No description available.

No description available.

Post-traumatic stress disorder (PTSD) is a debilitating disorder with a prevalence rate of approximately 5%. Unfortunately, this disorder is commonly associated with another debilitating disorder, alcohol use disorder (AUD). Of the 5% of people diagnosed with PTSD, 30%-59% also suffer from AUD. Currently, there are limited effective treatment options for those suffering from comorbid PTSD/AUD. Previous research has suggested that biological sex differentially impacts PTSD comorbid with AUD, however, the underlying mechanisms are enigmatic. The goal of this study was to better understand the underlying mechanisms that mediate sex differences in a rodent model of comorbid PTSD/AUD by analyzing specific behavioral tasks and changes in neuronal function of specific brain regions. Chronic inflammation has been implicated in PTSD and AUD respectively, with differences between sexes being observed. Females tend to express elevated levels of inflammation in both disorders compared to males in brain regions such as, the hippocampus, amygdala, and prefrontal cortex. Tumor necrosis factor α (TNF-α) is a proinflammatory cytokine that is released during neuronal inflammation. To further examine these sex differences, a comorbid PTSD/AUD rodent model was implemented using restraint stress (RS) and chronic intermittent ethanol use (CIE). Following the exposure to RS and CIE a fear conditioning procedure was implemented to assess changes in future stress sensitivity. The fear conditioning paradigm was accomplished by conditioning the animal to pair a tone with a foot shock, followed by extinction of that behavior in a different context where the animal received the tone but no foot shock. Thereafter, the animal was placed back in the context they received the foot shock, known as context renewal, but acquired no tone or foot shock. The behavior in these different contexts was analyzed to test memory and stress sensitivity. Brain tissue was collected to analyze TNF-α protein expression in regions associated with learning, memory, and addiction such as, the prelimbic cortex (PrL), infralimbic cortex (IfL), and the hippocampus. The results of the fear conditioning revealed that the females froze more altogether compared to the males, and there was more freezing of the females with RS and CIE during context renewal. It is expected that TNF-α protein expression will be significantly elevated in females when compared to males, regardless of treatment group. Females exposed to RS and CIE will have significantly higher TNF-α levels when compared to all other treatment groups. Finally, increases in TNF-α protein expression will be region specific with the PrL and IfL regions exhibiting significantly greater expression than the hippocampus. This study will aid in better understanding the sex differences and lead to better treatment options that are sex-dependent for those diagnosed with comorbid PTSD/AUD.

Background: The high prevalence of mental disorders related to posttraumatic stress among Syrian refugees is often in contrast with their low utilization ofmental health care in the host countries. Mental health self-stigma, i.e., internalized stigma of having a mental disorder, could prevent individuals from seeking mental health care. Therefore, we aimed to provide evidence on different aspects of mental health self-stigmatization among adult Syrian refugees with posttraumatic stress symptoms residing in Germany. Moreover, we investigated associations with sociodemographic and psychopathological variables in order to identify those at higher risk of self-stigmatization. Material and Methods: Overall, 133 participants with mild to moderate posttraumatic stress symptoms were recruited in the metropolitan areas of Leipzig, Dresden and Halle, Germany, using a multimodal approach. Mental health self-stigma was assessed using the Self-Stigma of Mental Illness Scale – Short Form (SSMIS-SF), consisting of four subscales (Stereotype awareness, Stereotype agreement, Application to self, Harm to self-esteem), each scoring from 5 (low) to 45 (high) points. Linear regression analysis was used to test associations of sociodemographic and psychopathological variables with self-stigma subscales. Results: On average, self-stigma ratings ranged from 16.5 (SD = 6.6) points on Application to self to 28.3 (SD = 7.5) points on Stereotype awareness. Results showed higher scores on Application to self for individuals who were younger (t =2.65, p=0.009) and single (F = 5.70, p = 0.004). Regression analyses yielded statistically significant associations between having multiple comorbidities and a higher Application to self stigma ( = 0.18, p = 0.044), controlling for sociodemographic covariates. Discussion: Mental health self-stigma was increased among Syrian refugees in Germany. Correlates of increased self-stigma could inform efforts to improve access to mental health care among Syrian refugees with mental ill-health. Longitudinal studies following an intersectional approach by concurrently examining multiple forms of public and internalized stigma could provide helpful insights for developing tailored stigma reduction efforts in this context.

