Experiential avoidance increases PTSD risk following child maltreatment
- March 5, 2014
Science Daily/Penn State
Child abuse is a reliable predictor of post-traumatic stress disorder, but not all maltreated children suffer from it, according researchers, who examined why some maltreated children develop PTSD and some do not.
The research team found that adolescent girls who experienced maltreatment in the past year and were willing to talk about their painful experiences and their thoughts and emotions, were less likely to have PTSD symptoms one year later. Those who tried to avoid painful thoughts and emotions were significantly more likely to exhibit PTSD symptoms down the road.
Approximately 40 percent of maltreated children develop PTSD at some point in their lives. Shenk sought to identify the factors that kept the remaining 60 percent from experiencing the disorder.
"Children and adolescents react very differently to abuse, and we don't yet know who is going to develop PTSD and who won't," said Shenk. "What factors explain who will develop PTSD and who will not? This study attempted to identify those causal pathways to PTSD."
"If we can find what the cause or risk pathway is, then we know what to target clinically," he said.
http://www.sciencedaily.com/releases/2014/03/140305125239.htm
Poor sleep quality linked to reduced brain gray matter in Gulf War vets
February 28, 2014
Science Daily/American Academy of Sleep Medicine
A new study of Gulf War veterans found an association between poor sleep quality and reduced gray matter volume in the brain's frontal lobe, which helps control important processes such as working memory and executive function. "This study emphasizes the importance of seeking medical help if you are troubled by the poor quality of your sleep," said American Academy of Sleep Medicine President. "A board certified sleep medicine physician can identify the cause of your sleep problem and develop an effective treatment plan for you."
Total cortical, lobar gray matter, and hippocampal volumes were quantified from magnetic resonance imaging (MRI), and subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Multiple linear regressions were used to determine the association of sleep quality with total and regional brain volumes.
According to the authors, the cross-sectional design of the study did not allow them to determine a causal relationship between sleep and frontal lobe volume. They noted that additional research is needed to determine if effective treatment of disturbed sleep leads to improved structural and functional integrity of the frontal lobes.
Sleep is one of the three key components of health that make up the Performance Triad, Army Medicine's operational approach to help soldiers optimize their own health in order to improve their performance and resiliency.
http://www.sciencedaily.com/releases/2014/02/140228160618.htm
Mental health of most UK troops serving in Afghanistan, Iraq is 'resilient'
February 26, 2014
Science Daily/BMJ-British Medical Journal
Despite prolonged combat missions to Iraq and Afghanistan, there has been no overall increase in mental health problems among United Kingdom soldiers, finds a review of the available evidence.
But certain groups of soldiers do seem to be more vulnerable to mental ill health on their return home, while alcohol problems continue to give cause for concern among regulars. The researchers focused on Iraq and Afghanistan because of the lengthy and challenging nature of the conflict experienced by British soldiers in these two countries, including protracted counter insurgency and repeated exposure to improvised explosive devices (IEDs), snipers, and suicide bombers.
Their analysis, which draws on 34 studies, shows that, overall, most UK regulars returning from deployment have remained psychologically resilient, despite the adversities they faced.
Rates of post-traumatic stress disorder, or PTSD, among most UK regulars returning from deployment range between 1.3% and 4.8%, the evidence suggests; the prevalence of PTSD among the UK general population is 3%, say the authors.
Depression and anxiety are the most frequently reported common mental health disorders among soldiers who have served in Iraq and Afghanistan. But overall rates are no higher than among soldiers who have not been deployed to these regions -- or indeed the general population, the research indicates.
Harmful drinking, however, continues to give cause for concern, affecting up to one in five regular soldiers, while aggressive and violent behaviour is also more likely among those returning from deployment, particularly soldiers in combat roles who are experiencing mental health issues.
But despite the unique stressors soldiers face, rates of suicide and self-harm are lower than they are among the general population, except for army recruits under the age of 20.
And the evidence suggests that levels of social support during childhood and after leaving the Army have a greater impact on suicide rates than deployment.
Overall, UK troops fare better than their US peers in terms of their mental health, possibly because UK Army recruits tend to be older, have shorter tours of duty, and have better access to healthcare, say the authors. But UK troops are more likely to report harmful levels of drinking than their US peers.
There is also some evidence to suggest that good training, leadership and unit cohesion may help to stave off mental health problems, in addition to which the Army has invested heavily in initiatives to mitigate the effects of trauma and ease soldiers' return home.
These include 'third location decompression'(TLD) -- 36 hours of social, supportive, and educational intervention after prolonged operational deployment before returning home -- and the Trauma Risk Management Programme (TRiM) -- peer support designed to pick up vulnerability to mental health problems in the wake of a traumatic incident.
