Soldiers who kill in combat less likely to abuse alcohol
- June 10, 2014
Science Daily/American University
New research documents the impact of combat experiences on alcohol use and misuse among National Guard soldiers. Whereas much research regarding combat personnel is based on post-experience data, this study's design uses both pre- and post-deployment data to identify the association between different types of combat experiences and changes in substance use and misuse.
It's no secret that combat experiences are highly stressful and can contribute to instances of post-traumatic stress disorder and depression among soldiers post-deployment. It also comes as no surprise that many soldiers afflicted with these conditions abuse alcohol in an attempt to self-medicate.
But new research coauthored by Cristel Russell, an associate professor of marketing with American University's Kogod School of Business, and researchers with the Walter Reed Army Institute of Research finds that the most traumatic of all combat experiences, killing, is less likely to lead to alcohol abuse.
The study, titled "Changes in Alcohol Use after Traumatic Experiences: The Impact of Combat on Army National Guardsmen" and published in the June issue of the journal Drug and Alcohol Dependence, runs contrary to previous research.
"We were very surprised by the findings. Most previous research supported the prediction that more traumatic experiences would lead to more negative health outcomes, such as alcohol abuse," said Russell. "We found the opposite -- that the most traumatic experiences of killing in combat actually led to a decrease in alcohol abuse post-deployment."
Mortality Salience
Why would killing in combat, thought to be one of the most difficult stressors, cause soldiers to become less likely to abuse alcohol? Russell and her colleagues believe that killing experiences may cause soldiers to have an increased sense of mortality and vulnerability that triggers a focus on self-preservation, which manifests itself in reduced high-risk alcohol consumption.
"We reason that a possible explanation may be that soldiers who experience killing during combat become more aware of their own vulnerability to death. Mortality salience is known to have effects on decisions that people make including, in our case, the decision to not take risks and abuse alcohol, presumably to live longer," said Russell. "This is a post hoc explanation and our future research is going to try and explore this intriguing explanation further."
Comparing Pre-and-Post Deployment Data
The study is also one of the first to compare pre-and post- deployment data. Russell and her colleagues used this approach to better identify the associations between different types of combat experiences and changes in alcohol consumption.
For the study, Russell and her fellow researchers surveyed 1,397 members of an Army National Guard Infantry Brigade Combat Team three months before and three months after their deployment to Iraq in 2005-2006. Members of the unit completed anonymous surveys regarding behavioral health and alcohol use and, in the post-survey, the combat experiences they had during deployment.
Aside from the stunning revelation that soldiers who kill in combat are less likely to abuse alcohol post-deployment, survey results revealed that the prevalence of alcohol use increased from 70.8% pre-deployment to 80.5% post-deployment and that alcohol misuse more than doubled, increasing from 8.51% before deployment to 19.15% after deployment.
Next Steps
This study acknowledges that future research is needed on this complex topic. Russell and her colleagues plan to explore the influence mortality salience has on soldiers who have killed while in combat in further detail.
"It is important for healthcare providers and researchers to better understand and account for the fact that traumatic events do not necessarily result in a negative outcome and that positive outcomes can in fact be born from traumatic events," said Russell. "Building on these findings, future research should take into account the degree to which individuals are equipped to deal with stressful situations and assess how coping strategies may affect their behavioral response to potentially traumatic events. There may be ways to promote coping pre- or post-traumatic experiences."
http://www.sciencedaily.com/releases/2014/06/140610122010.htm
Unexpected death of a loved one linked to onset of psychiatric disorders
May 29, 2014
Science Daily/Columbia University's Mailman School of Public Health
The sudden loss of a loved one can trigger a variety of psychiatric disorders in people with no history of mental illness. While previous studies have suggested there is a link between sudden bereavement and an onset of common psychiatric disorders, this is the first study to show the association of acute bereavement and mania in a large population sample.
In people aged 30 years or older, the unexpected death of a loved one roughly doubled the risk for new-onset mania after controlling for prior psychiatric diagnoses, other traumatic experiences, and certain demographic variables like sex, race, income, education, and marital status. For those <50 years of age or ≥70 years, the risk increase was more than fivefold. There was no significant effect in people younger than 30 years.
"Our findings should alert clinicians to the possible onset of a wide range of psychiatric disorders, including disorders such as mania, after an unexpected death in otherwise healthy individuals," says Katherine Keyes, PhD, assistant professor of Epidemiology at the Mailman School of Public Health, and principal investigator. "However, it is also notable that the majority of individuals in the present study did not develop mental health issues in the wake of an unexpected death of a loved one."
