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Child and Adolescent Psychiatric... Oct 2016There is a strong, bidirectional link between substance abuse and traumatic experiences. Teens with cooccurring substance use disorders (SUDs) and posttraumatic stress... (Review)
Review
There is a strong, bidirectional link between substance abuse and traumatic experiences. Teens with cooccurring substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) have significant functional and psychosocial impairment. Common neurobiological foundations point to the reinforcing cycle of trauma symptoms, substance withdrawal, and substance use. Treatment of teens with these issues should include a systemic and integrated approach to both the SUD and the PTSD.
Topics: Adolescent; Humans; Life Change Events; Stress Disorders, Post-Traumatic; Substance-Related Disorders
PubMed: 27613348
DOI: 10.1016/j.chc.2016.05.006 -
Current Cardiology Reports Jun 2023To provide an update of the current evidence of cardiac disease-induced posttraumatic stress disorder (CDI-PTSD) with a focus on acute coronary events. (Review)
Review
PURPOSE OF REVIEW
To provide an update of the current evidence of cardiac disease-induced posttraumatic stress disorder (CDI-PTSD) with a focus on acute coronary events.
RECENT FINDINGS
A cardiovascular disease, particularly a life-threatening cardiac event is often a highly stressful experience that can induce PTSD in patients and their caregivers, taking a chronic course if left untreated. There are several features distinguishing CDI-PTSD from "traditional" PTSD induced by external trauma, namely enduring somatic threat, inability to avoid trauma-related cues and hyperarousal with internal body sensations leading to constant fear of recurrent cardiac events. An increased risk of recurrent CVD events may be explained by pathophysiological changes, an unhealthy lifestyle and non-adherence to cardiac treatment. A trauma-focused approach might be useful to treat CDI-PTSD. Treatment options for patients and caregivers as well as long-term effects of trauma-focused interventions on physical and mental health outcomes should be future research directions.
Topics: Humans; Stress Disorders, Post-Traumatic; Cardiovascular Diseases; Acute Disease; Life Style; Acute Coronary Syndrome
PubMed: 37129760
DOI: 10.1007/s11886-023-01870-1 -
Die Rehabilitation Aug 2020Due to significant changes in the new ICD-11 classification, stress-related disorders have advanced further into clinical and scientific focus. In contrast to the ICD-10... (Review)
Review
Due to significant changes in the new ICD-11 classification, stress-related disorders have advanced further into clinical and scientific focus. In contrast to the ICD-10 classification, complex posttraumatic stress disorder as well as prolonged grief have been established as independent diagnoses. Additionally, the diagnostic criteria for adjustment disorder were newly conceptualized and refined. Stress-related disorders have a high relevance for out- and inpatient rehabilitation centers. Posttraumatic stress disorder (PTSD) has a 1-year-prevalence in Germany of 1-2%. Comorbidities such as depression or anxiety disorders are common. PTSD may also result from physical illness and can in turn complicate the course of the disease or even lead to chronification of symptoms. The most effective treatment is a trauma-focused psychotherapy, which usually takes place in an outpatient setting. Psychosomatic inpatient rehabilitation is a valuable resource in the treatment plan of PTSD. The optimal point is mostly following the acute therapy when reintegration to work and social life is the aim. As rehabilitation centers can provide a safe therapeutic setting for patients, allowing them to open up about their trauma, it can pave the way to a trauma focused treatment. Additionally, socio-medical aspects of trauma-related disorders will be touched upon in this overview.
Topics: Anxiety Disorders; Germany; Humans; International Classification of Diseases; Psychophysiologic Disorders; Stress Disorders, Post-Traumatic
PubMed: 32851609
DOI: 10.1055/a-1115-8520 -
The International Journal of Eating... Jun 2023Many individuals diagnosed with an eating disorder (ED) have been exposed to traumatic events, and some of these individuals are diagnosed with posttraumatic stress... (Review)
Review
OBJECTIVE
Many individuals diagnosed with an eating disorder (ED) have been exposed to traumatic events, and some of these individuals are diagnosed with posttraumatic stress disorder (PTSD). Although theorized by researchers and clinicians, it is unclear whether traumatic event exposure or PTSD interferes with outcomes from ED treatment. The objective of the current study was to systematically review the literature on traumatic events and/or PTSD as either predictors or moderators of psychological treatment outcomes in EDs.