"The evidence presented [here] shows that, in the main, UK military personnel have remained resilient in spite of having suffered significant numbers of fatalities and casualties in Iraq and Afghanistan," write the authors.
They acknowledge that there will be "a small but important group of veterans" who will need specialist mental healthcare services in the years ahead, and that it is too early to tell what the longer term psychological impacts of service in Iraq and Afghanistan might be.
But they conclude: "There appears to be some evidence that the considerable efforts the UK Armed Forces have made to ensure that deployed personnel are well trained, well led, cohesive, have access to high quality mental health services and a number of evidence based mitigation measures, such as TLD and TRiM, are important."
http://www.sciencedaily.com/releases/2014/02/140226211235.htm
Could PTSD involve immune cell response to stress?
- February 20, 2014
Science Daily/Ohio State University
Chronic stress that produces inflammation and anxiety in mice appears to prime their immune systems for a prolonged fight, causing the animals to have an excessive reaction to a single acute stressor weeks later, new research suggests.
After the mice recovered from the effects of chronic stress, a single stressful event 24 days later quickly returned them to a chronically stressed state in biological and behavioral terms. Mice that had not experienced the chronic stress were unaffected by the single acute stressor.
hese scientists previously determined that in mice with chronic stress, cells from the immune system were recruited to the brain and promoted symptoms of anxiety. The findings identified a subset of immune cells, called monocytes, that could be targeted by drugs for treatment of mood disorders – including, potentially, the recurrent anxiety initiated by stress that is a characteristic of PTSD.
The research reveals new ways of thinking about the cellular mechanisms behind the effects of stress, identifying two-way communication from the central nervous system to the periphery – the rest of the body – and back to the central nervous system that ultimately influences behavior.
“We haven’t proffered that there is a cellular component to PTSD, but there very well might be. And it’s very possible that it sits in the periphery as we’ve been describing in the mouse,” said John Sheridan, senior author of the study, professor of oral biology and associate director of Ohio State’s Institute for Behavioral Medicine Research.
“Our colleagues who study behavior talk about sensitization,” Sheridan said. “Clearly, the repeatedly stressed mice were sensitized. What we’re adding is that sensitization is associated with a specific cell type that resides in the spleen after the initial sensitization.
http://www.sciencedaily.com/releases/2014/02/140220193333.htm
40 percent of minors in Lorca suffer post-traumatic stress a year after earthquake
- January 22, 2014
Science Daily/Plataforma SINC
Spanish researchers have analyzed the impact of the Lorca catastrophe by the percentage of minors suffering post-traumatic stress. Results reveal that 55% of young people displayed this disorder a month on from the earthquake and 40% were still suffering a year later.
On 11 May 2011, Lorca suffered an earthquake measuring 5.1, preceded by another of 4.5, which killed nine people and caused significant material damage.
"The analysis indicates that 55% of the minors suffered from post-traumatic stress one month after the earthquake, while after one year this had decreased to 40%," as Concepción López Soler, researcher from the University of Murcia and co-author of the study with Juan José López García, explained.
"It is important to highlight that the younger age groups and girls are more sensitive to developing these symptoms, which coincides with the results of other studies," the Murcian researcher points out. "Young girls in particular are a special risk group." Among the younger students, 54% of girls showed symptoms of post-traumatic stress compared to 39% of boys.
Stress after trauma
"Natural disasters create a sense of loss of personal safety and endangered survival among the population," adds López Soler. Earthquakes are one of the disasters which cause the greatest psychological disturbances in the population and PTSD is the reaction most associated with adverse conditions.
"With previous earthquakes, the affected population has been quite variable," she states. Three years after the Turkey earthquake in 1999, the prevalence of PTSD was 59%; 18 months after the earthquake in Kashmir (between India and Pakistan), it was 64.8% and ten months after the disaster in L'Aquila (Italy) in 2009, it was greater than 60%.
http://www.sciencedaily.com/releases/2014/01/140122091734.htm
Urban night shift police more likely to suffer long-term job injuries
January 16, 2014
Science Daily/University at Buffalo
Police officers working the night shift are significantly more likely to suffer long-term on-the-job injuries than officers on day and afternoon shifts, according to new research.
The study found that, independent of age and gender, urban officers working nights were three times more likely than those on the day shift, and 2.2 times more likely than those on the afternoon shift, to suffer injuries resulting in leaves of more than 90 days.
"Leaves of this length suggest more serious types of injury and indicate that night shift work poses a more significant threat to the life and health of officers than previously assumed," says epidemiologist John Violanti, PhD, principle author of the study "Shift work and long-term injury among police officers," published in the current edition of the Scandinavian Journal of Work and Environmental Health.
The study assessed the association of daily shift schedules with the occurrence of injury leave and lengths of injury leave from 1994 to 2009 among a cohort of 419 officers from the City of Buffalo Police Department.
