Search

Current pharmacological treatments against post-traumatic stress disorder (PTSD) lack adequate efficacy. As a result, intense research has focused on identifying other molecular pathways mediating the pathogenesis of this condition. One such pathway is neuroinflammation, which has demonstrated a role in PTSD pathogenesis by causing synaptic dysfunction, neuronal death, and functional impairment in the hippocampus. Phosphodiesterase (PDE) inhibitors (PDEIs) have emerged as promising therapeutic agents against neuroinflammation in other neurological conditions. Furthermore, PDEIs have shown some promise in animal models of PTSD. However, the current model of PTSD pathogenesis, which is based on dysregulated fear learning, implies that PDE inhibition in neurons should enhance the acquisition of fear memory from the traumatic event. As a result, we hypothesized that PDEIs may improve PTSD symptoms through inhibiting neuroinflammation rather than long-term potentiation-related mechanisms. To this end, we tested the therapeutic efficacy of cilostazol, a selective inhibitor of PDE3, on PTSD-related anxiety symptoms in the underwater trauma model of PTSD. PDE3 is expressed much more richly in microglia and astrocytes compared to neurons in the murine brain. Furthermore, we used hippocampal indolamine 2,3-dioxygenase 1 (IDO) expression and interleukin 1 beta (IL-1β) concentration as indicators of neuroinflammation. We observed that cilostazol pretreatment prevented the development of anxiety symptoms and the increase in hippocampal IDO and IL-1β following PTSD induction. As a result, PDE3 inhibition ameliorated the neuroinflammatory processes involved in the development of PTSD symptoms. Therefore, cilostazol and other PDEIs may be promising candidates for further investigation as pharmacological therapies against PTSD. [ABSTRACT FROM AUTHOR]

Purpose: Public safety personnel (PSP) perform work that puts them at greater risk of psychological injury than the general public. PSP who subsequently develop posttraumatic stress disorder (PTSD) or other mental health conditions may need to take time off of work and use the workers compensation system. Very little is known about the experiences of PSP making this type of claim in Ontario to the Workplace Safety and Insurance Board (WSIB), or which healthcare professionals (HCP) PSP access as part of the treatment and return to work (RTW) process. This study captures the experiences of Ontario PSP in their RTW journeys, including with employers, WSIB, and HCPs. Methods: A survey-based study was conducted, using email and social media platforms to distribute the survey to PSP across Ontario. Quantitative data were summarized using means and frequencies, and open text results were analyzed using qualitative framework analysis. Results: 145 survey respondents met the inclusion criteria for the study. On a scale out of 5, PSP rated their experience with WSIB and employer support as poor on their first RTW attempt with an average rating of 2.93 and 2.46 respectively. The top three HCPs accessed by PSP were psychologists (61%), occupational therapists (OT; 60%) and general practitioners (GP; 44%). Respondents identified the cultural competence of HCPs in understanding their work demands and work culture as very important. Conclusions: To improve RTW experiences for PSP who make a workers compensation claim for a psychological injury, an increase in HCP cultural competence related to PSP work is indicated, as well as improved RTW processes and workplace support. [ABSTRACT FROM AUTHOR]

