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Neuroendocrine and immune responses to a cognitive stress challenge in veterans with and without PTSD
Carien S. de Kloet,Eric Vermetten,Arthur R. Rademaker,Elbert Geuze
European Journal of Psychotraumatology , 2012, DOI: 10.3402/ejpt.v3i0.16206
Abstract: Background: PTSD has been associated with altered hypothalamus–pituitary–adrenal-axis (HPA-axis), immune and sympathetic nervous system (SNS) regulation. The purpose of this study was to evaluate the effect of cognitive stress on these systems in PTSD patients and controls. Methods: The subjective units of distress score (SUDS), NK-cell response, plasma levels of noradrenalin and ACTH in response to cognitive stress were assessed in male veterans with PTSD (n=15) and age, region and year of deployment matched veterans without psychopathology (n=15). Results: The challenge induced an increase in SUDS, noradrenalin, ACTH and NK-cell response in both groups. Baseline levels of ACTH were lower in PTSD patients. The test was experienced as more stressful by PTSD patients and resulted in an augmented ACTH response in patients. The noradrenalin and NK-cell responses showed no group differences. The ACTH response correlated with the severity of symptoms in patients, and the noradrenalin response correlated with the ACTH and NK-cell response in controls, but not in patients. Discussion: PTSD patients experience more distress and present with an exaggerated pituitary response to this stressor. In addition, our results suggest an altered interaction between the HPA-axis, SNS and immune system in PTSD.
Aggression, Anxiety, and Social Development in Adolescent Children of War Veterans with PTSD Versus those of Non-Veterans  [cached]
Gh Ahmadzadeh,A Malekian
Journal of Research in Medical Sciences , 2004,
Abstract: Background: Evaluation of psychological problems in children of war veterans with PTSD can be the first step in improving the war – related trauma and interrupting the known phenomenon of transgeneration transmission of this trauma. Methods: Using three self – administered questionnaires, this study was carried out to compare aggression, anxiety, and social development (as some of the most expected mental health problems in this group according to literature) in adolescent children of war veterans and those of non-veterans. The two groups were matched regarding sex, academic achievement, stage of education, and economic status of the family. Results: After controlling the level of parental education (as a confounding variable), a higher rate of aggression and anxiety was found in adolescent children of war veterans with PTSD but the two groups showed no significant difference in social development. Conclusion: The higher rate of anxiety and aggression among children of war veterans with PTSD along with many other factors such as low socioeconomic status in this group signifies the importance of mental health screening programs and appropriate interventions in this group. Keywords: Aggression, Social Development, Anxiety, War Veterans, PTSD, Adolescent.
Disruption of bradycardia associated with discriminative conditioning in combat veterans with PTSD  [cached]
Jay P Ginsberg,Edwin Ayers,Louisa Burriss,Donald A Powell
Neuropsychiatric Disease and Treatment , 2008,
Abstract: Jay P Ginsberg1,2, Edwin Ayers3, Louisa Burriss1, Donald A Powell1,41Shirley L. Buchanan Neuroscience Laboratory, Dorn VA Medical Center, Columbia, SC, USA; 2Department of Pharmacology, Physiology, and Neuroscience, School of Medicine, 4Department of Psychology, University of South Carolina, Columbia, SC, USA; 3Department of Psychology, South Carolina State University, Orangeburg, SC, USAAbstract: The effects of combat-related posttraumatic stress disorder (PTSD) on heart rate (HR) responding associated with a discriminative delay eyeblink (EB) conditioning paradigm are reported. Combat PTSD+, Combat PTSD , and Noncombat PTSD veterans were assessed with psychometric self-report measures, and baseline heart rate variability (HRV) was measured before receiving a 72-trial session of discriminative EB classical conditioning. Two types (red or green light) of conditioned stimuli (CS) were used: one (CS+) predicted a tone, followed immediately by an aversive stimulus (corneal airpuff); the other (CS ) predicted a tone alone, not followed by the airpuff. The light signal was presented for 5 seconds, during which HR was measured. On all psychometric measures, the PTSD+ subgroup was significantly different from the PTSD subgroups (Combat + Noncombat), and the PTSD subgroups did not significantly differ from each other. A linear deceleration in HR to CS+ and CS signals was found in the combined PTSD subgroup and on CS trials in the PTSD+ subgroup, but was not present on CS+ trials in the PTSD+ subgroup. Results are interpreted with respect to a behavioral stages model of conditioned bradycardia and in terms of neural substrates which are both critical to HR conditioning and known to be abnormal in PTSD.Keywords: bradycardia, PTSD, combat veterans, classical conditioning
Original paper Sexual dysfunctions and marital adjustment in veterans with PTSD
Khodabakhsh Ahmadi,Ali Fathi-Ashtiani,Ali Zareir,Alireza Arabnia
Archives of Medical Science , 2006,
Abstract: Introduction: Considering that we have in Iran a lot of veterans who suffer from post-traumatic stress disorder (PTSD), this research was performed to identify sexual dysfunction among a group of veterans who suffer from PTSD. Material and methods: In this descriptive-correlation research we selected and studied 110 cases. Data gathering tools were sexual dysfunctions, PTSD checklist according to DSM-IV and Enrich marital satisfaction scale. Under study sexual dysfunctions in this research include: decrease of libido, decrease of arousal, premature ejaculation, aversion to intercourse, erectile dysfunction, ejaculation delay, masturbation, painful ejaculation, or without problem. Results: The results show 89.1% of veterans with PTSD, at least one with sexual dysfunction and only 10.9% with no problems. Also the results show that most dysfunction includes: decrease of libido (68.2%), decrease of arousal (61.8%) and premature ejaculation (41.8%).Other results show that 45.5%, i.e. nearly half of the PTSD subjects, were dissatisfied with their marriage and sexual relationship and the dissatisfaction level of 11% was very high. Discussion: Veterans afflicted with PTSD face marital maladjustment, which predisposes them to sexual disorders. Therefore, marriage counselling and prevention programmes should focus on reducing marital dissatisfaction. If marital maladjustment decreases, sexual problems and disorders will improve.