Violanti, a research scientist in the UB Department of Social and Preventive Medicine, UB School of Public Health and Health Professions, says, "The study results also point to the problems long-term injuries provoke for police managers as long injury absences put a strain on police personnel who must cover for the injured officers.
"This could lead to health problems for them, as well," says Violanti, an expert on the relationship of police officer stress to serious health risks.
A previous study by this research team found that police on night shifts suffer more on the job injuries overall than their colleagues on day and afternoon shifts, and Violanti says there are several possible explanations for the high injury rates.
"Sleep disturbance and fatigue-related impairment provoked by circadian disruption have been reported in previous studies of night shift workers," Violanti says, "and have been found to affect the kind of decision making that is required in fast-paced, ambiguous, high-risk police situations.
"Evening and night police shifts are inherently more active than day shifts, too. Not only do more crimes occur during these hours, but the calls for service are generally more hazardous and more frequent, which could result in more serious injuries," he says. Subjects were comprised of 312 men and 107 women with an average age of 43 (range 27-70 years) who had completed the Buffalo Cardio-Metabolic Occupational Police Stress Study, a cross-sectional study designed to examine associations between physiological biomarkers of stress, subclinical metabolic and vascular disease markers, lifestyle and psychosocial symptomology among police officers.
In this study, 16 years of day-to-day work records enabled researchers to take into account differences in age and gender across shifts and draw conclusions more accurately than previous research that relied heavily on self-reported data. The shifts considered were: day (8 a.m. to 4 p.m.), afternoon (4 p.m. to 11 p.m.) and night (11 p.m. to 8 a.m.). The percentages of subjects who worked predominantly on the day, afternoon, and night shifts were 41 percent, 32 percent and 27 percent, respectively. Violanti and his team followed the participants for the incidence of injuries that occurred while on duty.
Violanti says that night shift workers were younger and more likely to be male, had fewer years of work experience and were composed of a larger number of patrol officers (84 percent) than were the day shift workers. Overall 9.6% of the officers experienced a long term injury during the 16 year period. After adjustment for age and gender, long-term injury incidence rates were 3.1 times higher in night shift workers than in day shift workers and 2.2 times higher than in afternoon shift workers.
In order to prevent long-term injuries in this critical population, Violanti suggests that future research take into account some of the factors examined in this study.
"Research that integrates frequency and duration of injuries would be worthwhile, as would objective measurement, over time, of sleep duration and workload. Both would enhance our understanding of the role these factors might play in influencing the risk of police injury," he says. Violanti and his co-authors conducted a landmark 2012 study that found that police stress creates significant health risks, including more chronic disease and suicide, than in the general population.
http://www.sciencedaily.com/releases/2014/01/140116162017.htm
Study finds troubling relationship between drinking, PTSD symptoms in college students
- January 16, 2014
Science Daily/University at Buffalo
The estimated 9 percent of college students who have symptoms of PTSD are likely to drink more alcohol than peers without the psychological condition. In turn, heavy alcohol consumption exacerbates their PTSD symptoms.
These are the conclusions of the first empirical study to examine the bidirectional influences of the two phenomena, influences that had been theorized but never tested. The study, "Reciprocal Associations Between PTSD Symptoms and Alcohol Involvement in College: A Three-Year Trait-State-Error Analysis," was funded by the National Institute on Drug Abuse and is published in the most recent edition of the Journal of Abnormal Psychology (Vol. 22/4).
"College is a time of important developmental changes and a period of risk for heavy drinking, trauma exposure and post-traumatic stress symptoms," says Jennifer P. Read, PhD, associate professor of psychology at the University at Buffalo and principle investigator on the study.
"Heavy drinking is common on college campuses and related to risk for sexual assault, interpersonal violence and serious injury, any of which may trigger PTSD," says Read, who noted that although there has been an assumption that the two are mechanistically associated in the college population, until now, the nature of their relationship was unclear.
In a 2011 study of 3,000 college students, published in the journal Psychological Trauma, she found that about 9 percent met the criteria for PTSD, with the disorder found to be most common among those exposed to sexual and physical assault, most of whom were women.
A 2012 study by Read and colleagues found that the transition into college is marked by an escalation in heavy drinking, drug use and use-related negative consequences, and suggested interventions that may help to ameliorate problem substance use and ultimately facilitate a stronger transition into college and beyond.
http://www.sciencedaily.com/releases/2014/01/140116162109.htm
Veterans' brain injury examined
- January 9, 2014
Science Daily/Albert Einstein College of Medicine of Yeshiva University
Roadside bombs and other blasts have made head injury the “signature wound” of the Iraq and Afghanistan conflicts. Now, researchers are investigating the effect of repeated combat-related blast exposures on the brains of veterans with the goal of improving diagnostics and treatment.