Purpose: Posttraumatic stress disorder (PTSD) and depression are strong predictors of poor health-related quality of life (HRQOL) among injured U.S. military service members (SMs). Patterns of HRQOL between injury categories and injury categories stratified by mental health (MH) symptoms have not been examined. Among deployment-injured SMs and veterans (n = 4353), we examined HRQOL and screening data for PTSD and/or depression within specific injury categories. Methods: Participants included those enrolled in the Wounded Warrior Recovery Project with complete data for HRQOL (SF-36) from June 2017 to May 2020. Injuries were categorized using the Barell Injury Diagnosis Matrix (Barell Matrix). Mean physical component summary (PCS) and mental component summary (MCS) scores were calculated for each injury category and stratified by the presence or absence of probable PTSD and/or depression. Results: The average follow-up time that participants were surveyed after injury was 10.7 years. Most participants were male, non-Hispanic White, served in the Army, and enlisted rank. Mechanism of injury for 77% was blast-related. Mean PCS and MCS scores across the entire sample were 43.6 (SD = 10.3) and 39.5 (SD = 13.3), respectively; 50% screened positive for depression and/or PTSD. PCS and MCS scores were significantly lower within each injury category among individuals with probable PTSD and/or depression than those without. Conclusion: Among deployment-injured SMs, those with probable PTSD and/or depression reported significantly lower HRQOL within injury categories and HRQOL component (i.e., physical or mental) than those without. Findings are consistent with prior reports showing mental health symptoms to be strongly associated with lower HRQOL and suggest integration of mental health treatment into standard care practices to improve long-term HRQOL. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate symptomatology and diagnoses of PTSD and subthreshold PTSD and the screening properties of the Harvard Trauma Questionnaire (HTQ) within a sample of Dari-speaking women of refugee background receiving antenatal care. This cross-sectional study administered the HTQ to 52 Dari-speaking women at a public pregnancy clinic. The trauma module from the Structured Clinical Interview (SCID-5) was administered. Interview material was presented to an expert panel, blinded to the HTQ screening results, in order to achieve consensus diagnoses of PTSD using Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) criteria. Three women (5.8%) met DSM-5 criteria for PTSD. Eleven women (21.15%) met criteria for subthreshold PTSD, defined as meeting two or three of the DSM-5 criteria domains. A comparison of HTQ cut-off scores was conducted and a score of ≥ 2.25 on the HTQ demonstrated excellent sensitivity 1.00 (95% CI 0.29–1.00) and specificity 0.76 (95% CI 0.61–0.87) in detecting PTSD; however, a wide confidence interval for sensitivity was found. A cut-off score of ≥ 2 provided the best balance of sensitivity 1.00 (95% CI 0.72–1.00) and specificity 0.80 (95% CI 0.65–0.91) when assessing for subthreshold PTSD. Screening for perinatal PTSD for women of refugee background is recommended, in order to identify those at risk of DSM diagnosis and also those women experiencing distressing PTSD symptomatology. [ABSTRACT FROM AUTHOR]

To investigate factors associated with quality of life (QoL) and disaster-related psychiatric disorders, including posttraumatic stress disorder (PTSD) and major depressive episode (MDE), in the survivors of a gas explosion in Taiwan 5 years after the event. A community-based cross-sectional study of residents from an area that experienced a gas explosion was conducted 5 years after the event. The Short Form 12v2 (SF-12v2) was used to screen 2511 participants. The Disaster-Related Psychological Screening Test (DRPST) was used to assess probable MDE and PTSD. A total of 2511 participants, including 604 males and 1907 females, completed the QoL survey. The average age was 56.02 ± 16.78 years, and most participants were in the ≧65 age group (39.7%). The males had better QoL in the physical dimensions. Lifestyle was significantly positively associated with QoL. A total of 894 participants completed the DRPST, which showed some individuals with probable MDE (n = 93, 10.4%), probable PTSD (n = 22, 2.5%), or probable MDE and PTSD (n = 49, 5.5%); most people had no MDE or PTSD (n = 730, 81.7%). Those in the probable PTSD or MDE groups were significantly more likely to be female or to be experiencing stressors (p < 0.001). The participants continued to be affected by the disaster based on their QoL, even 5 years later. Females had a higher risk of probable psychiatric disorders and poorer QoL in the physical dimensions. Long-term follow-up, interventions and investigations after a disaster are needed. [ABSTRACT FROM AUTHOR]

To synthesize literature addressing maternal distress and associated variables in response to infant hospitalization in the NICU. CINAHL, Medline, PubMed, PsychINFO, and Scopus were searched for studies addressing maternal distress during NICU hospitalization published between January 2009 and August 2019. The initial literature search yielded 862 articles. Articles were included for analysis if (a) they were peer-reviewed, (b) maternal distress was defined or measured, and (c) maternal distress occurred in the NICU. Ultimately, 33 articles were included for analysis. Distress symptoms were not consistently measured across the literature by one specific instrument. However, despite the variety of instruments, distress was prevalent in this population. Individual elements of maternal distress in the NICU include depression, anxiety, trauma, and post-traumatic stress symptoms. These elements often occur together and tend to follow a specific trajectory during hospitalization. This body of literature was inconsistent regarding the timing of distress measurement as well as the relationship between relevant associated variables (e.g., marital status or infant illness severity) and maternal distress. Additionally, researchers often excluded mothers of non-preterm infants and infants with congenital anomalies from investigation. Researchers and clinicians should carefully consider timing and instrumentation in their interpretations of maternal distress measurement during a NICU hospitalization. Future work should focus on developing a comprehensive, valid, and reliable screening tool for clinicians and researchers to use to identify maternal distress in the NICU. Additionally, future research should address gaps in the populations included in studies. [ABSTRACT FROM AUTHOR]