Psychiatric diagnoses and punishment for misconduct: the effects of PTSD in combat-deployed Marines
Robyn M Highfill-McRoy, Gerald E Larson, Stephanie Booth-Kewley, Cedric F Garland
BMC Psychiatry , 2010, DOI: 10.1186/1471-244x-10-88
Abstract: A population-based study was conducted on all U.S. Marines who entered the military between October 1, 2001, and September 30, 2006, and deployed outside of the United States before the end of the study period, September 30, 2007. Demographic, psychiatric, deployment, and personnel information was collected from military records. Cox proportional hazards regression analysis was conducted to investigate associations between the independent variables and the three types of misconduct in war-deployed (n = 77 998) and non-war-deployed (n = 13 944) Marines.Marines in both the war-deployed and non-war-deployed cohorts with a non-PTSD psychiatric diagnosis had an elevated risk for all three misconduct outcomes (hazard ratios ranged from 3.93 to 5.65). PTSD was a significant predictor of drug-related discharges in both the war-deployed and non-war-deployed cohorts. In the war-deployed cohort only, a specific diagnosis of PTSD was associated with an increased risk for both demotions (hazard ratio, 8.60; 95% confidence interval, 6.95 to 10.64) and punitive discharges (HR, 11.06; 95% CI, 8.06 to 15.16).These results provide evidence of an association between PTSD and behavior problems in Marines deployed to war. Moreover, because misconduct can lead to disqualification for some Veterans Administration benefits, personnel with the most serious manifestations of PTSD may face additional barriers to care.Numerous studies have demonstrated that exposure to combat or other traumatic events is associated with an increase in psychiatric problems, including depression, substance abuse, anxiety disorders, and posttraumatic stress disorder (PTSD) [1-3]. Another area of concern is the relationship between combat exposure and antisocial behavior. The media have keenly focused on this topic, as evidenced by the publicity surrounding military misconduct both during and after deployment [4-7].Research on Vietnam War veterans strongly suggests an association between combat exposure and antiso
Comparison Study of Memory Status in War-PTSD Veterans With Depression and Non- Veterans Depressed Patient
Radfar Sh,Tahereh Jazayeri S,Haghani H,Habibi M
Tehran University Medical Journal , 2012,
Abstract: Background: Cognitive problems in patients with post-traumatic stress disorder (PTSD) include poor concentration and impaired memory. Prevalence of PTSD in all aspects of life is 8% in USA. Regarding the importance of memory in functional levels, this study was performed to review memory status in these patients. Methods: Fifty male war veterans with PTSD and major depression and 50 male non-veterans with depression participated in this study performed at psychiatric outpatient ward in Baqiyatallah hospital during 2008-2009. The patients met the DSM-IV diagnostic criteria. Depression severity, sex, age, educational level, and marital status were matched in both groups. A psychologist completed demographic and Mississippi questionnaires, PTSD checklist (PCL), beck depression Inventory and wechsler memory scale. The collected data were analyzed using SPSS software (version 11.0). A P-value smaller than 0.05 was considered significant.Results: The mean age of the veterans and non-veterans was 43.9±4.7 and 42±9.4 years, respectively. Memory status did not differ between the two groups (P>0.05). There was no statistically significant correlation between duration and severity of PTSD with memory impairment (P>0.05). A negative correlation was found between personal and general information with re-experiencing in the veterans (P<0.05). Impaired memory was correlated with age greater than 45, educational level lower than high school diploma, severity of depression and longer participation in war. Conclusion: Although both PTSD and major depression affected memory, but memory status did not differ between patients with PTSD and depression and patients with chronic depression.
