Life stressors trigger neurological disorders

April 22, 2014

Science Daily/Children's National Medical Center

When mothers are exposed to trauma, illness, alcohol or other drug abuse, these stressors may activate a single molecular trigger in brain cells that can go awry and activate conditions such as schizophrenia, post-traumatic stress disorder and some forms of autism.

Until now, it has been unclear how much these stressors have impacted the cells of a developing brain. Past studies have shown that when an expectant mother exposes herself to alcohol or drug abuse or she experiences some trauma or illness, her baby may later develop a psychiatric disorder later in life. But the new findings identify a molecular mechanism in the prenatal brain that may help explain how cells go awry when exposed to certain environmental conditions.

While it has been generally accepted that exposure to harmful environmental factors increase the susceptibility of the brain to neurological and psychiatric disorders, new types of environmental agents are continuingly added to the mix, requiring evolving studies, Hasimoto-Torii says.

Hashimoto-Torii notes that autism rates have increased substantially and "more people are having these exposures to environmental stressors," she says. While there have been many studies that have identified singular stressors, such as alcohol, there have not been enough studies to focus on many different environmental factors and their impacts, such as heavy metals as well as alcohol and other toxic exposure, she adds.

Identifying many risk factors helped Hashimoto-Torii and other researchers identify the gene that may be linked to neurological problems. "Different stressors may have different stress responses," she says. She examined risk factors specifically involving epilepsy, ADHD, autism and schizophrenia. Eventually, it may open the door "to provide therapy in the future to reduce the risk" and protect vulnerable cells.

http://www.sciencedaily.com/releases/2014/04/140422113430.htm

Domestic abuse linked to mental health problems in new mothers

- April 14, 2014

Science Daily/North Carolina State University

Domestic abuse is closely linked to postpartum mental health problems, including depression and post-traumatic stress disorder, in mothers, new research confirms. The research also found that specific types of abuse are associated with specific mental health problems. "The sheer scope of the mental health problems and types of abuse that we found tells us that we need to take a broader approach to tackling these issues," states a co-author. "And this is clearly not a 'lower class' problem -- medical professionals everywhere need to pay attention."

"We wanted to see whether and how intimate partner abuse -- physical, psychological and sexual -- influenced postpartum mental health in women, including problems such as depression, stress, anxiety, obsessive-compulsive disorder (OCD), and PTSD," says Dr. Sarah Desmarais, an assistant professor of psychology at NC State and lead author of a paper on the work.

The researchers interviewed 100 women from British Columbia who were largely from higher socioeconomic backgrounds and were not considered at high risk of postpartum mental health problems. The study participants were recruited to participate in a broad health and wellness study, which was not specifically focused on domestic abuse.

Sixty-one percent of the study participants reported symptoms of postpartum mental health problems within the first three months after childbirth. And 47 percent of the 100 women reported symptoms at "clinical" levels, meaning the symptoms were of at least moderate severity.

Eighty-four percent of the participants reported experiencing physical, psychological or sexual abuse at the hands of a partner prior to becoming pregnant. Seventy percent of the 100 participants reported some form of abuse by their romantic partner during pregnancy. These forms of abuse ranged from name-calling to rape and physical assault with a weapon.

"We found that women who had experienced abuse were more likely to suffer from postpartum mental health problems, and were much more likely to suffer from those problems if the abuse occurred during pregnancy," Desmarais says. "In addition, the more types of abuse they experienced, the more severe the mental health symptoms they reported. We also found that specific types of abuse were associated with specific problems."

The researchers found that psychological abuse -- verbal and emotional abuse -- was associated with stress and PTSD. Physical abuse was associated with depression, OCD and PTSD. Sexual abuse was associated with stress, depression and PTSD.

This means that some mental health problems could stem from any of the forms of abuse. For example, PTSD is associated with all three forms of abuse, but could be caused by any one of them; psychological abuse alone could lead to PTSD.

"This highlights the need for increased awareness of the prevalence of these issues, and the need for increased screening for abuse and mental health problems for pregnant women and new mothers," Desmarais says.

"The sheer scope of the mental health problems and types of abuse that we found tells us that we need to take a broader approach to tackling these issues," Desmarais adds. "And this is clearly not a 'lower class' problem -- medical professionals everywhere need to pay attention. But to do this effectively, we need to train doctors, nurses, and hospital staff in how to identify and respond to potential problems in this area."

http://www.sciencedaily.com/releases/2014/04/140414112439.htm

Hereditary trauma: Inheritance of traumas and how they may be mediated

April 13, 2014

Science Daily/ETH Zurich

Extreme and traumatic events can change a person -- and often, years later, even affect their children. Researchers of the University of Zurich and ETH Zurich have now unmasked a piece in the puzzle of how the inheritance of traumas may be mediated.