METHOD
A PRISMA search was conducted to identify studies that assessed the longitudinal association between traumatic events or PTSD and ED outcomes. Eighteen articles met the inclusion criteria for review.
RESULTS
Results indicated that traumatic event exposure was associated with greater ED treatment dropout, but individuals with a traumatic event history benefited from treatment similarly to their unexposed peers. Findings also indicated that traumatic events may be associated with greater symptom relapse posttreatment.
DISCUSSION
Given the limited number of studies examining PTSD, results are considered very tentative; however, similar to studies comparing trauma-exposed and nontrauma-exposed participants, individuals with PTSD may have similar treatment gains compared to individuals without PTSD, but individuals with PTSD may experience greater symptom relapse posttreatment. Future researchers are encouraged to examine whether trauma-informed care or integrated treatment for EDs and PTSD mitigates dropout from treatment and improves symptom remission outcomes. Furthermore, researchers are encouraged to examine how the developmental timing of traumatic events, self-perceived impact of trauma, and cumulative trauma exposure may be associated with differential ED treatment outcomes.
PUBLIC SIGNIFICANCE
Eating disorders (EDs), trauma, and posttraumatic stress disorder (PTSD) often co-occur. Individuals with traumatic event exposure and/or PTSD demonstrate greater ED symptoms; it is unclear whether these individuals benefit similarly in ED treatment to their peers. The current study found that individuals with traumatic event exposure are more likely to drop out of treatment but benefit from treatment with similar symptom remission. Traumatic history was associated with greater relapse posttreatment.
Topics: Humans; Stress Disorders, Post-Traumatic; Feeding and Eating Disorders; Treatment Outcome
PubMed: 36916450
DOI: 10.1002/eat.23933 -
Surgery For Obesity and Related... Aug 2022After bariatric surgery, some patients experience adverse psychiatric outcomes, including substance use, suicidality, and self-harm. These factors are commonly...
BACKGROUND
After bariatric surgery, some patients experience adverse psychiatric outcomes, including substance use, suicidality, and self-harm. These factors are commonly associated with posttraumatic stress disorder (PTSD) and related symptoms (PTSD-S) that develop following adverse childhood experiences (ACEs) and traumatic events. However, emerging evidence suggests that chronic discrimination also may contribute to PTSD-S. Weight-based discrimination is salient for people with obesity but has received little attention in relation to PTSD-S.
OBJECTIVE
Our study examined factors that may contribute to the link between experienced weight stigma (WS), which is common in individuals seeking bariatric surgery, and PTSD-S.
SETTING
Teaching hospital and surgical weight loss center in the United States.
METHODS
A total of 217 participants completed self-report surveys of experienced and internalized WS, ACEs, and PTSD-S. Demographics and trauma history were obtained from patient medical records. A stepwise multiple regression examined associations between experienced WS and internalized WS with PTSD-S, co-varying demographics, ACEs, and trauma, followed by examination of whether findings held co-varying anxiety/depressive symptoms in a participant subset (n = 189).
RESULTS
After accounting for covariates in step 1 and ACEs and trauma in step 2 (ΔR = .14), experienced WS and internalized WS accounted for substantial PTSD-S variance in steps 2 and 3 (ΔR = .12 and .13, respectively; overall model R =.44; P < .001). Findings held after co-varying anxiety/depressive symptoms.
CONCLUSIONS
Over and above ACEs and trauma, experienced WS and internalized WS may contribute to PTSD-S. Longitudinal research is needed to better elucidate the pathways underlying these associations.
