Veterans with post-traumatic stress disorder (PTSD) have increased rates of overweight/obesity, higher prevalence of obesity-related medical conditions, and greater morbidity and mortality compared to their peers without PTSD. The aim of this study was to assess the impact of PTSD on weight and metabolic parameters as well as the effect of weight change on metabolic indices. In a case-control cohort, we compared PTSD patients (n=364) with those without mental health disorders (NoMH, n=1,008) at baseline (i.e., eight years prior to enrollment) and on the trajectory of changes before the enrollment in the Miami VA MOVE!® (Weight Management for Veterans) program. Multilevel modeling for change was used to investigate changes in weight and physiological markers over time. The sample consisted of 1,372 veterans (1,208 men and 164 women). Mental health status, weight and metabolic parameters were obtained from medical record. The PTSD group was significantly younger, had lower average BMI at baseline, and higher prevalence of weight-related medical conditions. Groups did not differ by gender, race/ethnicity, or Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) status. At baseline, the PTSD group had significantly lower weight, lower HDL-cholesterol, and higher values for glucose and triglycerides than the NoMH group. The PTSD group had a significantly greater slope than NoMH group for HDL-cholesterol (p¬=.011). The difference in rate of change between groups for weight, glucose, and triglycerides was not significant. The sample as a whole showed a significant increase for weight and glucose while total cholesterol, blood pressure, and triglycerides decreased over time. Despite lower weight, veterans with PTSD had greater prevalence of weight related-medical conditions while rate of change in metabolic parameters over time was comparable to NoMH peers. Exploratory analyses showed that weight had a significant negative effect on total cholesterol and blood pressure. PTSD appears to be a significant risk factor for diabetes and overall metabolic dysfunction. The lack of results with regards to the effect of weight on HDL cholesterol, triglycerides, glucose and hemoglobin A1c are not surprising given the complex relationships among weight and these metabolic indices.

Indiana University-Purdue University Indianapolis (IUPUI) / Intimate partner violence is a problem in the United States (U.S.) military. Previous research has identified factors that increase a couple’s risk for engaging in violence. Most of these factors, such as age, alcohol, and relationship satisfaction are consistent across civilian and military samples. One factor that is unique to military samples is deployment; service members can be exposed to unique traumatic incidents while deployed which are generally unknown to most civilians. Deployments can also increase a service member’s risk for developing Post Traumatic Stress Disorder (PTSD), which can increase their risk for intimate partner violence. Previous research on the effect of deployments on intimate partner violence has produced mixed results. The purpose of this study was to analyze if deployment, total length of deployment, combat experiences from deployment, and PTSD symptoms increased risk for Air Force airmen to perpetrate intimate partner violence at a moderate or severe level of violence. Survey data from a representative sample of active duty Air Force airmen (N = 1,501) was used to conduct Chi-Square analyses and multinomial logistic regression models for perpetrated violence. Results of the study showed that deployment and combat experiences were not significant predictors of perpetrated violence. PTSD symptoms, in addition to alcohol misuse and relationship satisfaction, were significant predictors of moderate and severe perpetrated violence. In terms of practice and policy implications, the study results underscore the importance of widespread screening for these risk factors as well as the availability of interventions focused on alcohol use and relationship issues among service members. Future research could determine if PTSD symptoms moderate the relationship between combat experiences and intimate partner violence.

Thesis is submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Faculty of Humanities, University of the Witwatersrand, Johannesburg, 1998 / The study was directed at exploring the social and personal construction of meaning of male victims of violent crime. Three inter-related goals were identified: the extension of the nascent narrative/thematic tradition of analysis in the traumatic stress field; the deepening of appreciation of the experience of criminal victimization; and the exploration o f the role of social construction in the cognitive schematic adjustment of victims. In this instance the examination of the role of social construction was focussed centrally on the juxtaposition of the subject roles associated with masculinity and victimization. On the basis of both clinical observation and theory, it was postulated that aspects of masculine identification would create difficulties for men attempting to adjust to involuntary exposure to a context in which they were clearly victimized. The thesis provides comprehensive coverage of theory straddling cognitive adjustment to psychological trauma, mainstream and critical social psychological theory on victimization, developmental and descriptive dimensions of theory on masculinity and a range of literature on criminal victimization. The theoretical conceptualization underpinning the study offers a unique integration of this body of knowledge. In order to investigate the research question, ten adult, white, English speaking,South African men who had experienced a life-threatening, criminally motivated attack were interviewed about the event and their subsequent responses. The study was located within the qualitative research tradition allowing for the development of theory, and fox depth of description and interpretation. Semi-structured interviews were recorded and tnmscribdl w batim . Interview transcripts were subjected to a thematic content analysis by means of a computer-aided text interpretation. Frequency figures were calculated, but the emphasis of the analysis was in the area of descriptive and interpretive dimensions. Three central themes emerged as signi fi cant; those of Control, Disillusionment and Anger. Multiple facets of each theme are addressed, including centrally the interface between thematic dimensions and the social construction of masculinity. A meta-theoretical discourse analytic commentary is provided, addressing for example, the rob of the “hero” discourse in interviewee’s reports. In addition, the clinical implications of the data are explored. The study provides evidence of the inter-relationship between social and personal construction o f meaning in the aftermath of tramatization. It is suggested that in the context of victimization the social construction of masculinity is both more intractable and more permeable than might be supposed.

