Association Between Posttraumatic Stress Disorder Following Myocardial Infarction and Liver Enzyme Levels: A Prospective Study

Background: Research in rodents demonstrated that psychological stress increases circulating levels of alanine transaminase, aspartate transaminase, and alkaline phosphatase reflecting liver injury. Moreover, chronic posttraumatic stress disorder and transaminases predicted coronary heart disease. Aims: To investigate the hypothesis that severity of posttraumatic stress disorder following myocardial infarction would prospectively relate to liver enzymes. Methods: Study participants were 24 patients (mean 59±7years, 79% men) with an interviewer-rated diagnosis of posttraumatic stress disorder caused by an index myocardial infarction 3±3months before. After a mean follow-up of 26±6months, patients had a clinical interview to reassess posttraumatic stress disorder severity, a medical history, and blood collected to determine liver enzymes. Results: Total posttraumatic stress disorder symptoms assessed at study entry prospectively predicted plasma levels of alanine transaminase (r=.47, p=.031) and alkaline phosphatase (r=.57, p=.004), but not of aspartate transaminase (p=.15), controlling for follow-up duration and antidepressant use. Total posttraumatic stress disorder symptoms assessed at follow-up were associated with alanine transaminase (r=.72, p=.004), aspartate transaminase (r=.60, p=.018), and alkaline phosphatase (r=.64, p=.001) in the 16 patients who had maintained diagnostic posttraumatic stress disorder, but not in all 24 patients. Conclusions: The severity of posttraumatic stress disorder following myocardial infarction was associated with mild increase in liver enzyme levels, suggesting that chronic psychological stress relates to hepatic damage in humans. This might help to explain the previously observed increased cardiovascular risk in chronically traumatized individual

Treating Trauma with Exposure Therapy

Posttraumatic Stress Disorder will be a common diagnosis that is seen in the counseling profession. The disorder is becoming more frequent than any time before. Individuals suffering from Posttraumatic Stress Disorder experience a wide range of symptomology and often try to cope with PTSD until treatment is received. This paper will discuss in detail what Posttraumatic Stress Disorder is and how one is diagnosed with the disorder. In addition, Posttraumatic Stress Disorder symptomology varies from individual to individual. Throughout the paper, PTSD’s wide range of symptoms will be discussed in great detail. If Posttraumatic Stress Disorder is not treated properly, the symptomology can affect an individual for the rest of his or her life. So therefore, it is crucial for individuals to receive the right kind of treatment for their symptomology. There are many types of treatment for Posttraumatic Stress Disorder, although, this paper will focus on exposure therapy and how it helps individuals suffering from PTSD

Brief report: Maternal posttraumatic stress symptoms are related to adherence to their child's diabetes treatment regimen.

Although research suggests that posttraumatic stress disorder symptoms in relation to physical health diagnoses may be related to poor adherence to treatment regimens, so far, whether parental posttraumatic stress disorder symptoms have an impact on their child's adherence to insulin-dependent diabetes mellitus treatment has not been investigated. Using self-report questionnaires, the present study found that children of mothers who have posttraumatic stress disorder symptoms in relation to their child's diagnosis of type I diabetes showed poorer adherence to treatment than the children of mothers without posttraumatic stress disorder. However, this was only the case for younger children (aged 0-8 years) where mothers played a more active role in their child's treatment

Posttraumatic Stress Disorder and Community Collective Efficacy following the 2004 Florida Hurricanes

There is a paucity of research investigating the relationship of community-level characteristics such as collective efficacy and posttraumatic stress following disasters. We examine the association of collective efficacy with probable posttraumatic stress disorder and posttraumatic stress disorder symptom severity in Florida public health workers (n = 2249) exposed to the 2004 hurricane season using a multilevel approach. Anonymous questionnaires were distributed electronically to all Florida Department of Health personnel nine months after the 2004 hurricane season. The collected data were used to assess posttraumatic stress disorder and collective efficacy measured at both the individual and zip code levels. The majority of participants were female (80.42%), and ages ranged from 20 to 78 years (median = 49 years); 73.91% were European American, 13.25% were African American, and 8.65% were Hispanic. Using multi-level analysis, our data indicate that higher community-level and individual-level collective efficacy were associated with a lower likelihood of having posttraumatic stress disorder (OR = 0.93, CI = 0.88–0.98; and OR = 0.94, CI = 0.92–0.97, respectively), even after adjusting for individual sociodemographic variables, community socioeconomic characteristic variables, individual injury/damage, and community storm damage. Higher levels of community-level collective efficacy and individual-level collective efficacy were also associated with significantly lower posttraumatic stress disorder symptom severity (b = −0.22, p<0.01; and b = −0.17, p<0.01, respectively), after adjusting for the same covariates. Lower rates of posttraumatic stress disorder are associated with communities with higher collective efficacy. Programs enhancing community collective efficacy may be an important part of prevention practices and possibly lead to a reduction in the rate of posttraumatic stress disorder post-disaster