Losing a loved one suddenly also raised the risk of major depression, excessive use of alcohol, and anxiety disorders, including panic disorder, post-traumatic stress disorder, and phobias. The largest risk increases were for post-traumatic stress disorder, which was seen across age groups with an increased risk as high as 30-fold. Most other disorders were concentrated in the older age groups.
While developing a psychiatric disorder for the first time in old age is relatively rare, these data indicate that psychiatric disorder onset in older age is commonly associated with the death of a loved one, according to the authors.
"Clinically, our results highlight the importance of considering a possible role for loss of close personal relationships through death in assessment of psychiatric disorders. When someone loses a close personal relationship, even late in life, there is a profound effect on sense of self and self reflection. These data indicate that, even in adults with no history of psychiatric disorders, it is also a vulnerable risk period for the onset of a potentially disabling psychiatric disorder," says Dr. Keyes.
http://www.sciencedaily.com/releases/2014/05/140529154153.htm
Many children affected by PTSD after traffic accidents
- May 27, 2014
Science Daily/University of Gothenburg
Many children who are injured in traffic is subsequently affected by post traumatic stress disorder, a new study has shown. Many continue to suffer from mental and psychosocial problems one year after the accident. In addition, the rate still remains low of children who are involved in traffic accidents while wearing a helmet when cycling.
Nearly every third child in Sweden who is injured in traffic is subsequently affected by post traumatic stress disorder. Every fifth child is still suffering from mental and psychosocial problems one year after the accident. These are the conclusions of a thesis submitted at the Sahlgrenska Academy, which shows also that only 6 out of 10 Swedish children and adolescents who are involved in a traffic accidents wear a helmet when cycling.
Research student Eva Olofsson has examined the consequences of road traffic injuries in children. One of her studies shows that approximately 30% of children who are injured in traffic suffer from posttraumatic stress disorder one month after the accident.
Life in danger
The stress disorder lasts from three to six months in one sixth of the children. The children often experience much stress and fear in association with the accident, and may feel that their life is in danger. This can cause posttraumatic stress disorder (anxiety disorder) in the long term, and this may constitute a major obstacle in their everyday lives," says Eva Olofsson
Cycling accidents are the most common cause of traffic injuries in children. Eva Olofsson's results show that it has become significantly more common that children who are injured in traffic are wearing a cycle helmet: In 1993 approximately 40% of children who were injured were wearing a helmet, while the figure in 2006 was 80%.
The fraction of children with skull or brain injuries after a cycling accident who received care at Drottning Silvia's Children's Hospital in Gothenburg fell during the period 1993-2006, but the fall was not statistically significant.
The incidence of facial injuries also fell, while the fraction with injuries to the arms, in contrast, increased. "We can see that a cycle helmet provides good protection against severe and life-threatening skull and brain injuries, in all types of cycling accident. Further, a helmet protects against facial injuries," says Eva Olofsson.
http://www.sciencedaily.com/releases/2014/05/140527114459.htm
Cannabis effects on PTSD: Can smoking medical marijuana reduce symptoms?
- May 22, 2014
Science Daily/Taylor & Francis
Clinical research supports a conclusion that smoking cannabis [marijuana] is associated with PTSD symptom reduction in some patients. The results of a recent study indicated that patients in the sample reported an average of 75 percent reduction in all three areas of PTSD symptoms while using cannabis, yet further research is still called for by the researchers. “Many PTSD patients report symptom reduction with cannabis, and a clinical trial needs to be done to see what proportion and what kind of PTSD patients benefit, with either cannabis or the main active ingredients of cannabis,” said one of the researchers.
In 2009, New Mexico became the first state to authorize the use of medical cannabis for people with PTSD. Soon after the New Mexico PTSD regulation went into effect, one of the authors began receiving unsolicited phone calls from people asking to be evaluated as part of their application to the New Mexico Medical Cannabis Program. Therefore, the purpose of the study was to analyze data on PTSD symptoms collected durin
The results indicated that patients in the sample reported an average of 75 percent reduction in all three areas of PTSD symptoms while using cannabis, yet further research is still called for by the researchers. "Many PTSD patients report symptom reduction with cannabis, and a clinical trial needs to be done to see what proportion and what kind of PTSD patients benefit, with either cannabis or the main active ingredients of cannabis," said Dr. George Greer, one of the researchers.
http://www.sciencedaily.com/releases/2014/05/140522104850.htm
How the 'gut feeling' shapes fear
+ May 22, 2014
Science Daily/ETH Zürich
We are all familiar with that uncomfortable feeling in our stomach when faced with a threatening situation. By studying rats, researchers have been able to prove for the first time that our ‘gut instinct’ has a significant impact on how we react to fear. An unlit, deserted car park at night, footsteps in the gloom. The heart beats faster and the stomach ties itself in knots. We often feel threatening situations in our stomachs. While the brain has long been viewed as the center of all emotions, researchers are increasingly trying to get to the bottom of this proverbial gut instinct.
