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Harvard Review of Psychiatry

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https://www.readbyqxmd.com/read/29734229/understanding-resilience-and-preventing-and-treating-ptsd
#1
Sarah R Horn, Adriana Feder
Resilience is defined as the dynamic ability to adapt successfully in the face of adversity, trauma, or significant threat. Some of the key early studies of resilience were observational studies in children. They were followed by research in adults, studies testing interventions to promote resilience in different populations, and a recent upsurge of studies on the underlying genomic and neurobiological mechanisms. Neural and molecular studies in preclinical models of resilience are also increasingly identifying active stress adaptations in resilient animals...
May 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29734228/glucocorticoids-and-hippocampal-structure-and-function-in-ptsd
#2
Philip R Szeszko, Amy Lehrner, Rachel Yehuda
This review examines the putative link between glucocorticoid and hippocampal abnormalities in posttraumatic stress disorder (PTSD). Increased glucocorticoid receptor (GR) sensitivity in PTSD may permit enhanced negative feedback inhibition of cortisol at the pituitary, hypothalamus, or other brain regions comprising the hypothalamic-pituitary-adrenal (HPA) axis and would be expected to affect other physiological systems that are regulated by glucocorticoids. Molecular and transcriptional studies of cortisol are consistent with the hypothesis that cortisol actions may be amplified in PTSD as a result of enhanced GR sensitivity in monocytes and some brain regions, although cortisol levels themselves are unchanged and oftentimes lower than normal...
May 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29734227/fear-processing-psychophysiology-and-ptsd
#3
Seth Davin Norrholm, Tanja Jovanovic
The processing and regulation of fear is one of the key components of posttraumatic stress disorder (PTSD). Fear can involve both acute and potential threats that can manifest in different behaviors and result from activity within different neural nodes and networks. Fear circuits have been studied extensively in animal models for several decades and in human neuroimaging research for almost 20 years. Therefore, the centrality of fear processing to PTSD lends the disorder to be more tractable to investigation at the level of brain and behavior, and provides several observable phenotypes that can be linked to PTSD symptoms...
May 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29734226/functional-neuroanatomy-of-emotion-and-its-regulation-in-ptsd
#4
Jacklynn M Fitzgerald, Julia A DiGangi, K Luan Phan
Posttraumatic stress disorder (PTSD) is a devastating disorder, linked to profound mental, physical, occupational, and functional impairment. In addition, it is a highly complex disorder, characterized by symptom heterogeneity across multiple domains. Nevertheless, emotion dysregulation arising from the exaggerated response to threat or from the inability to regulate negative emotional states plays a defining role in the pathophysiology of PTSD. In order to improve our understanding of how emotion dysregulation manifests in this illness, functional neuroimaging research over the past 20 years provides great insight into underlying neuroanatomy of each component of emotion dysregulation in the context of PTSD...
May 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29734225/evidenced-based-treatment-of-posttraumatic-stress-disorder-an-updated-review-of-validated-psychotherapeutic-and-pharmacological-approaches
#5
Meredith E Charney, Samantha N Hellberg, Eric Bui, Naomi M Simon
LEARNING OBJECTIVES: After participating in this activity, learners should be better able to:• Evaluate psychotherapeutic and pharmacologic approaches to treating patients with posttraumatic stress disorder. ABSTRACT: A strong evidence base exists for psychological and pharmacological interventions for the treatment of posttraumatic stress disorder (PTSD). The published literature investigating the effectiveness of these treatments in reducing the symptoms and impairments associated with PTSD has expanded substantially in recent years...
May 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29734224/introduction
#6
Kerry J Ressler
No abstract text is available yet for this article.
May 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29517615/living-high-and-feeling-low-altitude-suicide-and-depression
#7
Brent M Kious, Douglas G Kondo, Perry F Renshaw
After participating in this activity, learners should be better able to:• Assess epidemiologic evidence that increased altitude of residence is linked to increased risk of depression and suicide• Evaluate strategies to address hypoxia-related depression and suicidal ideation ABSTRACT: Suicide and major depressive disorder (MDD) are complex conditions that almost certainly arise from the influences of many interrelated factors. There are significant regional variations in the rates of MDD and suicide in the United States, suggesting that sociodemographic and environmental conditions contribute...
March 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29394174/a-fourth-wave-of-psychotherapies-moving-beyond-recovery-toward-well-being
#8
John R Peteet
No abstract text is available yet for this article.
March 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29381527/community-public-policy-and-recovery-from-mental-illness-emerging-research-and-initiatives
#9
Enrico G Castillo, Bowen Chung, Elizabeth Bromley, Sheryl H Kataoka, Joel T Braslow, Susan M Essock, Alexander S Young, Jared M Greenberg, Jeanne Miranda, Lisa B Dixon, Kenneth B Wells
This commentary examines the roles that communities and public policies play in the definition and processes of recovery for adults with mental illness. Policy, clinical, and consumer definitions of recovery are reviewed, which highlight the importance of communities and policies for recovery. This commentary then presents a framework for the relationships between community-level factors, policies, and downstream mental health outcomes, focusing on macroeconomic, housing, and health care policies; adverse exposures such as crime victimization; and neighborhood characteristics such as social capital...
