Brain Function News

Risk-Taking Behaviors and Impulsivity Among Veterans With and Without

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

and Mild TBI

Military personnel commonly experience post-traumatic stress disorder () and mild traumatic brain injury (mTBI), both of which are associated with premature mortality. The present study examined two factors that may play a role in premature mortality-impulsivity and risk-taking behaviors-in a sample of 234 veterans screening positive for , mTBI, + mTBI, and controls. Analyses of variance demonstrated that veterans with , regardless of mTBI status, reported engaging in more frequent risky behaviors and reported a greater tendency to engage in impulsive behaviors when in a negative affective state. They also reported more premilitary delinquent behaviors and more suicide-related behaviors than controls. The present study highlights associations between impulsivity, risk-taking behaviors, and , and suggests continuity across the lifespan in terms of a predisposition to engage in impulsive and/or risky behaviors. Thorough evaluation of impulsivity and potentially risky behaviors is important in clinical settings to guide interventions and reduce the mortality and public health impact of high-risk behaviors in veterans.

UofM researcher appointed Anderson Chair in

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

Research

Brian Engdahl, Ph.D., a professor of neuroscience, cognitive science, and psychology at the at the University of Minnesota and psychologist and clinician investigator at the Minneapolis , has been appointed the Anderson Chair in Post-Traumatic Stress Disorder () Research at the University of Minnesota Medical School.

The Anderson Chair helps understand and heal the psychological scars that often haunt veterans as they return home from service. The $2 million gift honors the late William Lewis Anderson, a combat medic who died trying to save a wounded soldier on the battlefield in World War II.

Engdahl has served veterans for more than 30 years at the and Minneapolis and is working on numerous research initiatives to assess and treat veterans with serious disabilities, including .

"It's an honor to be named the Anderson Chair in Research," said Engdahl. "We hope to continue the great work done at the University of Minnesota and to help those who served our country but now are afflicted with and other life altering disabilities."

With Apostolos Georgopoulos, M.D., Ph.D., and his colleagues at the , Engdahl has recently helped discover that a special kind of brain scan can identify, with 95 percent accuracy, veterans with . Because this appears to be the first objective marker of a mental disorder, the findings should help develop better kinds of treatment, encourage more people who suffer from it to seek help, and reduce the stigma associated with and other mental disorders.

"The University of Minnesota has strong programs in brain science and on the provision of care for those with brain injury," said Aaron Friedman, M.D., vice president for health sciences and dean of the Medical School. "The awarding of this Chair to Professor Engdahl reflects his enormous contribution in understanding and treating brain injury."

University of Minnesota researcher appointed Anderson Chair in

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

Research

Brian Engdahl, Ph.D., a professor of neuroscience, cognitive science, and psychology at the at the University of Minnesota and psychologist and clinician investigator at the Minneapolis , has been appointed the Anderson Chair in Post-Traumatic Stress Disorder () Research at the University of Minnesota Medical School.

The Anderson Chair helps understand and heal the psychological scars that often haunt veterans as they return home from service. The $2 million gift honors the late William Lewis Anderson, a combat medic who died trying to save a wounded soldier on the battlefield in World War II.

The trail of trauma

When a disaster strikes, groups of people spontaneously form and start talking all at once.And your brain does the same thing in response to personal trauma. Groups of neurons in the cerebral cortex start firing at the same time, "talking" to each other, and get locked into a correlated pattern of activity. Previous work by University of Minnesota researchers identified a particular pattern so strongly associated with post-traumatic stress disorder () that they can clearly tell who has . Now, a new study shows that in people with , these patterns persist, just as do the intrusive, incapacitating memories or re-experiencing of the events, emotional numbing, and hyperarousal that define the disorder.

But, they found, in people who have not developed despite exposure to trauma, the patterns lack staying power. In them, "these patterns loosen and dissipate over weeks, months, or days," says lead researcher Lisa James, an assistant professor in the U's Department of Psychiatry and a researcher in the at the Minneapolis , where the study took place. "This wipes the slate clean."