This thesis presents research aimed at elucidating neurophysiological and neuropsychological correlates of two psychiatric disorders, schizophrenia and PTSD. Although psychiatric disorders are not traditionally known for featuring cognitive deficits, research over the past three decades has revealed that deficits in many aspects of cognitive functioning are present across a wide range of disorders. Here, we aim to further our understanding of these deficits and provide evidence of the clinical utility of neurophysiological correlates of cognitive dysfunction. The cause and course of cognitive deficits in PTSD is poorly understood, and an investigation of one potential explanatory mechanism, dissociative symptomatology, is presented in the first part of this thesis. Our results suggest that dissociative symptomatology plays a role in cognitive dysfunction in PTSD, as among the clinical variables tested (including PTSD symptomatology, dissociative symptoms, depressive symptoms, and anxiety symptoms) dissociative symptoms were the only significantly correlated variables to cognitive dysfunction in a sample of combat-trauma exposed veterans with and without PTSD. In the second part of this thesis, we investigate the potential clinical utility of a neurophysiological biomarker for semantic processing deficits, the N400, in schizophrenia. Our results indicate that N400 measures are stable over a one week period and therefore may be clinically useful as a neurophysiological biomarker for semantic processing abnormalities in schizophrenia. Overall, these two studies contribute to our knowledge of cognitive deficits in psychiatric disorders and demonstrate their complexity as well as their potential to provide clinically useful tools to aid in the identification of novel treatments targeted at ameliorating cognitive deficits in schizophrenia and PTSD. / Thesis / Master of Science (MSc)

The current study aimed to focus on Post-Traumatic Stress Disorder (PTSD) symptoms in parents who have a child diagnosed with a rare genetic syndrome called CHARGE Syndrome. While previous studies have investigated related factors to parental PTSD (Reda & Hartshorne, 2008; Wulffaert et al., 2009), this study was one of the first to focus on parental PTSD symptomology and possible traumatic experiences related to CHARGE (e.g., medical complications). Specific concerns related to PTSD addressed in the current study included trauma histories, the number of surgeries a child underwent, and parent stress levels. One hundred and ninety-seven parents completed surveys that met inclusion criteria for the study. Findings indicated that 48% of parents showed signs of PTSD based on reported symptomology. Additionally, higher parent stress levels were found to be contributed to greater symptomology presentation. Overall outcomes of the study demonstrate that PTSD and parent stress levels may affect parents' abilities to adequately provide the needed emotional support and care for their children with CHARGE Syndrome without support. This study paves the way for additional research in this area to focus on the screening and development of treatment resources for parents of children with CHARGE Syndrome. Future directions and limitations were discussed in detail.

The SARS-CoV-2 pandemic has been a worldwide chronic, stress-inducing natural catastrophe associated with increased emotional challenging. Patients with Post-traumatic stress disorder (PTSD), self-injury behavior, and obesity are predisposed to aggravation of their symptoms at this time, requiring new therapeutic approaches to balance their disrupted neuro-hormonal stress axis. Here we present our observations of an off-label treatment with lamotrigine in an adolescent girl with PTSD, self-injury behavior, and obesity. Lamotrigine was an efficacious pharmaceutical intervention that helped the patient deal with chronic stress and associated anxiety. The results are discussed based on our previous basic research outcomes in animals and humans that focused on the glutamate-cortisol circuits within the limbic brain.

Thesis (Ed.D.)--Boston University / Background: Season-ending injuries, particularly those to the anterior cruciate ligament (ACL), continue at a high-rate in many sports, particularly ski racing. Although many factors are thought to contribute to this injury rate in both genders, no study has looked at possible psychological influences. Hypothesis: There is a form of post-traumatic stress disorder (PTSD) that affects athletes after seeing someone in their own sport sustain a serious injury. The result could be a decrease in performance both on and off the mountain. In the worst-case scenario, this change in tactics could result in injury to themselves, representing an "injury contagion". Study Design: Case-control study; Level of evidence, 3. Methods: Students at four Eastern ski academies were studied for 3 consecutive years (2002-2005). The subjects ranged in age from 13-19 and consisted of 277 men (60.3%) and 182 women (39.7% ). When a subject sustained a season-ending injury, a peer group of that subject was tested for both psychological and performance effects. The results of this testing was compared to previous baseline testing and a similarly constructed control group from an academy without such an injury. Results: There were twelve season-ending injuries sustained over the three-year period. Significant data results were obtained from one aspect of the psychological testing of the peer group. There was a trend toward a possible "injury contagion" i.e. injury to a member of the peer group soon after injury to a teammate. Conclusions: Although the results of this study were inconclusive in establishing the existence of an "injury contagion", there were data to establish a psychological affect on some athletes after injury to one of their teammates. Clinical Relevance: Although a teammate's injury did not measurably effect performance and only showed mild evidence of a possible injury contagion, there were significant psychological affects noted in female subjects. School personnel should be trained in basic counseling techniques specific to this problem.

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