A Comparative Analysis of MMPI and Rorschach Findings Assessing Combat-Related PTSD in Vietnam Veterans—Analysis of MMPI and Rorschach Findings Assessing PTSD  [PDF]
Ioanna Katsounari, Jordan Jacobowitz
Psychology (PSYCH) , 2011, DOI: 10.4236/psych.2011.24053
Abstract: There has been a proliferation of assessment research on Post-traumatic Stress Disorder (PTSD) over the past twenty years. In spite of recent advances in the PTSD assessment research, there continues to be a controversy as to whether the MMPI or Rorschach is more useful in determining the presence of PTSD. The present comparative analysis of the research literature will carefully evaluate controlled empirical studies, which utilized psychometric measures such as the MMPI/2 and Rorschach to identify PTSD in Vietnam Veterans. This analysis is guided by the paucity of comparative data for standardized objective and projective instruments to assess combat-related PTSD. The analysis indicated that the MMPI as an assessment instrument focuses on symptom recognition of PTSD while the Rorschach seems to be more likely to identify chronic adaptations to trauma. The significance of pre-combat factors, such as preexisting personality, and their impact on the way individuals make meaning and express traumatic experiences needs to be further addressed in future research. The need for reliable and valid measures to assess combat-related PTSD is urgent as an increasing number of soldiers return from war zones.
Identification of domains and measures for assessment battery to examine well-being of spouses of OIF/OEF veterans with PTSD  [PDF]
Jeanne Hayes, PhD, MPA,Bonnie Wakefield, PhD, RN,Elena M. Andresen, PhD,Jeffrey Scherrer, PhD
Journal of Rehabilitation Research and Development , 2010,
Abstract: Family members play an important role in the physical and mental recovery of soldiers returning from Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). Posttraumatic stress disorder (PTSD) has been associated with strained marital and family relations and parenting difficulties, and many veterans with PTSD experience difficulty finding and maintaining employment. Family members who assist with the veteran's recovery also experience significant strain and may have to leave employment to care for the veteran. Our objective was to identify appropriate assessment measures for examining the well-being of spouses assisting with veterans' recovery and to identify opportunities for supporting veterans' spouses. We used a combination of expert panel input and qualitative methods (focus group interviews) to develop a battery of instruments for use in future research with OIF/OEF family members to examine well-being. Research is needed to elucidate and refine the special needs and issues surrounding PTSD in current and future OIF/OEF veterans and their families. This study provides a first step toward understanding appropriate measures. Expert panel methods and focus group interviews yielded valuable input on the domains and measures that should be included in the assessment battery as well as opportunities for assisting spouses.
Universitas Psychologica , 2005,
Abstract: The results of cognitive-behavioral group interventions applied from 2002 to 2004 to 42 colombian combat veteranswith Post Traumatic Stress Disorder (PTSD) are presented. The goal of the study was to stablish the effectiveness ofthe group interventions based in Prolonged Exposition and Stress Inoculation treatment processes. Differencesbetween pre-in-post symptomatology scores of PTSD were measured by Foa Posttraumatic Stress Diagnostic Scale(PDS) and the Beck Depression Inventory. The statistical analysis was made by t test for paired samples, with alpha of0.05. Results show significant decrease in symptomatology and severity level after the intervention both in depressionand PTSD symptoms.
Appetitive Aggression as a Resilience Factor against Trauma Disorders: Appetitive Aggression and PTSD in German World War II Veterans  [PDF]
Roland Weierstall, Sina Huth, Jasmin Knecht, Corina Nandi, Thomas Elbert
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0050891
Abstract: Background Repeated exposure to traumatic stressors such as combat results in chronic symptoms of PTSD. However, previous findings suggest that former soldiers who report combat-related aggression to be appetitive are more resilient to develop PTSD. Appetitive Aggression should therefore prevent widespread mental suffering in perpetrators of severe atrocities even after decades. Methods and Findings To test the long-term relationship between trauma-related illness and attraction to aggression, we surveyed a sample of 51 German male World-War II veterans (age: M = 86.7, SD = 2.8). War-related appetitive aggression was assessed with the Appetitive Aggression Scale (AAS). Current- and lifetime PTSD symptoms were assessed with the PSS-I. In a linear regression analysis accounting for 31% of the variance we found that veterans that score higher on the AAS show lower PSS-I symptom severity scores across their whole post-war lifetime (β = ? .31, p = .014). The effect size and power were sufficient (f2 = 0.51, (1-β) = .99). The same was true for current PTSD (β = ? .27, p = .030). Conclusions Appetitive Aggression appears to be a resilience factor for negative long-term effects of combat experiences in perpetrators of violence. This result has practical relevance for preventing trauma-related mental suffering in Peace Corps and for designing adequate homecoming reception for veterans.
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