Evaluation of Physical Activity Habits in Patients with Posttraumatic Stress Disorder

OBJECTIVE: In this study, we present data from a survey that aimed to assess the physical activity habits of adult Brazilian patients with Posttraumatic Stress Disorder. METHOD: Fifty male and female patients with Posttraumatic Stress Disorder participated in this study. The mean age at onset was 37±12 years, and the mean time between diagnosis and follow-up was 3.6±4.2 years. RESULTS: Substantial changes in physical activity habits were observed following the onset of PTSD. While more than half of the patients participated in physical activities prior to Posttraumatic Stress Disorder onset, there was a significant reduction in their participation afterwards. The justifications for stopping physical activities or sport participation were lack of time and lack of motivation. DISCUSSION: Several studies have shown that physical exercise decreases reverts symptoms of psychiatric disorders such as depression, anxiety and social isolation. We could therefore hypothesize that patients with Posttraumatic Stress Disorder who exercise should experience the same benefits. CONCLUSION: Our findings demonstrated that patients with Posttraumatic Stress Disorder have low levels of participation in sports or physical activities

Posttraumatic stress disorder

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenPost traumatic stress disorder (PTSD) and post-traumatic therapeutic intervention are relatively new concepts, and in fact it was only recently that psychiatric disorders connected with disastrous events were accepted as a separate category in the medical nomenclature. An attempt will be made here to shed some light on these concepts, principally in the hope that it may be of use to doctors in rural areas. Both old and recent papers, have been reviewed concerning the immediate as well as the long-term effects on individuals and groups who have been exposed to stressful experiences such as life-threatening situations. In addition to describing the symptoms of PTSD, risk factors are discussed such as individual vulnerability, particular circumstances, and the interaction of factors more conducive to chronic problems than the nature or intensity of the stressor. Then the term post-traumatic therapeutic intervention is evaluated. The view that emotional processing is the essence of treatment of the disorder is widely questioned. More comprehensive ideas about methods, and aid to people suffering from PTSD, are considered.Geðraskanir tengdar alvarlegri vá voru teknar upp sem sérstakur flokkur í greiningarlyklum læknisfræðinnar fyrir um 20 árum. Markmið þessarar greinar er að læknar í dreifðum byggðum landsins öðlist grundvallarskilning á áfallastreitu, átti sig á hverjir eru í áhættu og hvernig eigi að bregðast við. Til að ná þessu er rakin saga greiningarinnar og hvernig hugmyndir lækna hafa þróast um eðli áfallastreitu, meðferð og fyrirbyggjandi aðgerðir. Einkennum áfallastreitu er lýst og jafnframt er bent á áhættuþætti svo sem ýmsa veikleika fólks, aðstæður og samhengi ýmissa þátta, sem geta skipt meiru um langtímavanda fólks en eðli og styrkur áfallsins. Raktar eru efasemdir um gildi viðrunar tilfinninga (debriefing) í áfallahjálp, en jafnframt bent á aðra kosti í meðferð, sem heimilislæknar ættu að kunna skil á

Treating PTSD with Imagery Rescripting in underweight eating disorder patients: a multiple baseline case series study

BACKGROUND: Eating disorder patients with posttraumatic stress disorder have worse treatment results regarding their eating disorder than patients without posttraumatic stress disorder. Many eating disorder patients with co-morbid posttraumatic stress disorder symptoms are not treated for posttraumatic stress disorder symptoms during an underweight state. We propose that treatment of posttraumatic stress disorder is possible for underweight patients and that their trauma symptoms decrease with the use of Imagery Rescripting. We also investigated whether treatment of trauma influences eating disorder pathology in general and the process of weight gain specifically. METHOD: Ten patients in clinical treatment (BMI 14–16.5) participated. A multiple baseline design was used, with baseline varying from 6 to 10 weeks, a 6-week treatment phase, a 3-week follow-up period and a 3-month follow-up measurement. Data were analysed with mixed regression. RESULTS: Evidence was found that Imagery Rescripting had strong positive effects on posttraumatic stress disorder symptoms without interfering with eating disorder treatment. Positive effects were also found on a range of secondary emotional and cognitive measures. CONCLUSION: Imagery Rescripting of traumatic memories is a possible and safe intervention for underweight eating disorder patients. It also had positive clinical effects. Trial registration Netherlands trial register (NTR) Trial NL5906 (NTR6094). Date of registration 09/23/2016. https://www.trialregister.nl/trial/5906