Background: The objective is to pilot test the feasibility of assessing severity of posttraumatic stress disorder (PTSD) symptoms, as well as specific lower-order PTSD symptoms, experienced during neurological intensive care unit (neuro-ICU) admission and their relationship with 3-month quality of life (QoL) scores in multiple domains (i.e., physical, psychological, social, and environmental) in both patients and caregivers. Methods: Between 2015 and 2016, we enrolled neurologically intact patients and informal caregivers of patients who reported demographics and PTSD symptoms (PTSD Checklist-Specific; PCL-S) during neuro-ICU admission and completed a QoL assessment (World Health Organization Quality of Life; WHOQOL-BREF) 3 months later. Clinical data were extracted from medical records. We ran two bivariate correlation matrices among PTSD symptom dimensions in patients and caregivers. Then, we used multiple linear regression to examine the prospective association of total PCL-S scores with each QoL domain in both patients and caregivers after adjusting for clinically important variables. Next, we explored differential associations between the 4 PTSD symptom dimensions and each QoL domain in both patients and caregivers, adjusting for sex and age. Results: A total of 70 patients (45.7% women, 84.3% white, mean age 52.08 years) and 64 caregivers (64.1% women, 90.6% white, mean age 53.12 years) were included. PTSD symptom dimensions were moderately strongly correlated among patients (r = 0.65–0.79, p < 0.001) and caregivers (r = 0.55–0.78, p < 0.001). For both patients and caregivers, greater PTSD symptom severity was prospectively associated with lower QoL in all domains (β = − 0.289 to − 0.622; p < 0.05). Our exploratory analysis revealed that greater numbing symptoms were associated with lower psychological QoL in patients (β: − 0.397, p = 0.038), and lower physical (β: − 0.409, p = 0.014), psychological (β: − 0.519, p = 0.001), and social QoL (β: − 0.704, p < 0.001) in caregivers. Greater re-experiencing symptoms were associated with lower physical QoL in both patients (β: − 0.422, p = 0.047) and caregivers (β: − 0.4, p = 0.041). Conclusions: Our preliminary results indicated that greater severity of PTSD symptoms, and specifically numbing and re-experiencing symptoms, experienced by patients and caregivers during neuro-ICU admission was predictive of worse 3-month QoL. Continued study is needed to identify treatment targets for PTSD and QoL in this population. [ABSTRACT FROM AUTHOR]

We sought to develop a quality standard for the prescription of antidepressants for posttraumatic stress disorder (PTSD) that is both consistent with the underlying evidence supporting antidepressants as a treatment for PTSD and associated with the best levels of symptom improvement. We quantified antidepressant initiation during the first year of PTSD treatment in a 10-year national cohort of Department of Veterans Affairs (VA) users, and compared outcomes in a subgroup who completed patient-reported outcome measurement (PROM) as part of routine practice. We added progressively stringent measurement requirements. Prescribing quality for PTSD in the VA was stable over time. Use of PROM was rare in the case of antidepressant treatment, limiting our assessment of outcomes. [ABSTRACT FROM AUTHOR]