No description available.

Veterans of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn are presenting for treatment with high rates of combat-related posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI), spurring a need for clinical research on optimal treatment strategies. While exposure therapy has long been supported as an efficacious treatment for combat-related PTSD, some clinicians are hesitant to utilize this treatment for veterans with TBI history due to presumed cognitive deficits that may preclude successful engagement. The purpose of this study was to compare exposure therapy process variables in veterans with PTSD only and veterans with PTSD+TBI. Results suggest that individuals with PTSD+TBI engage successfully in exposure therapy, and do so no differently than individuals with PTSD only. Additional analyses indicated that regardless of TBI status, more severe PTSD was related to longer sessions, more sessions, and slower extinction rate during imaginal exposure. Finally, in a subset of participants, self-report of executive dysfunction did not impact exposure therapy process variables. Overall, findings indicate that exposure therapy should be the first-line treatment for combat-related PTSD regardless of presence of TBI history.

Many factors can discourage survivors of sexual assault from reporting their assaults. Even those survivors who disclose, their reporting experiences may not leave them feeling empowered or that they have received adequate support to begin the healing process after disclosure. Using a mixed methods approach, we examined the relationship between religious and spiritual coping strategies, the experience of social disclosure, and symptoms of posttraumatic stress disorder (PTSD) and depression using confirmatory factor analysis (CFA) and structural equation modeling (SEM). We further used qualitative data examining the ways that participants used religious/spiritual coping strategies in response to the trauma of sexual assault. In total, 94 female or non-binary participants were enrolled. The CFA showed good model fit for all latent factors except positive religious coping and positive social responses. The SEM path analysis found a significant relationship between the latent factor Distract and PTSD symptoms. No other variables were significant in the SEM model, likely due to the small sample size. Qualitative data themes were identified such as respondent-supported healing, responses promoting shutting down/isolation, and responses affecting self-blame for social disclosure and positive and negative religious coping. Finally, this study substantiates the importance of research assessing the needs and experiences of sexual assault survivors, as this is a population that is particularly vulnerable, and struggles to get adequate support and resources. An increase in understanding about the experiences, needs, and coping strategies of sexual assault survivors will help both informal and formal interventions become more effective.

The aim of this study was to look at the impact of post-traumatic stress disorder (PTSD) on the hippocampus, specifically any variations in volume between individuals with PTSD and a control group. Two databases, PubMed and Web of Science, were utilised to locate literature, with a focuson recent (5-year) articles. These were the study's inclusion requirements: (1) inclusion of adults with PTSD; (2) MRI as a method of studying changes in the brain ; (3) Comparison of outcomes with a control group with or without trauma. This studys exclusion criteria were: (1) non-English language papers, (2) non- adults participants, and (3) other imaging method than MRI. These criteria were intended to ensure the selection of appropriate articles and the uniformity of the systematic review. All the studies looked at MRI to investigate structural changes in the volume of the hippocampus. In the end I investigated 10 studies with a total of 3,826 participants and the findings of these investigations revealed that some studies shown dicreasing of hippocampal volume between patients with PTSD and the control group, whereas others found no such changes as the result of the investigation. These disparate findings show a lack of agreement in the available literature on the influence of PTSD on hippocampus volume. The selection of only recent (5 years) papers and the limited number of studies were the constraints. However, due to a lack of time, broader research could not be done, which made it difficult to draw more accurate conclusions from the study.