Posttraumatic Stress Disorder

The chapter begins by describing how PTSD is diagnosed, contrasting the ‘broad’, inclusive DSM formulations with the ‘narrow’ formulation focusing on core symptoms introduced in ICD-11. The ICD-11 distinction between PTSD and Complex PTSD is also described. We go on to consider why PTSD has been regarded as a disorder of memory, and the two signature changes consisting of vivid re-experiencing of the traumatic event in the present coupled with impaired voluntary recall of the event. Other aspects of memory affected in PTSD that are unrelated to the traumatic event include a general bias toward recalling negative rather than positive stimuli, verbal memory deficits, and difficulties in retrieving specific memories and suppressing unwanted memories. We discuss three prominent controversies, whether traumatic memories are ‘special’, whether traumatic events can be forgotten, and whether there is evidence for delayed onset PTSD. Contemporary theories of PTSD are then described including fear conditioning, neo-conditioning theories, the Ehlers and Clark cognitive model, and dual representation theory, all of which identify deficits in memory for context as central to the disorder. In the final section we discuss how traumatic memory changes with successful treatment and the likely mechanisms involved in psychological therapy for PTSD: Habituation/extinction, updating/reconsolidation, and metacognitive change

Posttraumatic Stress Disorder

Excerpt: Posttraumatic stress disorder (PTSD) is a psychological disorder precipitated by exposure to a traumatic event or a series of events. This event is usually experienced by an individual. However, PTSD can also develop as a result of observing or hearing of a traumatic event occurring in someone else\u27s life (such as a relative or a close friend). PTSD was introduced as a disorder in 1980 in the DSM-III. The DSM-Ill-R\u27s condition for diagnosis was the experiencing of a traumatic event that was outside the range of usual human experience. However, in DSM-IV, the focus is not so much on the nature of the event as it is on the individual\u27s response to the event and his or her vulnerability to developing the characteristic symptoms

Comorbid mood and anxiety disorders in victims of violence with posttraumatic stress disorder

OBJETIVO: Buscar estudos que avaliem a comorbidade entre transtorno de estresse pós-traumático e transtornos do humor, bem como entre transtorno de estresse pós-traumático e outros transtornos de ansiedade. MÉTODO: Revisamos a base de dados do Medline em busca de estudos publicados em inglês até abril de 2009, com as seguintes palavras-chave: "transtorno de estresse pós-traumático", "TEPT", "transtorno de humor", "transtorno depressivo maior", "depressão maior", "transtorno bipolar", "distimia", "transtorno de ansiedade", "transtorno de ansiedade generalizada", agorafobia", "transtorno obsessivo-compulsivo", "transtorno de pânico", "fobia social" e "comorbidade". RESULTADOS: Depressão maior é uma das condições comórbidas mais frequentes em indivíduos com transtorno de estresse pós-traumático, mas eles também apresentam transtorno bipolar e outros transtornos ansiosos. Essas comorbidades impõem um prejuízo clínico adicional e comprometem a qualidade de vida desses indivíduos. Comportamento suicida em pacientes com transtorno de estresse pós-traumático, com ou sem depressão maior comórbida, é também uma questão relevante, e sintomas depressivos mediam a gravidade da dor em sujeitos com transtorno de estresse pós-traumático e dor crônica. CONCLUSÃO: Os estudos disponíveis sugerem que pacientes com transtorno de estresse pós-traumático têm um risco maior de desenvolver transtornos afetivos e, por outro lado, transtornos afetivos pré-existentes aumentam a propensão ao transtorno de estresse pós-traumático após eventos traumáticos. Além disso, vulnerabilidades genéticas em comum podem ajudar a explicar esse padrão de comorbidades. No entanto, diante dos poucos estudos encontrados, mais trabalhos são necessários para avaliar adequadamente essas comorbidades e suas implicações clínicas e terapêuticas.OBJECTIVE: To review studies that have evaluated the comorbidity between posttraumatic stress disorder and mood disorders, as well as between posttraumatic stress disorder and other anxiety disorders. METHOD: We searched Medline for studies, published in English through April, 2009, using the following keywords: "posttraumatic stress disorder", "PTSD", "mood disorder", "major depressive disorder", "major depression", "bipolar disorder", "dysthymia", "anxiety disorder", "generalized anxiety disorder", "agoraphobia", "obsessive-compulsive disorder", "panic disorder", "social phobia", and "comorbidity". RESULTS: Major depression is one of the most frequent comorbid conditions in posttraumatic stress disorder individuals, but individuals with posttraumatic stress disorder are also more likely to present with bipolar disorder, other anxiety disorders and suicidal behaviors. These comorbid conditions are associated with greater clinical severity, functional impairment, and impaired quality of life in already compromised individuals with posttraumatic stress disorder. Depression symptoms also mediate the association between posttraumatic stress disorder and severity of pain among patients with chronic pain. CONCLUSION: Available studies suggest that individuals with posttraumatic stress disorder are at increased risk of developing affective disorders compared with trauma-exposed individuals who do not develop posttraumatic stress disorder. Conversely, pre-existing affective disorders increase a person's vulnerability to the posttraumatic stress disorder--inducing effects of traumatic events. Also, common genetic vulnerabilities can help to explain these comorbidity patterns. However, because the studies addressing this issue are few in number, heterogeneous and based on a limited sample, more studies are needed in order to adequately evaluate these comorbidities, as well as their clinical and therapeutic implications