We sought to develop a quality standard for the delivery of psychotherapy for posttraumatic stress disorder (PTSD) that is both consistent with the underlying evidence supporting psychotherapy as a treatment for PTSD and associated with the best levels of symptom improvement. We quantified psychotherapy receipt during the initial year of PTSD treatment in a 10-year national cohort of Department of Veterans Affairs (VA) users who completed patient-reported outcome measurement as part of routine practice. We added progressively stringent measurement requirements. The most stringent requirement was associated with superior outcomes. Quality of psychotherapy for PTSD in the VA improved over time. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Acupuncture & Tuina Science is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Terrorist attacks and mass shootings often involve youth. Knowledge is needed on how this may impact their health and functioning. This study investigates perceived academic performance and school wellbeing in 237 terror-exposed survivors of the Utøya youth camp attack according to their sociodemographic characteristics, health and mental health service (MHS) utilization. Semi-structured interviews were conducted after 4-5 and 14-15 months. The year following the attack, 143 (61%) survivors reported impaired academic performance and 66 (29%) impaired school wellbeing. Female survivors more often reported impaired performance. Non-Norwegian origin, being financially disadvantaged and less social support were associated with impaired wellbeing. Sleep problems, posttraumatic stress, anxiety/depression, somatic symptoms, and lower life satisfaction were associated with both impaired performance and impaired wellbeing. Survivors who had received MHS were more likely to report impaired or improved academic performance and school wellbeing. Higher age and posttraumatic stress reactions were associated with impaired academic performance after multivariate logistic regression adjustments for gender, somatic symptoms and social support. When additionally adjusting for impaired school wellbeing, age and impaired wellbeing were associated with impaired performance. Only posttraumatic stress reactions were associated with impaired wellbeing after similar adjustments. Non-Norwegian origin and being financially disadvantaged were not significantly associated with impaired wellbeing after adjusting for posttraumatic stress reactions, age and gender. Our findings demonstrate how a terrorist attack can considerably deteriorate young survivors' performance and wellbeing at school, which is associated with poorer health. Consequently, it is important to provide appropriate school support, and coordinate MHS with follow-up at school. [ABSTRACT FROM AUTHOR]

Objective: To observe the effect of liver-soothing and mind-regulating acupuncture method on the resting-state electroencephalography (EEG) in rats with post-traumatic stress disorder (PTSD), and to provide evidence for the effect mechanism study and clinical application of acupuncture intervention for PTSD.Methods: Sixty Sprague-Dawley (SD) rats were randomly divided into a blank control group, a model group, a grasping group, a paroxetine group and an acupuncture group, with 12 rats in each group. Except for rats in the blank control group, rats in the other groups were subjected to preparing the PTSD models using ‘incarceration plus electric shock’ method. After interventions, changes in rat behavior of each group were observed; changes in resting-state EEG were collected and analyzed with multichannel EEG acquisition and analysis system, and image analysis and statistical processing were performed.Results: Compared with the blank control group, the average escape latency in the model group was significantly longer (P<0.05), and the times of crossing the platform and the effective areas were all significantly reduced (P<0.01). Compared with the grasping group, the average escape latencies in the paroxetine group and acupuncture group were significantly shortened (P<0.05), and the times of crossing the platform and the effective areas were all significantly increased (P<0.05). There were no significant differences in the average escape latency, the times of crossing the platform and the effective areas between the acupuncture group and paroxetine group (all P>0.05). Compared with the blank control group, the α-wave power spectrum value in the model group was significantly decreased, and the power spectrum values of β-wave, δ-wave and э-wave were significantly increased (all P<0.01); compared with the grasping group, α-wave power spectrum values in the paroxetine group and acupuncture group were significantly increased (both P<0.01), and the power spectrum values of β-wave, δ-wave and э-wave were decreased significantly (all P<0.01). The power spectrum values of α-wave, β-wave, δ-wave and э-wave of rats in the acupuncture group were not significantly different from those in the paroxetine group (all P>0.05).Conclusion: Liver-soothing and mind-regulating acupuncture method can significantly improve the abnormal EEG activity in PTSD rats, which may be one mechanism of liver-soothing and mind-regulating acupuncture method in effectively affecting the brain function in PTSD rats. [ABSTRACT FROM AUTHOR]

In the last decade, it has become clear that the neuropeptide 'ghrelin' and its principal receptor have a large impact on anxiety and stress. Our recent studies have uncovered a link between plasma butyrylcholinesterase (BChE) and ghrelin. BChE actually turns out to be the key regulator of this peptide. This article reviews our recent work on manipulating ghrelin levels in mouse blood and brain by long term elevation of BChE, leading to sustained decrease of ghrelin. That effect in turn was found to reduce stress-induced aggression in group caged mice. Positive consequences were fewer bite wounds and longer survival times. No adverse effects were observed. Further exploration may pave the way for BChE-based treatment of anxiety in humans. [ABSTRACT FROM AUTHOR]

