 

"Not only is PTSD devastating to mental health, but it affects physical health too, raising risk for cardiovascular disease, diabetes, and obesity," said senior author Karestan C. Koenen, PhD, professor in the Department of Epidemiology at the Mailman School.

 

"Women with PTSD and the health professionals who care for them should be aware that these women are at greater risk for diabetes," said first author Andrea L. Roberts, PhD, research associate in the Department of Social and Behavioral Sciences at Harvard School of Public Health. "As fewer than half of Americans with PTSD receive treatment, our study adds urgency to the effort to improve access to mental health care to address factors that contribute to diabetes and other chronic diseases."

 

To assess type 2 diabetes, the researchers used a validated survey method that first asked women whether they had been diagnosed by a doctor, then confirmed diagnosis with information about test results, symptoms, and medications. PTSD was assessed using the Short Screening Scale. The nurses reported a range of trauma, including sexual assault, domestic violence, car accidents, and unexpected death of a loved one.

 

The study builds on past findings by the researchers, including a 2013 study that reported a link between PTSD and obesity. Other research has shown a link between mental health issues like anxiety, social phobia, and agoraphobia and type 2 diabetes.

 

Further research is needed to identify the biochemical and possible additional behavioral changes, such as sleep disturbance, that mediate the relationship between PTSD and type 2 diabetes.

http://www.sciencedaily.com/releases/2015/01/150107122906.htm

 

Federal legislation ignores PTSD toll on civilians

November 11, 2014

Science Daily/Drexel University

Federal laws explicitly addressing post-traumatic stress disorder (PTSD) have overwhelmingly focused on the needs of military personnel and veterans, according to a new analysis. The study is the first to examine how public policy has been used to address psychological trauma and PTSD in the US, providing a glimpse of how lawmakers think about these issues.

 

"Although trauma and PTSD are serious issues affecting military populations, the raw number of people affected by PTSD includes substantially more civilians simply because the civilian population is so much larger," said Purtle.

 

"It's almost as if lawmakers didn't want to suggest that PTSD was also a disorder among civilians," Purtle said. "This gives a sense of how elected officials at the federal level might think about the dimensions of this problem, and shows that it doesn't match up with what's known about who gets PTSD."

 

The emphasis on military personnel in legislation addressing PTSD may reflect the history of the disorder, which first became known through cases in military members and veterans following combat experiences. The federal government's role in providing medical care for veterans could also contribute to the legislation's heightened emphasis on military PTSD in contrast to civilian PTSD.

http://www.sciencedaily.com/releases/2014/11/141111124053.htm

 

Poor sleep quality linked to lower physical activity in people with PTSD

July 16, 2014

Science Daily/American Academy of Sleep Medicine

A new study shows that worse sleep quality predicts lower physical activity in people with post-traumatic stress disorder. Results show that PTSD was independently associated with worse sleep quality at baseline, and participants with current PTSD at baseline had lower physical activity one year later.

 

"We found that sleep quality was more strongly associated with physical activity one year later than was having a diagnosis of PTSD," said lead author Lisa Talbot, postdoctoral fellow at the San Francisco VA Medical Center and the University of California, San Francisco. "The longitudinal aspect of this study suggests that sleep may influence physical activity."

 

Further analysis found that sleep quality completely mediated the relationship between baseline PTSD status and physical activity at the one-year follow-up, providing preliminary evidence that the association of reduced sleep quality with reduced physical activity could comprise a behavioral link to negative health outcomes such as obesity.

 

"This study adds to the literature that shows that better sleep leads to healthier levels of exercise, and previous research has shown that better sleep leads to healthier food choices," said American Academy of Sleep Medicine President Dr. Timothy Morgenthaler. "It is clear that healthy sleep is an essential ingredient in the recipe for a healthy life."

 

"The findings also tentatively raise the possibility that sleep problems could affect individuals' willingness or ability to implement physical activity behavioral interventions," she said. "Sleep improvements might encourage exercise participation."

 

According to the National Center for PTSD of the U.S. Department of Veterans Affairs, PTSD symptoms such as nightmares or flashbacks usually start soon after a traumatic event, but they may not appear until months or years later. Symptoms that last longer than four weeks, cause great distress or interfere with daily life may be a sign of PTSD.

http://www.sciencedaily.com/releases/2014/07/140716123841.htm

Dreaming Takes the Sting out of Painful Memories

Nov. 27, 2011 —

Science Daily/University of California - Berkeley

They say time heals all wounds, and new research from the University of California, Berkeley, indicates that time spent in dream sleep can help us overcome painful ordeals.

 

UC Berkeley researchers have found that during the dream phase of sleep, also known as REM sleep, our stress chemistry shuts down and the brain processes emotional experiences and takes the edge off difficult memories.

 

The findings offer a compelling explanation for why people with post-traumatic stress disorder (PTSD), such as war veterans, have a hard time recovering from distressing experiences and suffer reoccurring nightmares. They also offer clues into why we dream.

 

"The dream stage of sleep, based on its unique neurochemical composition, provides us with a form of overnight therapy, a soothing balm that removes the sharp edges from the prior day's emotional experiences," said Matthew Walker, associate professor of psychology and neuroscience at UC Berkeley and senior author of the study to be published on Nov. 23, in the journal Current Biology.

 

For people with PTSD, Walker said, this overnight therapy may not be working effectively, so when a "flashback is triggered by, say, a car backfiring, they relive the whole visceral experience once again because the emotion has not been properly stripped away from the memory during sleep."

 

The results offer some of the first insights into the emotional function of Rapid Eye Movement (REM) sleep, which typically takes up 20 percent of a healthy human's sleeping hours. Previous brain studies indicate that sleep patterns are disrupted in people with mood disorders such as PTSD and depression.

 

While humans spend one-third of their lives sleeping, there is no scientific consensus on the function of sleep. However, Walker and his research team have unlocked many of these mysteries linking sleep to learning, memory and mood regulation. The latest study shows the importance of the REM dream state.

 

"During REM sleep, memories are being reactivated, put in perspective and connected and integrated, but in a state where stress neurochemicals are beneficially suppressed," said Els van der Helm, a doctoral student in psychology at UC Berkeley and lead author of the study.

 

"We know that during REM sleep there is a sharp decrease in levels of norepinephrine, a brain chemical associated with stress," Walker said. "By reprocessing previous emotional experiences in this neuro-chemically safe environment of low norepinephrine during REM sleep, we wake up the next day, and those experiences have been softened in their emotional strength. We feel better about them, we feel we can cope."

 

Walker said he was tipped off to the possible beneficial effects of REM sleep on PTSD patients when a physician at a U.S. Department of Veterans Affairs hospital in the Seattle area told him of a blood pressure drug that was inadvertently preventing reoccurring nightmares in PTSD patients.

 

It turns out that the generic blood pressure drug had a side effect of suppressing norepinephrine in the brain, thereby creating a more stress-free brain during REM, reducing nightmares and promoting a better quality of sleep. This suggested a link between PTSD and REM sleep, Walker said.

 

"This study can help explain the mysteries of why these medications help some PTSD patients and their symptoms as well as their sleep," Walker said. "It may also unlock new treatment avenues regarding sleep and mental illness."

http://www.sciencedaily.com/releases/2011/11/111123133346.htm

Member Login
Welcome, (First Name)!

Forgot? Show
Log In
Enter Member Area
My Profile Not a member? Sign up. Log Out