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first responder ptsd

Debra A Bangasser, Brittany Wicks
Posttraumatic stress disorder and major depression share stress as an etiological contributor and are more common in women than in men. Traditionally, preclinical studies investigating the neurobiological underpinnings of stress vulnerability have used only male rodents; however, recent studies that include females are finding sex-specific mechanisms for responding to stress. This Mini-Review examines recent literature using a framework developed by McCarthy and colleagues (2012; J Neurosci 32:2241-2247) that highlights different types of sex differences...
January 2, 2017: Journal of Neuroscience Research
Antonia N Kaczkurkin, Philip C Burton, Shai M Chazin, Adrienne B Manbeck, Tori Espensen-Sturges, Samuel E Cooper, Scott R Sponheim, Shmuel Lissek
OBJECTIVE: Heightened generalization of fear from an aversively reinforced conditioned stimulus (CS+, a conditioned danger cue) to resembling stimuli is widely accepted as a pathogenic marker of posttraumatic stress disorder (PTSD). Indeed, a distress response to benign stimuli that "resemble" aspects of the trauma is a central feature of the disorder. To date, the link between overgeneralization of conditioned fear and PTSD derives largely from clinical observations, with limited empirical work on the subject...
October 31, 2016: American Journal of Psychiatry
Patricia Pilkinton, Carlos Berry, Seth Norrholm, Al Bartolucci, Badari Birur, Lori L Davis
OBJECTIVE: Selective serotonin reuptake inhibitors (SSRIs) remain the first-line treatment for posttraumatic stress disorder (PTSD). However, adjunctive atypical antipsychotics are often used to target residual or refractory symptoms. Asenapine is a novel atypical antipsychotic that possesses a high serotonin (5-HT2A) to dopamine (D2) affinity ratio and alpha-adrenergic antagonism, which may be advantageous in treating PTSD. This pilot study aimed to identify the therapeutic potential of asenapine as an adjunctive treatment for PTSD...
August 15, 2016: Psychopharmacology Bulletin
Mark Goodhew, Allison M Salmon, Christina Marel, Katherine L Mills, Marianne Jauncey
The Sydney Medically Supervised Injecting Centre (MSIC) is a supervised injecting facility (SIF) where people who inject drugs (PWID) can do so legally, under health professional supervision. The majority of clients have low levels of education and employment, high rates of incarceration and unstable housing and poor social networks, and 70 % do not access local health services. These factors increase the risk of poor mental health, and it has been documented that PWID have elevated rates of mood, anxiety, personality and psychotic disorders; post-traumatic stress disorder (PTSD); and higher rates of trauma exposure, suicidality and self-harm...
October 12, 2016: Harm Reduction Journal
Martin J Dorahy, Roberto Lewis-Fernández, Christa Krüger, Bethany L Brand, Vedat Şar, Jan Ewing, Alfonso Martínez-Taboas, Pam Stavropoulos, Warwick Middleton
Controversy exists regarding the merits of exposure-based treatments for posttraumatic stress disorder (PTSD) versus a phased approach when prominent dissociative symptoms are present. The first aim of this study was to examine the degree to which diagnosing dissociation in two traumatized patients' vignettes influenced clinicians' preference for phase-oriented treatment and whether clinicians' treatment experience contributed to their treatment preference. The second aim was to assess the extent to which participants had observed traumatized patients worsen when treated with exposure therapy or phase-oriented therapy and whether the theoretical orientation and treatment experience of the clinician were related to the observed deterioration...
September 27, 2016: Journal of Trauma & Dissociation
Sarah R Horn, Robert H Pietrzak, Clyde Schechter, Evelyn J Bromet, Craig L Katz, Dori B Reissman, Roman Kotov, Michael Crane, Denise J Harrison, Robin Herbert, Benjamin J Luft, Jacqueline M Moline, Jeanne M Stellman, Iris G Udasin, Philip J Landrigan, Michael J Zvolensky, Steven M Southwick, Adriana Feder
Posttraumatic stress disorder (PTSD) is a debilitating and often chronic psychiatric disorder. Following the 9/11/2001 World Trade Center (WTC) attacks, thousands of individuals were involved in rescue, recovery and clean-up efforts. While a growing body of literature has documented the prevalence and correlates of PTSD in WTC responders, no study has evaluated predominant typologies of PTSD in this population. Participants were 4352 WTC responders with probable WTC-related DSM-IV PTSD. Latent class analyses were conducted to identify predominant typologies of PTSD symptoms and associated correlates...