The present study aimed to utilize a Receiver Operating Characteristic (ROC) approach in order to improve clinical decision-making for adolescents at risk for the development of psychopathology in the aftermath of a natural disaster. Specifically we assessed theoretically-driven individual, interpersonal, and event-related vulnerability factors to determine which indices were most accurate in forecasting PTSD. Furthermore, we aimed to translate these etiological findings by identifying clinical cut-off recommendations for relevant vulnerability factors. Our study consisted of structured phone-based clinical interviews with 2000 adolescent-parent dyads living within a 5-mile radius of tornados that devastated Joplin, MO, and northern Alabama in Spring 2011. Demographics, tornado incident characteristics, prior trauma, mental health, and family support and conflict were assessed. A subset of youth completed two behavioral assessment tasks online to assess distress tolerance and risk-taking behavior. ROC analyses indicated four variables that significantly improved PTSD diagnostic efficiency: Lifetime depression (AUC = .90), trauma history (AUC = .76), social support (AUC = .70), and family conflict (AUC = .72). Youth were 2-3 times more likely to have PTSD if they had elevated scores on any of these variables. Of note, event-related characteristics (e.g., property damage) were not related to PTSD diagnostic status. The present study adds to the literature by making specific recommendations for empirically-based, efficient disaster-related PTSD assessment for adolescents following a natural disaster. Implications for practice and future trauma-related developmental psychopathology research are discussed. [ABSTRACT FROM AUTHOR]

During intensive care treatment patients suffer from various forms of stress. Certain psychological and psychotherapeutic interventions (e. g. cognitive behavior therapy, hypnotherapy and psychoeducation) can provide relief. Even patients with a severely reduced ability to communicate can benefit from an early psychological intervention as supportive treatment. The aim of these interventions is to reduce psychological impairments and burdens, provide strategies for coping with physical handicaps or necessary treatment and avoid long-term negative psychological impacts. Organizational and institutional constraints as well as emotional stress are a specific challenge for intensive care personnel. In order to guarantee an efficient collaboration within an interdisciplinary team it is vital to follow clearly defined methods of communication exchange, such as daily ward rounds, regular multidisciplinary meetings and team or case-focused supervision. Properly functioning teamwork increases job satisfaction and is the key to an optimal therapy for the patients. [ABSTRACT FROM AUTHOR]

Purpose: To systematically compare specific domains of quality of life and social support as they pertain to the full trauma spectrum of (i) healthy individuals, (ii) those with ongoing post-traumatic stress disorder (PTSD), (iii) remitted PTSD, or (iv) those who failed to develop PTSD in spite of trauma exposure. Methods: Data were from the first wave of a psychiatric epidemiological catchment area study based in Montreal, Canada ( N = 2 433). PTSD diagnosis, quality of life, and social support outcomes were established by face-to-face structured interviews using standardized instruments. Outcomes were compared across the four groups. Results: Although the between-group contrasts suggested that those currently suffering from PTSD generally had a poorer quality of life across domains, the group in remission from PTSD did not. Exploratory analyses concerning subscales for quality of life showed particular impairments for specific domains dependent on PTSD diagnosis, with remitted and ongoing PTSD showing significantly different quality of life for subscales such as daily life/social relationships, spare time activities and autonomy, but similar scores for subscales of housing/neighborhood and personal relationships. Contrary to most previous findings, individuals suffering from PTSD did not report lower overall social support. Conclusions: For both outcomes of quality of life and social support, longitudinal research is required to fully understand these complex relationships as they evolve along the full trauma spectrum. [ABSTRACT FROM AUTHOR]

The association between stress and cancer incidence has been studied for more than seven decades. Despite plausible biological mechanisms and evidence from laboratory studies, findings from clinical research are conflicting. The objective of this study was to examine the association between PTSD and various cancer outcomes. This nation-wide cohort study included all Danish-born residents of Denmark from 1995 to 2011. The exposure was PTSD diagnoses ( n = 4131). The main outcomes were cancer diagnoses including: (1) all malignant neoplasms; (2) hematologic malignancies; (3) immune-related cancers; (4) smoking- and alcohol-related cancers; (5) cancers at all other sites. Standardized incidence ratios (SIR) were calculated. Null associations were found between PTSD and nearly all cancer diagnoses examined, both overall [SIR for all cancers = 1.0, 95 % confidence interval (CI) = 0.88, 1.2] and in analyses stratified by gender, age, substance abuse history and time since PTSD diagnosis. This study is the most comprehensive examination to date of PTSD as a predictor of many cancer types. Our data show no evidence of an association between PTSD and cancer in this nationwide cohort. [ABSTRACT FROM AUTHOR]