"Our work means that in resilient people the brain can actively adapt to traumatic experiences in a way that those with cannot. The better we understand the brain mechanisms associated with , the sooner we can apply that knowledge to evaluating treatment efficacy."

Co-author Apostolos Georgopoulos likens the situation in a trauma-exposed brain to an infection.

How

Magnetoencephalography

Magnetoencephalography (MEG)

A noninvasive technique that detects magnetic fields above the surface of the head produced by postsynaptic potentials in the brain.

works

The advantage of is its ability to detect brain activity on a scale of milliseconds. The researchers placed an apparatus resembling a helmet over the heads of the subjects, who were asked to fixate on a stationary dot with their eyes for 60 seconds. The helmet contained 248 sensors, each of which detected the magnetic fields generated in a population comprising tens of thousands of cortical cells. Together, the sensors scanned the magnetic activity over the whole cortex.

'It's like having a disease, where you make antibodies," says Georgopoulos, a Regents Professor of neuroscience and director of the . "If you can't make antibodies, you don't adapt to the virus. Similarly, if you don't de-correlate your brain networks, you're still sick."

Short-term tracking of the -linked patterns in people exposed to trauma could potentially identify those who are resilient vs. those who need treatment. Pattern tracking could also be used to monitor progress during treatments or to validate a simpler test for resilience, such as genetic or personality traits, the researchers say.

The work is published online in the journal JAMA Psychiatry.

How to eavesdrop on brain chatter

The researchers studied 86 veterans with and 113 veterans who were resilient to trauma. A questionnaire revealed the extent of their exposure to trauma; those with trauma exposure but no were, by definition, resilient controls.

The team used a noninvasive technique called (; see sidebar)) to study the magnetic fields generated in neurons of the right temporal lobe cortex as they received messages during neuronal "talk." Neurons receiving messages experience movements of ions across their outer membranes; these movements generate the magnetic fields.

The measured the strength of correlated patterns of activity in cell populations-i.e., simultaneous generation of magnetic fields-characteristic of . They discovered:

Among controls, weaker -related patterns tended to occur in those with highertrauma scores. In other words, "In controls, big trauma leads to a big adaptation," says Georgopoulos.

Also in controls, the right temporal cortex had a crucial node in which brain activity was decorrelated, a signal of adaptation. This area of the brain is a focus of future study.

Resilience isn't an all-or-nothing trait, but a continuum.

The trauma landscape

Most people are resilient to some events, so the question becomes: Why isn't everybody?

"About 60 to 90 percent of people will experience a potentially traumatic event in their lifetime, like a car accident or the sudden death of a loved one, but they are resilient. They don't develop symptoms of a psychiatric disorder," says James.

"Only seven percent of people in the general population and about 20 percent of veterans develop . Most come back [from service] without -what enables them to do that?"

To answer that question, the researchers are turning their attention to a search for genetic markers of resilience. If certain genes or, perhaps, personality traits, are found to be associated with resilience, that could allow researchers to predict one's degree of resilience before trauma hits.

" sufferers have options that include medications, talk therapy, and interventions to treat nightmares," James says. "We're interested in what happens in the brain as individuals with respond to treatment."

Mpls. VA brain research examines resilience to trauma

From MPR's coverage of the research from the

New research from the Minneapolis

VAMC

VA Medical Center (VAMC)

has identified brain patterns that appear to be markers of resilience to trauma. The findings could suggest why some people exposed to trauma develop post-traumatic stress disorder, or

PTSD

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

, while many others do not.

Researchers say the findings, published online Wednesday in the journal JAMA Psychiatry, point to a central mechanism showing how the brain can recover from traumatic events. ...

Risk and Protective Factors Associated With Symptoms of Post-Traumatic Stress, Depression, and Alcohol Misuse in

Operation Enduring Freedom - Afghanistan

Operation Enduring Freedom - Afghanistan (OEF)

The U.S. government used the term "Operation Enduring Freedom - Afghanistan" (OEF) to officially describe the War in Afghanistan, from the period between October 2001 and December 2014. ... Continued operations in Afghanistan by the United States' military forces, both non-combat and combat, now occur under the name "Operation Freedom's Sentinel".