The phenomenon has long been known in psychology: traumatic experiences can induce behavioural disorders that are passed down from one generation to the next. It is only recently that scientists have begun to understand the physiological processes underlying hereditary trauma. "There are diseases such as bipolar disorder, that run in families but can't be traced back to a particular gene," explains Isabelle Mansuy, professor at ETH Zurich and the University of Zurich. With her research group at the Brain Research Institute of the University of Zurich, she has been studying the molecular processes involved in non-genetic inheritance of behavioural symptoms induced by traumatic experiences in early life.

Mansuy and her team have succeeded in identifying a key component of these processes: short RNA molecules. These RNAs are synthetized from genetic information (DNA) by enzymes that read specific sections of the DNA (genes) and use them as template to produce corresponding RNAs. Other enzymes then trim these RNAs into mature forms. Cells naturally contain a large number of different short RNA molecules called microRNAs. They have regulatory functions, such as controlling how many copies of a particular protein are made.

"With the imbalance in microRNAs in sperm, we have discovered a key factor through which trauma can be passed on," explains Mansuy. However, certain questions remain open, such as how the dysregulation in short RNAs comes about. "Most likely, it is part of a chain of events that begins with the body producing too much stress hormones."

Importantly, acquired traits other than those induced by trauma could also be inherited through similar mechanisms, the researcher suspects. "The environment leaves traces on the brain, on organs and also on gametes. Through gametes, these traces can be passed to the next generation. The scientists hope that their results may be useful to develop a blood test for diagnostics.

http://www.sciencedaily.com/releases/2014/04/140413135953.htm

One in three intensive care survivors develop depression that typically manifests as physical symptoms

- April 6, 2014

Science Daily/The Lancet

A third of intensive care patients develop depression that typically manifests as physical, or somatic, symptoms such as weakness, appetite change, and fatigue, rather than psychological symptoms, according to one of the largest studies to investigate the mental health and functional outcomes of survivors of critical care.

The study suggests that intensive care unit (ICU) survivors could be three times more likely to experience depression than the general population, and that depression is four times more common than post-traumatic stress disorder (PTSD) after critical illness.

"Considering that each year, at least 5 million individuals are admitted to ICU in North America alone -- more than are diagnosed with cancer -- and about 80% survive, it's a significant public health issue", explains study leader Dr James Jackson, psychologist and assistant professor of medicine at Vanderbilt University Medical Center in the USA.

"We need to pay more attention to preventing and treating the physical rather than psychological symptoms of depression in ICU survivors," says Dr Jackson. "The physical symptoms of depression are often resistant to standard treatment with antidepressant drugs and we need to determine how best to enhance recovery with a new focus on physical and occupational rehabilitation."

According to Dr Jackson, "Substantial time and energy has been invested in addressing PTSD in survivors of critical illness, but our findings suggest that it is less pervasive than depression. Patients of all ages are at risk of developing post-ICU mental health and functional disabilities and more needs to be done to ensure that these impairments don't become permanent."

"These findings have important implications. When depression manifests as physical symptoms, patients are less likely to receive a diagnosis. If they are diagnosed, they are less likely to respond to treatment…Traditional pharmacological therapies for depression might be less likely to provide significant benefit alone (or at all). Instead, doctors might need to address the many diagnoses that contribute to poor sleep, impaired concentration, weakness, and fatigue."

http://www.sciencedaily.com/releases/2014/04/140406214411.htm

Japanese Town: Half the survivors of mega-earthquake, tsunami, have PTSD symptoms

- March 6, 2014

Science Daily/Brigham Young University

A new study shows that more than half the survivors in one Japanese town exhibited 'clinically concerning' symptoms of PTSD following the country's mega-earthquake and tsunami. Two-thirds of survivors also reported symptoms of depression. Having work to do has proven important in increasing resilience.

One year after the quake, Brigham Young University professor Niwako Yamawaki and scholars from Saga University evaluated the mental health of 241 Hirono citizens. More than half of the people evaluated experienced "clinically concerning" symptoms of post-traumatic stress disorder. Two-thirds of the sample reported symptoms of depression.

Those rates exceed levels seen in the aftermath of other natural disasters, but what happened in Japan wasn't just a natural disaster. Leaked radiation from nuclear power plants forced residents of Hirono to relocate to temporary housing far from home.