Topics: Bariatric Surgery; Humans; Stress Disorders, Post-Traumatic; Substance-Related Disorders; Surveys and Questionnaires; Weight Prejudice
PubMed: 35811291
DOI: 10.1016/j.soard.2022.05.011 -
Child and Adolescent Psychiatric... Apr 2024There is an ongoing diagnostic and treatment challenge for migrant youth with posttraumatic stress disorder (PTSD) that many clinicians face. Current studies have helped... (Review)
Review
There is an ongoing diagnostic and treatment challenge for migrant youth with posttraumatic stress disorder (PTSD) that many clinicians face. Current studies have helped clinicians to develop a better understanding of the migrant youth's journey including potentially traumatic and adverse events they encounter. This includes determining if premigration, migration, and postmigration stressors have had an impact on the individual. This has also helped clinicians, educators, and legal advocates to use a collaborative approach to address the migrant youth's needs for managing the severity of PTSD symptoms.
Topics: Humans; Adolescent; Stress Disorders, Post-Traumatic; Transients and Migrants; Longitudinal Studies
PubMed: 38395506
DOI: 10.1016/j.chc.2023.10.005 -
Neuroscience Letters May 2017Resilience to traumatic stress is a complex psychobiological process that protects individuals from developing posttraumatic stress disorder (PTSD) or other untoward... (Review)
Review
Resilience to traumatic stress is a complex psychobiological process that protects individuals from developing posttraumatic stress disorder (PTSD) or other untoward consequences of exposure to extreme stress, including depression. Progress in translational research points toward the neuropeptide Y (NPY) system - among others - as a key mediator of stress response and as a potential therapeutic focus for PTSD. Substantial preclinical evidence supports the role of NPY in the modulation of stress response and in the regulation of anxiety in animal models. Clinical studies testing the safety and efficacy of modulating the NPY system in humans, however, have lagged behind. In the current article, we review the evidence base for targeting the NPY system as a therapeutic approach in PTSD, and consider impediments and potential solutions to therapeutic development.
Topics: Animals; Anxiety; Brain; Humans; Neuropeptide Y; Resilience, Psychological; Stress Disorders, Post-Traumatic; Stress, Psychological
PubMed: 27913193
DOI: 10.1016/j.neulet.2016.11.061 -
Journal of Sleep Research Aug 2021Emotion processing abnormalities and sleep pathology are central to the phenomenology of paediatric posttraumatic stress disorder, and sleep disturbance has been linked...
Emotion processing abnormalities and sleep pathology are central to the phenomenology of paediatric posttraumatic stress disorder, and sleep disturbance has been linked to the development, maintenance and severity of the disorder. Given emerging evidence indicating a role for sleep in emotional brain function, it has been proposed that dysfunctional processing of emotional experiences during sleep may play a significant role in affective disorders, including posttraumatic stress disorder. Here we sought to examine the relationship between sleep and emotion processing in typically developing youth, and youth with a diagnosis of posttraumatic stress disorder . We use high-density electroencephalogram to compare baseline sleep with sleep following performance on a task designed to assess both memory for and reactivity to negative and neutral imagery in 10 youths with posttraumatic stress disorder, and 10 age- and sex-matched non-traumatized typically developing youths. Subjective ratings of arousal to negative imagery (ΔArousal = post-sleep minus pre-sleep arousal ratings) remain unchanged in youth with posttraumatic stress disorder following sleep (mean increase 0.15, CI -0.28 to +0.58), but decreased in TD youth (mean decrease -1.0, 95% CI -1.44 to -0.58). ΔArousal, or affective habituation, was negatively correlated with global change in slow-wave activity power (ρ = -0.58, p = .008). When considered topographically, the correlation between Δslow-wave activity power and affective habituation was most significant in a frontal cluster of 27 electrodes (Spearman, ρ = -0.51, p = .021). Our results highlight the importance of slow-wave sleep for adaptive emotional processing in youth, and have implications for symptom persistence in paediatric posttraumatic stress disorder. Impairments in slow-wave activity may represent a modifiable risk factor in paediatric posttraumatic stress disorder.