The present study investigated the influence of HIV-related stigma, social support, and impact of HIV diagnosis on posttraumatic growth (PTG) in adults living with HIV (N = 126). In addition, the study aimed to identify if social support moderated the relationship between stigma and PTG. Lastly, the study attempted to determine how impactful receiving an HIV diagnosis was to the sample. One hundred and twenty-six adults living with HIV within the state of Florida (41% response rate) participated in the research. Participants were recruited from a series of support groups and HIV focused agencies throughout the state, and responded through face to face survey administration. Each assessment packet consisted of the following assessments: (a) Posttraumatic Growth Inventory; [PTGI], Tedeschi & Calhoun, 1996, (b) Multidimensional Scale of Perceived Social Support; [MSPSS], Zimet, Dahlem, Zimet, & Farley, 1988, (c) Berger HIV Stigma Scale; Berger, Ferrans, & Lashley, 2001, (d) Impact of Event Scale [IES-R . Weiss & Marmar, 1996], (e) Reynolds Short Form Social Desirability Scale; Reynolds, 1982, and (f) a demographic questionnaire. Multiple regression analysis was used to determine whether the independent variables were predictive of the outcome of PTG. Findings from the study revealed that each of the predictor variables (i.e., stigma, social support, and impact of diagnosis) contributed significantly (p<.05) to the model, and accounted for 12% of the variance in PTGI scores. In examining the moderating presence of social support between stigma and PTG, there was no found significant interaction between stigma and social support. Significant differences in PTG scores were also identified amongst differing demographic groups, specifically participant ethnicity and religious orientation. Findings also revealed that 38.5% of the sample reported their HIV diagnosis as so impactful that they would likely qualify for a clinical diagnosis of posttraumatic stress disorder (PTSD). Furthermore, a detailed discussion of previous literature, study procedures and methodology, counselor implications, counselor educator implications, and recommendations for future research are discussed.

Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) frequently co-occur. Comorbid PTSD+SUD confers heightened risk of other mental health concerns, suicidality, mortality, and functional impairment. Current treatments for comorbid PTSD+SUD show inconsistent results, highlighting the need for a more comprehensive understanding of the associations between PTSD and SUD symptoms. The current dissertation aimed to characterize the associations between PTSD and SUD using structural equation modelling among three different samples with differing clinical severity and presentation: (1) concurrent disorders sample with a high prevalence of PTSD; (2) an in-patient sample seeking treatment for PTSD; and (3) a subclinical sample of healthcare workers and public safety personnel. Data were extracted from multiple clinical databases across different studies to evaluate the associations between PTSD symptoms and alcohol/cannabis/substance use-related problems. Furthermore, the role of underlying mechanisms such as dissociation and emotion dysregulation, which are associated with both PTSD and SUD, were analyzed. All analyses used a structural equation modelling framework to represent the complex clinical presentation of comorbid PTSD+SUD analytically. A relatively consistent pattern of results was observed across the three samples. Global PTSD symptoms were significantly associated with cannabis-related problems, alcohol-related problems, and other illicit substance-related problems. Among PTSD symptoms, the reactivity symptom cluster (characterized by symptoms of hypervigilance, irritability, reckless behaviour, problems with concentration and sleep disturbances) was significantly associated with alcohol/cannabis/substance-related v problems across among the three samples. Furthermore, underlying mechanisms such as dissociation and emotion dysregulation significantly mediated the relations between PTSD symptoms and alcohol/cannabis/substance-related problems. Overall, the current results contribute to the limited literature examining the associations between PTSD and SUD symptoms. Lastly, the current results have important clinical implications for identifying efficacious treatment targets for comorbid PTSD+SUD. / Dissertation / Doctor of Philosophy (PhD) / Psychological distress following a traumatic event, known as traumatic stress, is often associated with problematic alcohol and/or substance use. The co-occurrence of these two confers a heightened risk of other mental health problems. As such, studying how these phenomena are associated with one another and what about each thing is more important to the association is important to understand. The purpose was to examine the connection between these phenomena among three different groups of people: two treatment-seeking groups and non-treatment seeking group one group. Traumatic stress was associated with problematic substance use in all three groups. In addition, other factors like mentally escaping from your body and having difficulties with regulating your emotions explained how traumatic stress and problematic substance use were connected to each other. These findings can help clinicians hone their treatment programs to better help individuals struggling with traumatic stress and problematic substance use.