March 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29016379/oxidative-stress-inflammation-and-neuroprogression-in-chronic-ptsd
#10
Mark W Miller, Alex P Lin, Erika J Wolf, Danielle R Miller
Posttraumatic stress disorder is a serious and often disabling syndrome that develops in response to a traumatic event. Many individuals who initially develop the disorder go on to experience a chronic form of the condition that in some cases can last for many years. Among these patients, psychiatric and medical comorbidities are common, including early onset of age-related conditions such as chronic pain, cardiometabolic disease, neurocognitive disorders, and dementia. The hallmark symptoms of posttraumatic stress-recurrent sensory-memory reexperiencing of the trauma(s)-are associated with concomitant activations of threat- and stress-related neurobiological pathways that occur against a tonic backdrop of sleep disturbance and heightened physiological arousal...
March 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/28795979/treating-obsessive-compulsive-disorder-in-the-postpartum-period-diagnostic-and-cultural-considerations
#11
Angela Fang, Noah C Berman, Justin A Chen, Lisa Zakhary
No abstract text is available yet for this article.
March 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29465479/ketamine-associated-brain-changes-a-review-of-the-neuroimaging-literature
#12
Dawn F Ionescu, Julia M Felicione, Aishwarya Gosai, Cristina Cusin, Philip Shin, Benjamin G Shapero, Thilo Deckersbach
Major depressive disorder (MDD) is one of the most prevalent conditions in psychiatry. Patients who do not respond to traditional monoaminergic antidepressant treatments have an especially difficult-to-treat type of MDD termed treatment-resistant depression. Subanesthetic doses of ketamine-a glutamatergic modulator-have shown great promise for rapidly treating patients with the most severe forms of depression. As such, ketamine represents a promising probe for understanding the pathophysiology of depression and treatment response...
February 20, 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29465478/glutamatergic-modulators-in-depression
#13
Ioline D Henter, Rafael Teixeira de Sousa, Carlos A Zarate
Both preclinical and clinical studies have implicated glutamatergic system dysfunction in the pathophysiology of mood disorders such as bipolar depression and major depressive disorder. In particular, rapid reductions in depressive symptoms have been noted in response to subanesthetic doses of the glutamatergic modulator ketamine in subjects with major depressive disorder or bipolar depression. These results have prompted the repurposing or development of other glutamatergic modulators, both as monotherapy or adjunctive to other therapies...
February 20, 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29303920/mirtazapine-therapy-for-posttraumatic-stress-disorder-implications-of-alpha-adrenergic-pharmacology-on-the-startle-response
#14
Ian R McGrane, Michael D Shuman
No abstract text is available yet for this article.
January 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29303919/efficacy-and-safety-of-intensive-transcranial-magnetic-stimulation
#15
Tomas Sverak, Libor Ustohal
Repetitive transcranial magnetic stimulation (rTMS) is customarily applied on a daily basis for prolonged periods of time for the treatment of psychiatric diseases. The process is demanding in terms of staff and patient time, and the onset of the effect is slow. Recently, intensive rTMS protocols have been introduced in which stimulation is applied to the same area more than once a day with a higher than standard number of pulses. This article reviews 16 articles to determine the safety and efficacy of such protocols...
January 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29303918/suicidal-risk-and-affective-temperaments-evaluated-with-the-temps-a-scale-a-systematic-review
#16
Gustavo H Vázquez, Xenia Gonda, María Lolich, Leonardo Tondo, Ross J Baldessarini
BACKGROUND: Among risk factors for suicidal behavior, there is growing interest in associations with stable affective temperament types, particularly based on assessment with the TEMPS-A self-rating scale. AIM: As research on this topic has not been reviewed systematically, we synthesized relevant, reported research findings. METHODS: Systematic searching identified peer-reviewed reports pertaining to associations of suicidal behavior or ideation with affective temperament types evaluated with TEMPS-A...
January 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29303917/clinical-and-environmental-risk-factors-for-bipolar-disorder-review-of-prospective-studies
#17
Ciro Marangoni, Gianni L Faedda, Ross J Baldessarini
After participating in this activity, learners should be better able to:• Evaluate factors that have been identified in prospective studies as predicting the onset of bipolar disorder ABSTRACT: The prodromal phase of bipolar disorder (BD) remains incompletely characterized, limiting early detection of BD and delaying interventions that might limit future morbidity and disability. Retrospective and family-risk studies have consistently found evidence of prodromal psychopathology in subjects later diagnosed with BD...
January 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/28437359/what-s-in-a-med-check-unpacking-the-psychopharmacology-encounter
#18
Justin A Chen, Nicholas Kontos, Scott N Wilson
No abstract text is available yet for this article.
January 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29117025/heads-up-the-presentation-of-schizoaffective-disorder-in-an-elite-college-soccer-player-with-prior-concussion
#19
Solomon J Adelsky, Simon Ducharme, Emily K Wilner, Benjamin Yudkoff, Simon Lejeune
No abstract text is available yet for this article.
November 2017: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29117024/behavioral-genetics-in-criminal-and-civil-courts
#20
Maya Sabatello, Paul S Appelbaum
Although emerging findings in psychiatric and behavioral genetics create hope for improved prevention, diagnosis, and treatment of disorders, the introduction of such data as evidence in criminal and civil proceedings raises a host of ethical, legal, and social issues. Should behavioral and psychiatric genetic data be admissible in judicial proceedings? If so, what are the various means for obtaining such evidence, and for what purposes should its admission be sought and permitted? How could-and should-such evidence affect judicial outcomes in criminal and civil proceedings? And what are the potential implications of using behavioral and psychiatric genetic evidence for individuals and communities, and for societal values of equality and justice? This article provides an overview of the historical and current developments in behavioral genetics...
November 2017: Harvard Review of Psychiatry
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