Topics: Adolescent; Child; Emotions; Female; Humans; Male; Pilot Projects; Sleep; Stress Disorders, Post-Traumatic
PubMed: 33442931
DOI: 10.1111/jsr.13261 -
Current Psychiatry Reports Feb 2019Posttraumatic stress disorder is a chronic, heterogeneous disorder for which a multitude of psychotherapies, pharmaceuticals, and immerging treatment programs are... (Review)
Review
PURPOSE OF REVIEW
Posttraumatic stress disorder is a chronic, heterogeneous disorder for which a multitude of psychotherapies, pharmaceuticals, and immerging treatment programs are available. Majority of efficacy studies focus on Caucasian male military populations, which may be a reason why not all patients respond to treatment with long-term positive outcomes. Additionally, effects of treatment on symptom clusters have been neglected. This work reviews treatment of PTSD and its symptom clusters exclusively in civilian populations, which have been historically under-examined in the literature.
RECENT FINDINGS
Exposure therapy stands at the forefront of successful PTSD treatment and offers a more cost-effective solution to pharmacotherapy; however, refugees and patients with comorbid depression may not experience such strong benefits. For exposure therapy and other forms of psychotherapy, non-inferiority studies point to promise of internet-delivered and telemedicine-based methods for reaching populations that may not have access to in-person care. SSRIs are the most widely used pharmaceutical treatment for PTSD; moderate initial benefits are observed yet long-term retention and outcomes may be enhanced by adjunct treatment. Again, refugees are a group that experiences lesser benefit. Research has begun to explore efficacy of treatments for individual symptom clusters, with hyperarousal benefiting most from currently available modalities. Avoidance, intrusion, negative thoughts and beliefs, and dissociation are symptoms requiring more research for focused interventions. Treatment of PTSD has evolved to (1) include equivalent proportions of men and women, along with focused female-exclusive cohorts; (2) explore novel methods of treatment online and in various cultural contexts; and (3) less focus on medication as evidenced by current clinical trials. In addition to further efficacy and safety studies in more diverse ethnic populations, work is needed to examine what therapies are best for targeting specific symptom clusters of PTSD. This research will drive precision treatment, and such research is beginning to point towards underlying mechanisms of pathology and change.
Topics: Depression; Humans; Implosive Therapy; Refugees; Stress Disorders, Post-Traumatic
PubMed: 30734097
DOI: 10.1007/s11920-019-0994-3 -
Psychological Trauma : Theory,... Nov 2018Posttraumatic stress disorder (PTSD) and opioid use disorder (OUD) co-occur at high rates, and this co-occurrence is associated with a range of problems related to... (Review)
Review
OBJECTIVE
Posttraumatic stress disorder (PTSD) and opioid use disorder (OUD) co-occur at high rates, and this co-occurrence is associated with a range of problems related to mental and physical health. OUD is commonly treated with opioid agonist therapies (OAT), which have been shown to be effective for reducing opiate use and related negative health consequences. Given the high comorbidity of PTSD and OUD, many individuals in OAT have PTSD and continue to experience symptoms of both disorders despite OAT treatment. In this review, the extant literature on PTSD among individuals in OAT is presented.
METHOD
Relevant studies (N = 26) were identified systematically through a search of PubMed and PsychInfo databases.
RESULTS
Literature regarding prevalence and clinical characteristics of patients with PTSD in OAT and treatment outcomes related to both OUD and PTSD is reviewed.
CONCLUSION
Clinical implications of the body of work and recommendations for future research are provided. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Topics: Analgesics, Opioid; Comorbidity; Humans; Opioid-Related Disorders; Stress Disorders, Post-Traumatic
PubMed: 28758767
DOI: 10.1037/tra0000312