/

Operation Iraqi Freedom

Operation Iraqi Freedom (OIF)

The period of the Iraq war lasting from 2003 to 2010 was referred to as Operation Iraqi Freedom (OIF) by the United States military. The conflict is also known as the War in Iraq, the Occupation of Iraq, the Second Gulf War, Gulf War II, and Gulf War 2.

Veterans

Military personnel returning from the conflicts in Iraq and Afghanistan commonly experience mental health problems and efforts are underway to determine risk and protective factors associated with postdeployment mental health concerns. This study examined the contribution of trait neuroticism, predeployment life events, combat experience, perceptions of threat, and postdeployment social support on mental health symptoms at 6 months, 12 months, and 24 months postdeployment. Two hundred seventy-one veterans completed self-report measures. Hierarchical regression analyses demonstrated that neuroticism predicted post-traumatic stress and depressive symptoms at all 3 time points; perceived threat predicted post-traumatic stress symptoms at Time 1 and Time 2 and depressive symptoms at Time 2. Social support was a strong negative predictor of post-traumatic stress and depressive symptoms. Alcohol misuse was not significantly predicted by any of the variables. The present study highlights the role of perceived threat and trait neuroticism on postdeployment mental health symptoms and indicates social support is a robust protective factor. Efforts aimed at increasing sustained postdeployment social support may help defend against significant mental health problems among veterans.

Neural Network Modulation by Trauma as a Marker of Resilience Differences Between Veterans With

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

and Resilient Controls

Importance and resilience reflect 2 distinct outcomes after exposure to potentially traumatic events. The neural mechanisms underlying these different outcomes are not well understood.

Objective To examine the effect of trauma on for veterans with and resilient controls using magnetoencephalography.

Design Participants underwent diagnostic interviews, a measure of exposure to potentially traumatic events, and magnetoencephalography.

Setting US Department of Veterans Affairs medical center.

Participants Eighty-six veterans with and 113 resilient control veterans recruited from a large Midwestern medical center.

Main Outcome Measures Multiple regression analyses were performed to examine the effect of lifetime trauma on global and local . In analyses examining the local , the partial regression coefficient indicates the strength and direction of the effect of trauma on the synchronous interactions between the 2 neural signals recorded by a pair of sensors. The partial regression coefficient, or slope, is the primary outcome measure for these analyses.

Results Global were significantly modulated downward with increasing lifetime trauma scores in resilient control veterans (P = .003) but not in veterans with (P = .91). This effect, which was primarily characterized by negative slopes (ie, decorrelations) in small neural networks, was strongest in the right superior temporal gyrus. Significant negative slopes were more common, stronger, and observed between sensors at shorter distances than positive slopes in both hemispheres (P < .001 for all) for controls but not for veterans with PTSD.

Conclusions Neural modulation involving decorrelation of neural networks in the right superior temporal gyrus and, to a lesser extent, other areas distinguishes resilient veterans from those with and is postulated to have an important role in healthy response to trauma.

The War Against

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

From the article:

How one machine and two Minnesota researchers are forever changing the stigma surrounding Post-Traumatic Stress Disorder

Apostolos Georgopoulos looks like a brain scientist. Animated, friendly, and crowned with a mane of flyaway gray hair, he shakes my hand and ushers me into his office. He immediately offers to make me coffee, then, in the next breath, insists I sit in the throne situated next to the window-a gift he received for being a Regents professor of neuroscience at the University of Minnesota. "Isn't it something?" he says enthusiastically. "I don't even know how they got it in here!" ...

U of M working to help veterans with

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

U of M researcher Brian Engdahl talks about new research that could help diagnose and treat post-traumatic stress disorder (), which often affects veterans.

Post-traumatic stress disorder: a right temporal lobe syndrome?