"This was the world's fourth-biggest recorded earthquake, and also the tsunami and nuclear plant and losing their homes -- boom boom boom boom within such a short time," said Yamawaki, a psychology professor at BYU. "The prevalence one year after is still much higher than other studies of disasters that we found even though some time had passed."

Yamawaki got the idea for this study while shoveling mud from a damaged Japanese home one month after the tsunami flooded coastal towns. She had just arrived for a previously scheduled fellowship at Saga University. During her off-time, she traveled to the affected area and volunteered in the clean-up effort. One seemingly stoic homeowner broke down in tears when Yamawaki and her husband thanked her for the chance to help.

"She said 'This is the first time I have cried since the disaster happened,'" Yamawaki said. "She just said 'Thank you. Thank you for letting me cry.'"

"Having something to do after a disaster really gives a sense of normalcy, even volunteer work," Yamawaki said.

As the researchers got to know survivors, they heard from so many that they missed seeing their former neighbors. The mass relocation outside the radiation zone broke up many neighborhood ties.

"Japanese are very collectivistic people and their identity is so intertwined with neighbors," Yamawaki said. "Breaking up the community has so much impact on them."

While it's hard to fathom the scope of the devastation in the coastal region of Fukushima, most survivors believe something like this will happen again. If so, this new study provides a blueprint for how to help them put their lives back together again.

http://www.sciencedaily.com/releases/2014/03/140306095526.htm

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

Neurofeedback Tunes Key Brain Networks, Improving Well-Being in PTSD

Dec. 3, 2013 —

Science Daily/University of Western Ontario

Pioneering research conducted at Western University points to a promising avenue for the treatment of post-traumatic stress disorder (PTSD): utilising neurofeedback training to alter the plasticity of brain networks linked to the condition.

uring neurofeedback, intentional control of one's own brain activity may be learned with what's called a brain-computer interface, which is able to represent graphically a person's real-time brain activation on a computer. This can be done noninvasively with brainwave activities, for example, where the computer monitor behaves like a virtual "mirror" to real electrical oscillations produced by neurons in the cortex. These are recorded by surface sensors on the scalp, also known as an electroencephalogram (EEG).

Senior author and principal investigator Dr. Ruth Lanius, a professor at the Department of Psychiatry at Western's Schulich School of Medicine & Dentistry and a scientist with Lawson Health Research Institute, adds "The last decade of neuroscience research has offered a deeper understanding of the key brain networks involved in cognitive and emotional functions.

We are now on the threshold of being able to use this information to understand the neural mechanisms underlying certain disorders and their treatments. Neurofeedback offers great promise as a type of brain training that is directly based on the functional activation of these brain networks. We are therefore thrilled to see the first evidence of this in action, along with significant changes in subjective well-being. Our hope and vision for the future is that this approach could improve and potentially augment PTSD treatment."

http://www.sciencedaily.com/releases/2013/12/131203112213.htm

Children significantly more likely to develop PTSD if mother afflicted

- November 27, 2013

Science Daily/American Associates, Ben-Gurion University of the Negev

While fewer than 10 percent (8.4 percent) of the mothers were suffering from PTSD, more than a fifth (21 percent) of their children presented PTSD symptoms in a recent study on the topic. Children who developed PTSD symptoms also had more psychosomatic complaints such as constipation, diarrhea and headaches.

In the study published in the Journal of Depression & Anxiety, while fewer than 10 percent (8.4 percent) of the mothers were suffering from PTSD, more than a fifth (21 percent) of their children presented PTSD symptoms. Children who developed PTSD symptoms also had more psychosomatic complaints such as constipation, diarrhea and headaches.

"This study reinforces the existing body of knowledge regarding the importance of evaluating and treating parental responses in time of stress," the researchers explain.

"Parents are often the key to understanding children's responses generally and specifically in times of stress. The study also highlights the close interrelations between 'body and soul' among children and adults."

In the study, some 160 mothers of preschool children were interviewed about symptoms exhibited by their children and their own responses during Operation Cast Lead. More than 750 rockets were fired into Southern Israel from Gaza from December 2008 to January 2009.