Quality of life is frequently impaired among survivors of critical illness, and psychiatric morbidity is an important element contributing to poor quality of life in these patients. Among potential manifestations of psychiatric morbidity following critical illness, symptoms of posttraumatic stress are prevalent and intricately linked to the significant stressors present in the intensive care unit (ICU). As our understanding of the epidemiology of post-ICU posttraumatic stress disorder improves, so must our ability to identify those at highest risk for symptoms in the period of time following critical illness and our ability to implement strategies to prevent symptom development. In addition, a focus on strategies to address clinically apparent psychiatric morbidity will be essential. Much remains to be understood about the identification, prevention, and management of this significant public health problem. This article addresses the importance of uniformity in future epidemiologic studies, proposes framing of risk factors into those likely to be modifiable versus non-modifiable, and provides an assessment of modifiable risk factors in the context of a novel conceptual model that offers insight into potential strategies to attenuate symptoms of posttraumatic stress among survivors of critical illness. [ABSTRACT FROM AUTHOR]

Posttraumatic stress disorder (PTSD) affects a minority of trauma-exposed persons and is associated with significant impairment. This longitudinal study examined risk factors for PTSD. We tested whether the presence of injuries resulting from trauma exposure predicted the course of PTSD symptoms. In addition, we tested whether gender, trauma type, perceived life threat, and peritraumatic dissociation predicted the onset of PTSD symptoms. 236 trauma-exposed civilians were assessed for PTSD symptoms with a structured interview at four occasions during 6 months posttrauma. Path analysis showed that a model in which the female gender, assault, perceived life threat, and peritraumatic dissociation predicted PTSD severity at 1 week, and injury predicted PTSD severity 8 weeks after the traumatic event showed the best fit. However, a similar model without injury showed comparable fit. It is concluded that injuries have a negligible effect on the course of PTSD. [ABSTRACT FROM AUTHOR]

Tooth clenching, more than tooth grinding, is considered one of the most detrimental oral parafunctional activities and has been implicated as an important factor in the etiology and maintenance of temporomandibular disorders (TMD). This frequent parafunctional behavior is of major concern to dentists because of its possible consequences on the different components of the stomatognathic system as excessive occlusal forces are able to cause dental restoration and/or hard dental tissue breakdown (wear, cracks), periodontal breakdown (mobility) or TMD. The aim of this paper was to present a synthesis of recent publications (published during the last 10 years) dealing with some aspects of tooth clenching and its relationship to TMD: methods for the evaluation of tooth clenching, epidemiological data, effect of tooth clenching on the temporomandibular joint (TMJ) and the masticatory muscles, relationship between tooth clenching, stress and psychological factors and biological function of tooth clenching. A search in the National Library of Medicine PubMed database was performed using the association of the two key words 'tooth clenching' and 'temporomandibular disorders'. However, although tooth clenching and tooth grinding are considered two different disorders, it appeared in most papers that these two parafunctional activities are often associated so that it was not always possible to systematically separate the data relevant to tooth clenching from those relevant to tooth grinding. Awake clenching is reported by about 20% of the general population and by 50-80% in TMD populations. This oral parafunction is responsible for excessive mechanical stress in the TMJ which may lead to disk displacement and/or joint damage with internal derangement or osteoarthritis. Experimental low-level tooth clenching in pain-free individuals has been shown to produce symptoms sufficiently severe to meet the diagnostic criteria for TMD myofascial pain. However, the masticatory muscle pain is usually short-lasting and self-limiting which questions the nature of the relationship between tooth clenching and TMD. The etiology of the muscle pain can be ascribed either to damaged muscle fibers or to a reduction in blood supply. Although there is strong evidence that some TMD patients are characterized by high levels of distress, anxiety and somatization, conflicting evidence still exists regarding the causality of the relationships between tooth clenching or grinding, stress and TMD. On the other hand, tooth clenching or grinding could be considered as a useful prophylactic behavior for stress-related psychosomatic diseases, such as stomach ulcer and/or neuroses, by down-regulating the limbic system, the autonomic nervous system and the hypothalamic-pituitary-adrenal axis. [ABSTRACT FROM AUTHOR]