In a recent paper (Georgopoulos et al 2010 J. Neural Eng. 7 016011) we reported on the power of the -based test to differentiate post-traumatic stress disorder () subjects from healthy control subjects and to classify them with a high degree of accuracy. Here we show that the main differences in cortical communication circuitry between these two groups lie in the miscommunication of temporal and parietal and/or parieto-occipital right hemispheric areas with other brain areas. This lateralized temporal-posterior pattern of miscommunication was very similar but was attenuated in patients with in remission. These findings are consistent with observations (Penfield 1958 Proc. Natl Acad. Sci. USA 44 51-66, Penfield and Perot 1963 Brain 86 595-696, Gloor 1990 Brain 113 1673-94, Banceaud et al 1994 Brain 117 71-90, Fried 1997 J. Neuropsychiatry Clin. Neurosci. 9 420-8) that electrical stimulation of the temporal cortex in awake human subjects, mostly in the right hemisphere, can elicit the re-enactment and re-living of past experiences. Based on these facts, we attribute our findings to the re-experiencing component of and hypothesize that it reflects an involuntarily persistent activation of interacting neural networks involved in experiential consolidation.

Attachment Style Classification and

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

in Former Prisoners of War

Adult attachment style and post-traumatic stress disorder () symptomatology were investigated in 107 former prisoner of war veterans. Those with secure attachment styles scored significantly lower on measures of than did those with insecure styles, and attachment style was a stronger predictor of symptom intensity than was trauma severity. The suggested association between attachment style and 's development and persistence are discussed in relation to research and clinical practice.

Study Points at a Clear-Cut Way to Diagnose

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

From the article:

For all the attention focused on

PTSD

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

in recent years, doctors have never had a clear-cut way to be certain a patient has it. But Minnesota scientists now believe they have found a long-sought

PTSD

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

fingerprint that confirms the disorder by measuring electromagnetic fields in the brain. The finding, detailed in the latest issue of the Journal of Neural Engineering, could help the 300,000 cases of

PTSD

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

that are anticipated among the 2 million U.S. troops who have gone to war in Afghanistan and Iraq.

"This shows that

PTSD

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

is a brain disease," says Dr. Apostolos Georgopoulos, who led the research along with Brian Engdahl and a team from the

BSC

Brain Sciences Center (BSC)

A research group in collaboration with the Minnesota American Legion, Minneapolis VA Medical Center, and the University of Minnesota.

at the Minneapolis

VAMC

VA Medical Center (VAMC)

and University of Minnesota. "There have been questions that this is a made-up disorder and isn't a true brain disease, but it is." Just as importantly, he says, the magnetic-imaging biomarker shows changes over time in a brain's electrical activity, allowing mental-health workers to chart the effectiveness of various therapies. "It will be a tremendous tool in monitoring treatment," he says, "because these abnormal communication patterns will be normalized as the treatment works." ...

The

Synchronous Neural Interactions

Synchronous Neural Interactions (SNI)

Zero-lag partial correlations in pairs of MEG time series and denote the strength and polarity (positive or negative) of neuronal interactions. Anomalies in SNIs as assessed by MEG differentiate psychiatric disorders from healthy brain functioning and can discriminate among various brain diseases. From this research, a highly distinctive, unique PTSD SNI signature characterized by miscommunication of temporal and parietal and/or parieto-occipital right hemispheric areas with other brain areas has emerged. These findings, in addition to the growing research applying MEG to other psychiatric disorders, highlight the utility of MEG in identifying biomarkers of disease and underscore the potential for broader clinical applications of MEG.

test as a functional neuromarker for post-traumatic stress disorder (

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

): a robust classification method based on the bootstrap

Traumatic experiences can produce post-traumatic stress disorder () which is a debilitating condition and for which no biomarker currently exists (Institute of Medicine (US) 2006 : Diagnosis and Assessment (Washington, DC: National Academies)). Here we show that the test which assesses the functional interactions among neural populations derived from magnetoencephalographic () recordings (Georgopoulos A P et al 2007 J. Neural Eng. 4 349-55) can successfully differentiate patients from healthy control subjects. Externally cross-validated, bootstrap-based analyses yielded >90% overall accuracy of classification. In addition, all but one of 18 patients who were not receiving medications for their disease were correctly classified. Altogether, these findings document robust differences in brain function between the and control groups that can be used for differential diagnosis and which possess the potential for assessing and monitoring disease progression and effects of therapy.