Working with the Preschool Psychiatric Unit at Soroka University Medical Center, the BGU researchers examined the relationship between PTSD symptoms and socio-demographic, family attributes and psychosomatic symptoms among children exposed to Grad missile attacks in Beer-Sheva, Israel.

http://www.sciencedaily.com/releases/2013/11/131127110607.htm

PTSD raises risk for obesity in women

- November 20, 2013

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

Women with post-traumatic stress disorder (PTSD) gain weight more rapidly and are more likely to be overweight or obese than women without the disorder, find researchers. It is the first study to look at the relationship between PTSD and obesity over time.

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

"PTSD is not just a mental health issue," says study senior author Karestan Koenen, PhD, Mailman School associate professor of Epidemiology. "Along with cardiovascular disease and diabetes, we can now add obesity to the list of known health risks of PTSD."

"The good news from the study is that it appears that when PTSD symptoms abate, risk of becoming overweight or obese is also significantly reduced," says first author Laura D. Kubzansky, PhD, Professor of Social and Behavioral Sciences at Harvard School of Public Health. However, despite the growing evidence of potential far-reaching problems associated with PTSD, it's estimated that only half of women in the United States with the disorder are ever treated. "Hopefully, wider recognition that PTSD can also influence physical health will improve this statistic, leading to better screening and treatments, including those to prevent obesity," says Dr. Kubzansky.

Normal-weight women who developed PTSD during the study period had 36% increased odds of becoming overweight or obese compared with women who experienced trauma but had no symptoms of PTSD. The higher risk was evident even for women with sub-threshold symptoms levels and remained after adjusting for depression, which has also been proposed as a major risk factor for obesity. In women with PTSD that began prior to the study period, body mass index increased at a more rapid pace than women without PTSD.

The observed effect of PTSD on obesity is likely stronger in the general population of women than in nurses, notes Dr. Koenen. "Nurses are great for studies because they report health measures like BMI with a high degree of accuracy. But they are also more health conscious and probably less likely to become obese than most of us, which makes these results more conservative than they would otherwise be."

Symptoms of PTSD rather than the trauma itself seemed to be behind the weight gain. "We looked at the women who developed PTSD and compared them to women who experienced trauma but did not develop PTSD. On the whole, before their symptoms emerged, the rate of change in BMI was the same as the women who never experienced trauma or did experience trauma but never developed symptoms," says Dr. Kubzansky.

How exactly does PTSD lead to weight gain? The biological pathway is unknown, but scientists have a number of guesses. One is through the over-activation of stress hormones. PTSD may lead to disturbances in functioning of the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system, each of which are involved in regulating a broad range of body processes, including metabolism. Another is through unhealthy behavior patterns that may be used to cope with stress. Ongoing research is looking at whether PTSD increases women's preference for processed foods and decreases their likelihood of exercising.

http://www.sciencedaily.com/releases/2013/11/131120192339.htm

Teens from military families suffer from deployments

- November 19, 2013

Science Daily/Health Behavior News Service

Teens that have had a parent or sibling on military deployment were more likely to have suicidal thoughts or be depressed than teens without military connections, finds a new study.

"We've been in the longest war in recent history with increased numbers of individuals experiencing combat and being deployed for longer periods of time -- and multiple times," says study co-author Julie Cederbaum, Ph.D., a researcher at the University of Southern California. "We are logically thinking about the adult that is being deployed, but we're not talking enough about the kids left behind and how they might manage the military experience of their parent."

More than 13 percent of the teens surveyed had a parent or sibling in the military. Teens who had experienced just one deployment of a parent or sibling were 40 percent more likely to feel sad or hopeless, 24 percent more likely to have suicidal thoughts and 15 percent more likely to be depressed than teens that did not have military connections.

"You see an even bigger shift with two or more deployments," Cederbaum says. "These kids were 56 percent more likely to experience feelings of sadness or hopelessness, 34 percent to have thought about suicide and 41 percent more likely to experience depressive symptoms."

Anita Chandra, Ph.D., a researcher at the RAND Corporation who has extensively studied military families says that there are many important factors that influence the mental health of teens with military connections, including the teens' age, the total number of months a parent is deployed and whether the parent was deployed into combat. Reintegration -- when a parent returns home -- can be an emotionally difficult time for military families, as well.

Additionally, Chandra notes, not all mental health findings of teens with military connections are negative. "We also know that kids in these families have exhibited a lot of rebound and recovery from deployment stress and a lot of resilience."

Even though the Iraq war ended in 2011 and American troops are withdrawing from Afghanistan, the mental health of children in military families is likely to remain an important issue.

"While many deployed service members return home with minimal reintegration issues, we know that a fair number of folks coming back from deployment aren't doing particularly well," says Cederbaum. "Their children may now be in a home where there's potential traumatic brain injury, mental distress, or substance misuse. That service member or veteran is going through an adjustment and the family has to readjust as well."