Background: There has been considerable focus on the burden of mental illness (including post-traumatic stress disorder, PTSD) in returning Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans, but little attention to the burden of medical illness in those with PTSD.Objectives: (1) Determine whether the burden of medical illness is higher in women and men OEF/OIF veterans with PTSD than in those with No Mental Health Conditions (MHC). (2) Identify conditions common in those with PTSD.Design: Cross-sectional study using existing databases (Fiscal Year 2006-2007).Setting: Veterans Health Administration (VHA) patients nationally.Patients: All 90,558 OEF/OIF veterans using VHA outpatient care nationally, categorized into strata: PTSD, Stress-Related Disorders, Other MHCs, and No MHC.Measurements: (1) Count of medical conditions; (2) specific medical conditions (from ICD9 codes, using Agency for Health Research and Quality's Clinical Classifications software framework).Main Results: The median number of medical conditions for women was 7.0 versus 4.5 for those with PTSD versus No MHC (p<0.001), and for men was 5.0 versus 4.0 (p<0.001). For PTSD patients, the most frequent conditions among women were lumbosacral spine disorders, headache, and lower extremity joint disorders, and among men were lumbosacral spine disorders, lower extremity joint disorders, and hearing problems. These high frequency conditions were more common in those with PTSD than in those with No MHC.Conclusions: Burden of medical illness is greater in women and men OEF/OIF veteran VHA users with PTSD than in those with No MHC. Health delivery systems serving them should align clinical program development with their medical care needs. [ABSTRACT FROM AUTHOR]

Purpose: To characterize child survivors' mental health and quality of life after a massive earthquake. Methods: A population-based survey of 596 children aged between 8 and 16 years was conducted in the severely affected areas of the earthquake, using a multi-stage systematic sampling design. Results: The point prevalence rates of posttraumatic stress disorder (PTSD) and depression among the child survivors aged between 8 and 16 years 15 months after the earthquake were 12.4 and 13.9%, respectively. Health-related quality of life (HRQoL) was found to be strongly and negatively associated with PTSD and depression. Children who had lost family members were most likely to develop PTSD (OR = 6.6; P < 0.001) as well as depression (OR = 4.1; P < 0.001). Children who reported no utilization of mental health services were four times more likely to suffer from PTSD than those who did not ( P = 0.002). Conclusions: More than one in five child survivors were identified as having PTSD or depression; HRQoL of these identified children were deeply compromised. Utilization of mental health services may significantly reduce the risk of developing PTSD symptoms. [ABSTRACT FROM AUTHOR]

The Impact of Event Scale-revised (IES-R) is one of the most widely used measures of posttraumatic stress reactions. However, for some purposes, such as large epidemiological studies, there is a need for briefer instruments. The aim of this study was to develop and validate an abbreviated version of the IES-R that could capture the three current symptom clusters of posttraumatic stress disorder (PTSD). Stepwise multiple regression was applied to abbreviate the IES-R in one sample. The abbreviated version was then tested in three separate samples of individuals exposed to different kinds of potentially traumatic events. Agreement with a reference measure of PTSD, the PTSD checklist (PCL), was calculated for the abbreviated and the full-scale versions of IES. The abbreviation procedure resulted in a subset of six items (the IES-6), which correlated highly (pooled correlation = 0.95) with the IES-R across samples. Correlations between the IES-6 and IES-R subscales were somewhat lower ( r = 0.78–0.94). Both the IES-6 and IES-R were in high agreement with the PCL. The IES-6 appears to be a robust brief measure of posttraumatic stress reactions. It may be useful for research in epidemiological studies, and it may also have a role as a screening instrument in clinical practice. [ABSTRACT FROM AUTHOR]