September 2, 2016: Journal of Psychiatric Research
Laurel Hourani, Stephen Tueller, Paul Kizakevich, Gregory Lewis, Laura Strange, Belinda Weimer, Stephanie Bryant, Ellen Bishop, Robert Hubal, James Spira
The objective of this pilot study was to design, develop, and evaluate a predeployment stress inoculation training (PRESIT) preventive intervention to enable deploying personnel to cope better with combat-related stressors and mitigate the negative effects of trauma exposure. The PRESIT program consisted of three predeployment training modules: (1) educational materials on combat and operational stress control, (2) coping skills training involving focused and relaxation breathing exercises with biofeedback, and (3) exposure to a video multimedia stressor environment to practice knowledge and skills learned in the first two modules...
September 2016: Military Medicine
Michelle D Sherman, Jenna L Gress Smith, Kristy Straits-Troster, Jessica L Larsen, Abigail Gewirtz
Although considerable research has examined the impact of posttraumatic stress disorder (PTSD) on couples and partners, relatively little is known about how it can affect parenting, children, and the parent-child relationship. Although adverse effects of parental PTSD on child functioning have been documented, the processes by which these outcomes occur are unknown. Further, parents' perspectives of how their PTSD affects parenting and children have yet to be studied. This 3-site, mixed methods exploratory study included 19 veteran parents who had a diagnosis of PTSD...
July 21, 2016: Psychological Services
Anthony Walker, Andrew McKune, Sally Ferguson, David B Pyne, Ben Rattray
BACKGROUND: First responders and military personnel experience rates of post-traumatic stress disorder (PTSD) far in excess of the general population. Although exposure to acute traumatic events plays a role in the genesis of these disorders, in this review, we present an argument that the occupational and environmental conditions where these workers operate are also likely contributors. PRESENTATION OF THE HYPOTHESIS: First responders and military personnel face occupational exposures that have been associated with altered immune and inflammatory activity...
2016: Extreme Physiology & Medicine
Florian Duclot, Iara Perez-Taboada, Katherine N Wright, Mohamed Kabbaj
Only a portion of the population exposed to trauma will develop persistent emotional alterations characteristic of posttraumatic stress disorder (PTSD), which illustrates the necessity for identifying vulnerability factors and novel pharmacotherapeutic alternatives. Interestingly, clinical evidence suggests that novelty seeking is a good predictor for vulnerability to the development of excessive and persistent fear. Here, we first tested this hypothesis by analyzing contextual and cued fear responses of rats selected for their high (high responders, HR) or low (low responders, LR) exploration of a novel environment, indicator of novelty seeking...
October 2016: Neuropharmacology
Eric A Dedert, Terrell A Hicks, Paul A Dennis, Patrick S Calhoun, Jean C Beckham
Existing models of the role of posttraumatic stress disorder (PTSD) symptoms and smoking have almost exclusively examined mean symptom levels, rather than the acute elevations that might trigger smoking lapse immediately or increase risk of a smoking lapse in the next few hours. We examined ecological momentary assessments (EMA) of PTSD symptom clusters and smoking in the first week of a quit attempt in 52 people with PTSD. In multilevel models including PTSD symptom means, acute elevations, and lagged acute elevations together as simultaneous predictors of odds of smoking in the same models, pre-quit smoking occasions were significantly related to acute elevations in symptoms, including PTSD totals (OR=1...
September 2016: Addictive Behaviors
John C Crabbe, Jason P Schlumbohm, Wyatt Hack, Amanda M Barkley-Levenson, Pamela Metten, K Matthew Lattal
The comorbidity of substance- and alcohol-use disorders (AUD) with other psychiatric conditions, especially those related to stress such as post-traumatic stress disorder (PTSD), is well-established. Binge-like intoxication is thought to be a crucial stage in the development of the chronic relapsing nature of the addictions, and self-medication through binge-like drinking is commonly seen in PTSD patients. We have selectively bred two separate High Drinking in the Dark (HDID-1 and HDID-2) mouse lines to reach high blood ethanol concentrations (BECs) after a 4-h period of access to 20% ethanol starting shortly after the onset of circadian dark...
May 2016: Alcohol
Risë B Goldstein, Sharon M Smith, S Patricia Chou, Tulshi D Saha, Jeesun Jung, Haitao Zhang, Roger P Pickering, W June Ruan, Boji Huang, Bridget F Grant
OBJECTIVES: To present current, nationally representative US findings on the past-year and lifetime prevalences, sociodemographic correlates, psychiatric comorbidity, associated disability, and treatment of DSM-5 posttraumatic stress disorder (PTSD). METHODS: Face-to-face interviews with 36,309 adults in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. PTSD, alcohol and drug use disorders, and selected mood, anxiety, and personality disorders were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5...
August 2016: Social Psychiatry and Psychiatric Epidemiology
Natalie E Hundt, Juliette M Harik, Terri L Barrera, Jeffrey A Cully, Melinda A Stanley
OBJECTIVE: The purpose of this study was to assess how patient and provider factors influence the use of evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD). METHOD: This study used a 2 × 2 survey design to assess providers' willingness to select EBPs for patients presented in clinical case vignettes. PTSD providers (N = 185) were randomized and asked to respond to 1 of 4 case vignettes in which the patients' age and alcohol use comorbidity were manipulated...