Increasing mental health screenings in pediatric and school settings and creating a safe environment for teens of military families to talk about their experiences and feel supported are ways to help identify and reach at-risk youth, Cederbaum says.

http://www.sciencedaily.com/releases/2013/11/131119193439.htm

Taking stock of research on sleepless soldiers

October 16, 2013

Science Daily/Springer

Various behavioral treatment options are helping to treat the sleeplessness experienced by American soldiers who have been deployed in recent military operations. A review of research has been done on deployment-related insomnia among military personnel and veterans, conducted since 2010.

Insomnia is reported by up to 54 percent of the two million men and women who have served in various American combat efforts since 11 September 2001, compared to up to 22 percent of civilian adults. Although it is possible that a person's insomnia may develop prior to joining the military, it can also occur during the service period, or post-deployment when the soldier returns to civilian life. Studies have found that deployment-related stressors like combat exposure, mild traumatic brain injury, irregular sleep/wake schedules and the adjustment of returning home, all contribute to sleeplessness.

Soldiers who suffer from insomnia while being deployed have a bigger chance of developing traumatic stress reactions such as depression and posttraumatic stress disorders, and even committing suicide. Also, it contributes to physical war-related injuries.

Behavioral interventions such as cognitive-behavioral therapy and imagery rehearsal therapy often yield positive results in trying to reduce the effects of insomnia and nightmares, respectively. These treatments can be delivered during in-person sessions with clinicians, brief follow up sessions via telephone, or online and mobile resources. Training was recently rolled out to prepare providers in the Veterans Health Administration to use cognitive behavioral treatment of insomnia.

The goal is to eventually educate 1,000 clinicians in an effort to bridge the gap between veterans who need treatment, and available providers. Training of clinicians in military settings and other non-VA clinics is equally important to meet the needs of our service members and veterans.

"Training providers to be knowledgeable about insomnia and behavioral treatment options is a vital component to the treatment of chronic insomnia and managing its impact on other disorders," say the authors, who believe more research is needed on methods to increase access to care.

"In addition to research and clinical efforts specifically for service members and veterans, research and clinical efforts directed at military family members are also important components in providing the care needed and promoting health and recovery among service members and their families."

http://www.sciencedaily.com/releases/2013/10/131016123732.htm

Insomnia Linked to PTSD and Other Mental Disorders After Military Deployment

June 28, 2013 —

Science Daily/Perelman School of Medicine at the University of Pennsylvania

A new study from the Perelman School of Medicine at the University of Pennsylvania and the Naval Health Research Center has shown Military service members who have trouble sleeping prior to deployments may be at greater risk of developing posttraumatic stress disorder (PTSD), depression and anxiety once they return home. The new study, published in the July 2013 issue of the journal SLEEP, found that pre-existing insomnia symptoms conferred almost as a large of a risk for those mental disorders as combat exposure.

"Understanding environmental and behavioral risk factors associated with the onset of common major mental disorders is of great importance in a military occupational setting," said lead study author Philip Gehrman, PhD, assistant professor of Psychology in the Department of Psychiatry, member of the Penn Sleep Center, and the Philadelphia VA Medical Center. "This study is the first prospective investigation of the relationship between sleep disturbance and development of newly identified positive screens for mental disorders in a large military cohort who have been deployed in support of the recent operations in Iraq or Afghanistan."

"One of the more interesting findings of this study is not only the degree of risk conferred by pre-deployment insomnia symptoms, but also the relative magnitude of this risk compared with combat-related trauma," says Gehrman. "The risk conferred by insomnia symptoms was almost as strong as our measure of combat exposure in adjusted models."

The researchers also found that short sleep duration (less than six hours of sleep per night), separate from general insomnia, was associated with new-onset PTSD symptoms.

"We found that insomnia is both a symptom and a risk factor for mental illness and may present a modifiable target for intervention among military personnel," says Gehrman. "We hope that by early identification of those most vulnerable, the potential exists for the designing and testing of preventive strategies that may reduce the occurrence of PTSD, anxiety, and depression."

The research team says that additional study is needed to investigate whether routine inquiry about insomnia symptoms and application of appropriate early, effective interventions reduces subsequent morbidity from mental disorders. They note that in a military population, assessment of insomnia symptoms could easily be incorporated into routine pre-deployment screening.

http://www.sciencedaily.com/releases/2013/06/130628160829.htm