It is not only the brain that controls processes in our abdominal cavity; our stomach also sends signals back to the brain. At the heart of this dialogue between the brain and abdomen is the vagus nerve, which transmits signals in both directions -- from the brain to our internal organs (via the so called efferent nerves) and from the stomach back to our brain (via the afferent nerves). By cutting the afferent nerve fibres in rats, a team of researchers led by Urs Meyer, a member of staff in the Laboratory of Physiology & Behaviour at ETH Zurich, turned this two-way communication into a one-way street, enabling the researchers to get to the bottom of the role played by gut instinct. In the test animals, the brain was still able to control processes in the abdomen, but no longer received any signals from the other direction.
Less fear without gut instinct
In the behavioural studies, the researchers determined that the rats were less wary of open spaces and bright lights compared with controlled rats with an intact vagus nerve. "The innate response to fear appears to be influenced significantly by signals sent from the stomach to the brain," says Meyer.
Stomach influences signalling in the brain
"A lower level of innate fear, but a longer retention of learned fear -- this may sound contradictory," says Meyer. However, innate and conditioned fear are two different behavioural domains in which different signalling systems in the brain are involved. On closer investigation of the rats' brains, the researchers found that the loss of signals from the abdomen changes the production of certain signalling substances, so called neurotransmitters, in the brain.
"We were able to show for the first time that the selective interruption of the signal path from the stomach to the brain changed complex behavioural patterns. This has traditionally been attributed to the brain alone," says Meyer. The study shows clearly that the stomach also has a say in how we respond to fear; however, what it says, i.e. precisely what it signals, is not yet clear. The researchers hope, however, that they will be able to further clarify the role of the vagus nerve and the dialogue between brain and body in future studies.
http://www.sciencedaily.com/releases/2014/05/140522104848.htm
School-based interventions could benefit children from military families
- May 20, 2014
Science Daily/University of Missouri-Columbia
Nearly two million children in the United States have experienced a parent's military deployment. Previous research has shown that these children may be at increased risk for emotional, behavioral and relationship difficulties, yet little is known about how best to address military children's specialized needs. Now, a researcher says school-based interventions could benefit children whose parents have deployed.
David Albright, an assistant professor at the MU School of Social Work, says military children are an overlooked population in need of more attention from school officials. To best help military children, teachers, administrators, guidance counselors and social workers should be aware of military culture and how it may influence children's behaviors at school.
"Many children who act out in school are asked about common causes of bad behavior, such as bullying or parents' divorce," Albright said. "Rarely are children asked whether parents or siblings serve in the military. If their loved ones are away, these children may be experiencing feelings of separation or worrying about whether their parents will be injured or killed. If family members recently have returned from active duty, they may be displaying symptoms of Post-Traumatic Stress Disorder (PTSD) or Traumatic Brain Injury (TBI) that can make children's home lives more stressful."
Albright recommends school counselors, social workers, teachers and administrators re-examine how they evaluate children who are struggling or misbehaving in school. Albright says that when asking children about factors at home, school officials should determine whether parents or siblings are deployed or have been deployed because those experiences affect children's home lives and may reflect in their behaviors at school.
Schools can develop better interventions to help these children once officials begin to ask if behavioral problems may be related to parents' military experience, Albright said.
"Right now, we don't have a set of approved best practices for supporting children from military families," Albright said. "If schools begin asking whether family members serve, then we can better help these children."
Albright suggests developing interventions that could be implemented in schools that directly target military children and their family members.
http://www.sciencedaily.com/releases/2014/05/140520123517.htm
PTSD symptoms common after an ICU stay
- May 19, 2014
Science Daily/American Thoracic Society (ATS)
Patients who have survived a stay in the intensive care unit (ICU) have a greatly increased risk of developing symptoms of post-traumatic stress disorder (PTSD), according to a new study. “An ICU stay can be traumatic for both patients and their families,” said one investigator. “In our analysis of more than 3,400 ICU patients, we found that one quarter of ICU survivors exhibited symptoms of PTSD.”
“An ICU stay can be traumatic for both patients and their families,” said Ann M. Parker, MD, a Pulmonary and Critical Care Medicine fellow at Johns Hopkins University in Baltimore, Maryland. “In our analysis of more than 3,400 ICU patients, we found that one quarter of ICU survivors exhibited symptoms of PTSD.” The systematic review of 28 studies involved a total of 3,428 adult ICU survivors. Evaluation included testing with validated PTSD instruments, most commonly the Impact of Events Scale (IES, score range 0-75), administered one month or more after the ICU stay.