To determine the relationship between measures of critical illness (sedative/analgesic administration, wakefulness and organ dysfunction), intensive care unit (ICU) recall and symptoms of posttraumatic stress disorder. Prospective, observational study with post-ICU follow-up. Medical and surgical ICUs at a teaching hospital. Two hundred seventy-seven subjects requiring > 36 h of mechanical ventilation were enrolled; 149 completed follow-up interviews 2 months later and 80 at 6 months. None. ICU recall was greater for events occurring at the end of critical illness; however, 18% of subjects had amnesia for the entire ICU course. Factual ICU recall was weakly associated with increased wakefulness during mechanical ventilation ( r 2 = 0.03–0.11, p< 0.05). Posttraumatic stress disorder prevalence was 17% at 2 months and 15% at 6 months. The avoidance-numbing cluster had the highest specificity (91%) for a formal diagnosis and the re-experiencing cluster had the lowest (69%). Recall of a delirious memory during critical illness was associated with more severe posttraumatic stress symptoms, but there was no association between posttraumatic stress symptoms and factual recall of ICU events. Neither ICU recall nor posttraumatic stress symptoms were associated with the intensity of sedative administration during mechanical ventilation. Posttraumatic stress symptoms were lowest in patients either the most awake during mechanical ventilation or the least awake. Wakefulness during mechanical ventilation has a greater influence on post-ICU recall and posttraumatic stress symptoms than sedative drug exposure or severity of illness. It is difficult to predict the future psychological consequences of an individual patient's critical illness. [ABSTRACT FROM AUTHOR]

Orthostatically triggered panic was examined in female Cambodian refugees. Heart rate, blood pressure (BP), panic, and dizziness responses were assessed during orthostatic challenge in three diagnostic groups: orthostatic panic without comorbid posttraumatic stress disorder (PTSD), orthostatic panic with PTSD, and other mental disorders without orthostatic panic or PTSD. During orthostatic challenge, the panic group without PTSD showed a significant drop, whereas the group with other mental disorders showed an increase in systolic BP. The group with panic and PTSD showed a blunted systolic BP response during orthostasis that fell between the responses of the other groups. Catastrophic, culturally specific cognitions present during orthostatic challenge were significantly correlated with the amount of reported panic upon standing. Some patients recalled previous traumatic events during the orthostatic challenge. The findings suggest that orthostatically induced panic attacks in Cambodian refugees are generated by an interaction of orthostasis physiology, catastrophic cognitions, and trauma associations. [ABSTRACT FROM AUTHOR]

This study sought to replicate past research that has shown differences in physiological responsiveness among survivors of motor vehicle accidents (MVAs) with posttraumatic stress disorder (PTSD) and those survivors who do not develop this disorder. Such physiological differences have been found specifically with heart rate (HR) reactivity. This study also attempts to account for differences among those survivors with PTSD who do respond physiologically in laboratory situations and those who do not show a physiological response when presented with audiotaped descriptions of their accidents. Results replicated the significant differences in HR reactivity between diagnostic groups with chronic PTSD versus those with subsyndromal PTSD and non-PTSD. Variables related to the severity of the diagnosis and trauma were found to discriminate between physiological responders and nonresponders with chronic PTSD. [ABSTRACT FROM AUTHOR]

In view of the relatively understudied status of work-related posttraumatic stress disorder (PTSD), this study retrospectively examined 44 workers whose claims were accepted for workers' compensation benefits in the absence of significant coexisting physical injuries. The majority of workers (82%) directly experienced the traumatic event while the rest witnessed the event. Over half (54%) of those directly experiencing the event were involved in armed robberies, whereas 38% were physically or verbally assaulted in nonrobbery situations. Almost half of the workers were assigned a coexisting mood or anxiety diagnosis. Psychoactive medication was prescribed to 66% of workers, and 93% of all workers received some form of psychological/psychiatric treatment. Twenty-three percent of the group received vocational rehabilitation assistance and only 43% returned to their previous job with the accident employer. Findings suggest that work-related PTSD is both complex and disabling and merits further investigation. [ABSTRACT FROM AUTHOR]

Purpose Of Review: This review summarizes the increasing public health concern about PTSD and suicide, and the population-based studies that have examined this association. Further, we discuss methodological issues that provide important context for the examination of this association.Recent Findings: The majority of epidemiologic studies have shown that PTSD is associated with an increased risk of suicide; however, a notable minority of studies have documented a decreased risk of suicide among persons with PTSD. Methodological (e.g., sample size and misclassification) and etiologic issues (e.g., complicated psychiatric comorbidity) may explain the conflicting evidence. PTSD may be associated with an increased risk of suicide, but further research is needed. Increasing the use of appropriate methods (e.g., marginal structural models that can evaluate both confounding and effect modification, machine learning methods, quantification of systematic error) will strengthen the evidence base and advance our understanding. [ABSTRACT FROM AUTHOR]