April 11, 2016: Psychological Trauma: Theory, Research, Practice and Policy
John J McGrath, Sukanta Saha, Ali Al-Hamzawi, Laura Andrade, Corina Benjet, Evelyn J Bromet, Mark Oakley Browne, Jose M Caldas de Almeida, Wai Tat Chiu, Koen Demyttenaere, John Fayyad, Silvia Florescu, Giovanni de Girolamo, Oye Gureje, Josep Maria Haro, Margreet Ten Have, Chiyi Hu, Viviane Kovess-Masfety, Carmen C W Lim, Fernando Navarro-Mateu, Nancy Sampson, José Posada-Villa, Kenneth S Kendler, Ronald C Kessler
OBJECTIVE: While it is now recognized that psychotic experiences are associated with an increased risk of later mental disorders, we lack a detailed understanding of the reciprocal time-lagged relationships between first onsets of psychotic experiences and mental disorders. Using data from World Health Organization World Mental Health (WMH) Surveys, the authors assessed the bidirectional temporal associations between psychotic experiences and mental disorders. METHOD: The WMH Surveys assessed lifetime prevalence and age at onset of psychotic experiences and 21 common DSM-IV mental disorders among 31,261 adult respondents from 18 countries...
March 17, 2016: American Journal of Psychiatry
Claudia Carmassi, Camilla Gesi, Marly Simoncini, Luca Favilla, Gabriele Massimetti, Maria Cristina Olivieri, Ciro Conversano, Massimo Santini, Liliana Dell'Osso
The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) has recently recognized a particular risk for posttraumatic stress disorder (PTSD) among first responders (criterion A4), acknowledging emergency units as stressful places of employment. Little data is yet available on DSM-5 among emergency health operators. The aim of this study was to assess DSM-5 symptomatological PTSD and posttraumatic stress spectrum, as well as their impact on work and social functioning, in the emergency staff of a major university hospital in Italy...
2016: Neuropsychiatric Disease and Treatment
Howard Burdett, Nicola T Fear, Norman Jones, Neil Greenberg, Simon Wessely, Roberto J Rona
Two-phase mental health screening methods, in which an abridged mental health measure is used to establish who should receive a more comprehensive assessment, may be more efficient and acceptable to respondents than a stand-alone complete questionnaire. Such two-phase methods are in use in US armed forces post-deployment mental health screening. This study assesses the sensitivity and specificity of abridged instruments (used in the first phase) compared to the full instruments (the second phase), and whether false negative cases resulting from the use of abridged tests were detected by another test, among a UK military screening sample...
September 2016: International Journal of Methods in Psychiatric Research
Ian H Stanley, Melanie A Hom, Thomas E Joiner
First responders-police officers, firefighters, emergency medical technicians (EMTs), and paramedics-experience significant job-related stressors and exposures that may confer increased risk for mental health morbidities (e.g., posttraumatic stress disorder [PTSD], suicidal thoughts and behaviors) and hastened mortality (e.g., death by suicide). Inherent in these occupations, however, are also factors (e.g., camaraderie, pre-enlistment screening) that may inoculate against the development or maintenance of psychiatric conditions...
March 2016: Clinical Psychology Review
Michelle Firestone, Janet Smylie, Sylvia Maracle, Constance McKnight, Michael Spiller, Patricia O'Campo
OBJECTIVES: Mental health and substance use have been identified as health priorities currently facing Indigenous peoples in Canada; however, accessible and culturally relevant population health data for this group are almost non-existent. The aim of the Our Health Counts study was to generate First Nations adult population health data in partnership with the De dwa da dehs ney>s Aboriginal Health Access Centre in Hamilton, Ontario. METHODS: Analysis involved data gathered through respondent-driven sampling...
September 2015: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Shkelzen Elezaj, Zafer Gashi, Afrim Zeqiraj, Driton Grabanica, Anton Shllaku, Bujar Gruda, Vesel Musaj
OBJECTIVE: Our objective was to determine the effect of PTSD on changing the quality of sperm in veterans with PTSD, and the percentage of successful procedures intrauterine insemination (IUI) as a first-line treatment of male infertility patients with post-traumatic stress disorder (PTSD). PATIENTS AND METHODS: The study is designed as a prospective observational study. The study was started from February 2013 until May of 2014. Our study included a total of 51 patients who were treatment for infertility in private Hospital for gynecology, endocrinology and infertility, IVF Center in Peja, and those who were outpatients treated for chronic PTSD in the Polyclinic, Biolab-Zafi, in Klina the Republic of Kosovo...
October 2015: Medical Archives
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