Brain scans pinpoint stress disorder in war veterans

From the article:

There's never been a simple test to diagnose post-traumatic stress, but a group of Minnesota scientists say they've found a high-tech way to identify people who have the disorder -- by studying their brain signals. The discovery could have huge implications for the way

PTSD

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

is diagnosed and treated in the future, says Dr. Apostolos Georgopoulos, who led the research as director of the

BSC

Brain Sciences Center (BSC)

A research group in collaboration with the Minnesota American Legion, Minneapolis VA Medical Center, and the University of Minnesota.

at the Minneapolis

VAMC

VA Medical Center (VAMC)

.

PTSD is thought to afflict tens of thousands of combat veterans, but it can be hard to diagnose. It's a collection of psychological symptoms that can, in some cases, be caused by other conditions, such as head injuries or depression. That's one reason that exact numbers are hard to pin down; the VA estimates that anywhere from 11 to 20 percent of returning veterans from Afghanistan and Iraq have

PTSD

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

. But in a study released Wednesday, Dr. Georgopoulos and his research team found what they call the first "biological marker" for

PTSD

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

: A distinctive pattern of brain signals that can be detected with a $2 million device called

MEG

Magnetoencephalography (MEG)

A noninvasive technique that detects magnetic fields above the surface of the head produced by postsynaptic potentials in the brain.

(magnetoencephalography). ...

Post-Traumatic Stress Disorder and Service Utilization in a Sample of Service Members from Iraq and Afghanistan

Objective: The purpose of this study was to evaluate levels of post-traumatic stress disorder (), depression, alcohol abuse, quality of life, and mental health service utilization among returnees from Operation Enduring Freedom and . Methods: One hundred twenty returnees, enrolled for health care at a midwestern Veterans Affairs medical center, completed questionnaires approximately 6 months after their return from deployment. Results: levels (12%) were consistent with previous research while problematic drinking levels were also elevated (33%). and, to a lesser degree, alcohol abuse were associated with lower quality of life in multiple domains, even when controlling for the influence of depression. Of those screening positive for , 56% reported using mental health services. Only 18% of those screening positive for alcohol abuse reported using such services. Conclusions: and alcohol problems are prevalent in Operation Enduring Freedom/ returnees and associated with lower quality of life. Mental health service utilization is limited, even among returnees enrolled for Veterans Affairs health care.

A comparative study of

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

assessment under standard conditions and in the field

Little is known about the performance of clinician-administered structured diagnostic interviews when given under variable levels of examiner training and monitoring. We sought to explore this question. We examined the performance of a self-report questionnaire and a structured clinical interview in the assessment of post-traumatic stress disorder () in two community samples of war veterans. One sample was interviewed under standard conditions (N = 372) and the other under unknown and less standardized conditions (N = 420), more closely approximating 'field conditions'. Interview results were used to predict questionnaire-based status. Kappas, sensitivities, specificities, and positive predictive powers were moderate and of similar magnitude in both samples. Our results suggest that even under uncertain ('field') conditions, clinician-administered structured interviews can produce results comparable to those produced under more tightly controlled conditions.

Sleep in a community sample of elderly war veterans with and without

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

Background: Although sleep disturbances are commonly reported by individuals with , objective findings have been inconsistent, due in part to small sample sizes, comorbid psychiatric disorders, variations in the recentness of trauma exposure, and the use of subjects involved in psychiatric treatment.

Methods: A community sample of elderly males (n = 59) exposed to war trauma 28-50 years ago and free from sleep-affecting medications and disorders other than completed 3 nights of polysomnography. Of these participants, 30 met criteria for current ; three were receiving supportive outpatient psychotherapy.

Results: Two statistically significant differences were observed: Those with had a higher percentage of rapid eye movement (REM) sleep and fewer arousals from non-REM sleep. The perceptions of sleep quality among the participants with were lower than the perceptions of non- participants. Although participants with untreated obstructive sleep apnea and sleep movement disorders were not included in the sample, many cases were detected on initial screening. Treatment resulted in improved sleep and increased feelings of well being.