Now, researchers at Albert Einstein College of Medicine of Yeshiva University, in cooperation with Resurrecting Lives Foundation, are investigating the effect of repeated combat-related blast exposures on the brains of veterans with the goal of improving diagnostics and treatment.
Mild traumatic brain injury can cause problems with cognition, concentration, memory and emotional control as well as post-traumatic stress disorder (PTSD). Einstein scientists are using advanced MRI technology and psychological tests to investigate the structural and biological impact of repeated head injury on the brain and to assess how these injuries affect cognitive function.
"Right now, doctors diagnose concussion purely on the basis of someone's symptoms," said Michael Lipton, M.D., Ph.D., associate director of Einstein's Gruss Magnetic Resonance Research Center. "We hope that our research will lead to a more scientifically valid diagnostic technique -- one that uses imaging to not only detect the underlying brain injury but reveal its severity. Such a technique could also objectively evaluate therapies aimed at healing the brain injuries responsible for concussions." Dr. Lipton is also associate professor of radiology, of psychiatry and behavioral sciences and of neuroscience at Einstein and medical director of MRI services at Montefiore Medical Center, the University Hospital for Einstein.
The Einstein researchers are studying 20 veterans from Ohio and Michigan who were deployed in Iraq and Afghanistan and have exhibited symptoms of repeated concussion. Twenty of the veterans' siblings or cousins without concussion are acting as controls. The researchers are using an advanced MRI-based imaging technique called diffusion tensor imaging (DTI) to identify injured brain areas.
DTI "sees" the movement of water molecules within and along axons, the nerve fibers that constitute the brain's white matter. This imaging technique allows researchers to measure the uniformity of water movement (called fractional anisotropy, or FA) throughout the brain. Abnormally low FA within white matter indicates axon damage and has previously been associated with cognitive impairment in patients with traumatic brain injury. (The researchers also use DTI in an ongoing study of amateur soccer players to assess possible brain injury from repeatedly heading soccer balls.)
The final group of veterans is scheduled to visit Einstein for testing in February 2014. Preliminary results should be available later this year.
Resurrecting Lives Foundation recruited the veterans and their family members and facilitates their visits to Einstein. The Foundation is also funding the research itself. The foundation's mission is to assist in the recovery and reintegration of veterans with Traumatic Brain Injury (TBI) from Operation Iraqi Freedom and Operation Enduring Freedom.
"At Resurrecting Lives Foundation, we honor our fallen heroes by caring for their brothers and sisters who return," said Chrisanne Gordon, M.D., founder and chairwoman of the foundation. "The research Dr. Lipton and his team are conducting will help us fulfill this mission."
http://www.sciencedaily.com/releases/2014/01/140109124941.htm
Brain trauma raises risk of later PTSD in active-duty marines
- December 11, 2013
Science Daily/University of California, San Diego Health Sciences
In a novel study of U.S. Marines investigating the association between traumatic brain injury (TBI) and the risk of post-traumatic stress disorder (PTSD) over time, a team of scientists report that TBIs suffered during active-duty deployment to Iraq and Afghanistan were the greatest predictor for subsequent PTSD, but found pre-deployment PTSD symptoms and high combat intensity were also significant factors.
Traumatic brain injuries are common. At least 1.7 million Americans annually sustain a TBI, with an estimated 5 million Americans living with TBI-related disabilities. More than half (56.8 percent) of the servicemen reported a TBI prior to deployment; almost a fifth (19.8 percent) reported a TBI during deployment. The vast majority of deployment-related TBIs (87.2 percent) were deemed mild, with less than 24 hours of post-traumatic amnesia. Of the 117 Marines whose TBI resulted in lost consciousness, 111 said it was less than 30 minutes.
"The severity of post-deployment PTSD symptoms depends, in part, on the severity of pre-existing symptoms from prior trauma and combat intensity," said Baker. "An individual with no pre-existing PTSD symptoms and low combat intensity is at minimal risk for developing PTSD -- less than a 1 percent probability. Increases in pre-existing symptom scores and combat intensity modestly increase post-deployment symptom scores by 1 to 2 percent.
"By contrast, deployment-related mild TBI increases post-deployment symptom scores by 23 percent, and moderate to severe injuries increase scores by 71 percent. This percent increase is equivalent to a 14-point increase in combat intensity scores for mild TBI, and a 37-point increase for moderate or severe TBI."
Baker noted many factors, both environmental and individual, may contribute to development of PTSD. Two of the most important are pre-existing psychiatric symptoms and the nature of the "trauma event." "However, TBI was the strongest predictor of PTSD, even when controlling for pre-existing symptoms and combat intensity," she said. "These findings may be used to identify individuals who may be at risk for developing PTSD and provide them with more immediate health care."
http://www.sciencedaily.com/releases/2013/12/131211183807.htm