Elevated amygdala activity to sad facial expressions:a state marker of bipolar but not unipolar depression

Background - Difficulties in emotion processing and poor social function are common to bipolar disorder (BD) and major depressive disorder (MDD) depression, resulting in many BD depressed individuals being misdiagnosed with MDD. The amygdala is a key region implicated in processing emotionally salient stimuli, including emotional facial expressions. It is unclear, however, whether abnormal amygdala activity during positive and negative emotion processing represents a persistent marker of BD regardless of illness phase or a state marker of depression common or specific to BD and MDD depression. Methods - Sixty adults were recruited: 15 depressed with BD type 1 (BDd), 15 depressed with recurrent MDD, 15 with BD in remission (BDr), diagnosed with DSM-IV and Structured Clinical Interview for DSM-IV Research Version criteria; and 15 healthy control subjects (HC). Groups were age- and gender ratio-matched; patient groups were matched for age of illness onset and illness duration; depressed groups were matched for depression severity. The BDd were taking more psychotropic medication than other patient groups. All individuals participated in three separate 3T neuroimaging event-related experiments, where they viewed mild and intense emotional and neutral faces of fear, happiness, or sadness from a standardized series. Results - The BDd—relative to HC, BDr, and MDD—showed elevated left amygdala activity to mild and neutral facial expressions in the sad (p < .009) but not other emotion experiments that was not associated with medication. There were no other significant between-group differences in amygdala activity. Conclusions - Abnormally elevated left amygdala activity to mild sad and neutral faces might be a depression-specific marker in BD but not MDD, suggesting different pathophysiologic processes for BD versus MDD depression

Posttraumatic Growth among Latina Victims of Interpersonal Violence in Psychological Treatment

Posttraumatic growth (PTG) is an area of research that describes the positive psychological changes that often occur after a traumatic event (Tedeschi & Calhoun, 2004). To date, PTG has been documented in many countries for individuals that have experienced a range of traumatic experiences (Tedeschi & Calhoun, 2004; Weiss & Berger, 2010a). However, there is no research on PTG changes as a result of participation in psychological treatment with Latinas in the US. This study used data obtained at a local community mental health clinic to assess PTG levels before and after a trauma treatment among 77 Latinas victims of interpersonal violence. It was hypothesized that: 1. There would be a significant increase in PTG from pre to post treatment, 2. religious affiliations and attending religious services would be positively associated with PTG at post intervention, 3. minutes and duration of treatment would be positive predictors of PTG, 4. post-treatment PTG would be positively associated with post-treatment PTSD symptoms. It was concluded that pre-treatment PTG was a positive predictor while post-treatment PTSD symptoms were negatively associated with post-treatment PTG. Measures of religion were not significant predictors of post-treatment PTG. Clinical implications of this study are discussed and recommendations are made for further research on PTG change during treatment

Cognitive behavioral therapy for PTSD and somatization: An open trial

No treatment, to date, has been developed to improve both posttraumatic stress disorder (PTSD) and medically unexplained physical symptoms (MUPS), despite mounting evidence of high comorbidity between PTSD and MUPS. This study assessed the feasibility, acceptability, and treatment outcomes of an adapted cognitive behavioral therapy for PTSD and abridged somatization in a sample of eight participants. Fifteen percent of completers did not meet PTSD criteria after treatment completion and 62.5% improved their somatic symptoms. There was a significant difference between pre- and post-treatment depression symptoms, as well as in psychological and physical functioning measures. Results indicated a small to moderate effect size (d = 0.27–0.78) in PTSD severity scores, and moderate to large effect size in depression symptoms and psychosocial and physical functioning variables (d = 0.39–1.12). Preliminary evidence of acceptability indicates that the current CBT intervention may be suitable for Latinos individuals with PTSD and MUPS. ► We treated 8 Latinos with PTSD and unexplained physical symptoms with an adapted CBT intervention. ► We found moderate effect size in PTSD symptoms reduction. ► We found moderate to large effect size in depression symptoms. ► We found moderate to large effect sizes in psychosocial/physical functioning variables. ► This treatment is a promising approach for PTSD and MUPS in a non-White population