Conclusions: Alterations in REM and arousals characterized in this sample. When comorbid sleep disorders were ruled out, sleep was clinically similar across the groups. Trauma-related sleep disturbances that subjects reported as arising early in the course of the disorder appear to have declined over time.

Trauma exposure, resilience, social support, and

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

construct validity among former prisoners of war

Background: The aim of this study was to investigate predictors of persistent symptoms of and to examine the construct validity of in a national sample of 270 World War II and Korean Conflict prisoners of war (POWs). Method: POWs were interviewed at two points in time (1965 and 1990). Predictors included symptomatology measured in 1965 by items from the Cornell Medical Index (CMI), severity of captivity trauma, resilience factors, and post-trauma social support. The criterion, symptomatology in the early 1990s, was evaluated with the module of the Structured Clinical Interview for DSM (SCID). Results: The CMI provided only partial coverage of criteria and appeared to provide only a general index of distress. Clustering of SCID items in two-dimensional space via multidimensional scaling analysis offers some construct validation for the DSM's differentiation of symptoms into criterion groups, although there was not a perfect match. Trauma severity is best related to symptomatology experienced in 1990, mitigated in part by greater education level and age at the time of trauma exposure. Surprisingly, 1965 distress added only a modest amount to the prediction of current distress, while post-trauma social support added none. Conclusions: These findings support previous work showing the severe psychological sequelae of POW status 40-50 years after captivity, and indicate that trauma severity during captivity is the best predictor of current symptomatology. Results also add to our understanding of the conceptual differentiation of symptoms into separate and distinct symptom clusters.

Polysomnographic sleep is not clinically impaired in vietnam combat veterans with chronic

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

Background: Because sleep is typically disturbed in , this study was undertaken to evaluate a group of Vietnam combat veterans with the disorder using clinical polysomnographic techniques.

Methods: Eighteen Vietnam combat veterans with and 10 healthy non-combat-exposed Vietnam era veterans participated in 2 nights of polysomnographic study and a multiple sleep latency test.

Results: No significant differences between subjects and controls were noted except for greater sleep onset latency to stage 2 (p < .03), and lower arousals/hour from stages 3 & 4 (p < .04) on night 2, and lower subjectively estimated total sleep time on night 1 (p < .005) in the case of subjects. Otherwise, results from the second night served to replicate those from the first, and no significant differences appeared on 2 successive nights for any polysomnographic variable. No daytime hypersomnolence was detected.

Conclusions: Polysomnographically recorded sleep was notably better than expected in the presence of clinically significant with typical histories of disrupted sleep. In these subjects, there is no clinically significant sleep disorder or typical pattern of sleep disturbance detectable by standard polysomnography.

Assessment of

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder (PTSD)

A complex psychiatric syndrome that develops in response to trauma exposure. Individuals with PTSD experience intrusive recollections or reexperiencing of the traumatic event, avoidance of trauma reminders, emotional numbing, and hyperarousal. In addition, PTSD is associated with high rates of concomitant physical and mental health problems, increased health care use, and impairment in social and occupational functioning. Almost 7% of the general population and up to 30% of veterans meet lifetime criteria for PTSD. Indeed, PTSD is one of the most common psychiatric disorders, representing a significant and costly public health concern.

in World War II Veterans

Four scales were compared in a community sample of 330 American former prisoners of war and combat veterans of World War II. The Mississippi Scale for Combat-Related (M-), the Minnesota Multiphasic Personality Inventory-2 Pk scale, and the Impact of Event Scale (IES) all demonstrated moderate relationships with as defined by the Structured Clinical Interview for DSM-III-R. Comparative validities were similar to those observed in Vietnam veteran samples. Confirmatory factor analysis indicated that the 3 scales loaded significantly on 1 factor. The impact of Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria changes was examined and found to be minimal. Implications for the use of the M-, Pk, and IES in combat-related assessment are discussed.