“Our meta-analysis confirms that a large proportion of patients who survive an ICU stay will suffer PTSD symptoms, which are associated with worse health-related quality of life,” said Thiti Sricharoenchai, MD, Instructor in the Division of Pulmonary and Critical Care Medicine at Thammasat University, Thailand who conducted this study as a post-doctoral research fellow at Johns Hopkins University. “Further research should focus on PTSD screening, prevention, and treatment in this vulnerable patient population.”
http://www.sciencedaily.com/releases/2014/05/140519114240.htm
Post-traumatic stress disorder: We need more awareness about events that trigger it
- May 19, 2014
Science Daily/University of Greenwich
Post-Traumatic Stress Disorder (PTSD) is more likely to be recognized in those suffering military combat trauma than in rape and accident victims, according to new research.
Carried out by Dr Ian Tharp, Senior Lecturer in Psychology at the University of Greenwich, the study was led by Chris Merritt, a Greenwich psychology graduate who is currently studying for a Doctorate in Clinical Psychology at King's College London.
During the research, nearly 3,000 participants were shown a description of an individual experiencing identical PTSD symptoms, such as flashbacks, in relation to either military combat, a serious industrial accident or sexual assault, in particular rape.
In comparison to those shown the military scenario, participants were much less likely to recognize the symptoms as PTSD, or even consider them a mental health problem, when associated with either an industrial accident or serious sexual assault.
Dr Tharp says: "The association between PTSD and military combat experience is frequently portrayed in film and television, and the current research supports the pervasive 'traumatised veteran' stereotype.
"However, PTSD can arise from a variety of traumatic experiences, including road traffic accidents, physical or sexual assault, and natural disasters. Across the wider population, these non-military traumas are much more common.
"Furthermore, the likelihood of experiencing and subsequently developing PTSD following these type of events can be much greater than that for military combat."
Dr Tharp concludes: "The implications are that many people who develop PTSD following non-military combat traumas -- particularly rape -- are less likely to have it recognized by those around them, and are also less likely to seek help for their difficulties."
The study, carried out alongside a third researcher, Professor Adrian Furnham of University College London, was published in the Journal of Affective Disorders.
Chris Merritt adds: "The results show that greater awareness of the key symptoms of trauma is needed within the community in order to identify possible cases of PTSD. This enhanced understanding would also help support services, such as charities, guide individuals towards professional treatments."
http://www.sciencedaily.com/releases/2014/05/140519105812.htm
Ties between alcohol, PTSD examined
- May 15, 2014
Science Daily/Taylor & Francis
Alcohol abuse occurs in 52% of men and 28% of women with posttraumatic stress disorder (PTSD). Comorbid alcoholism and PTSD leads more frequently to low income, unemployment, and overall social dysfunction than either condition on its own, in part due to the clinical challenges their simultaneous treatment poses. Researchers set out to examine relationships between the factors contributing to these challenges.
Researchers found that respondents with more severe PTSD symptoms showed a higher degree of association between problem drinking and a need to regulate negative affect ("coping motives"). Additionally, associations between negative attitudes toward distress and alcohol-related consequences were stronger among the more severe PTSD sufferers. Thus, for individuals with severe PTSD, practicing the ability to carry out uncomfortable activities may be associated with a decreased likelihood of comorbid alcohol use disorder.
The less severe PTSD symptom group was associated significantly with drinking to avoid stressful situations, running counter to the researchers' hypothesis in this area. Overall, these findings point towards the need for PTSD treatment that takes into account the relationship between co-occurring symptoms and varying degrees of alcohol involvement.
http://www.sciencedaily.com/releases/2014/05/140515095547.htm
Tracking the source of 'selective attention' problems in brain-injured vets
May 9, 2014
Science Daily/Acoustical Society of America (ASA)
The obvious cognitive symptoms of minor traumatic brain injury can dissipate within a few days, but blast-exposed veterans may continue to have problems focusing attention on one sound source and ignoring others, an ability known as "selective auditory attention.” According to a new study, such apparent "hearing" problems actually may be caused by diffuse injury to the brain's prefrontal lobe.
An estimated 15-20 percent of U.S. troops returning from Iraq and Afghanistan suffer from some form of traumatic brain injury (TBI) sustained during their deployment, with most injuries caused by blast waves from exploded military ordnance. The obvious cognitive symptoms of minor TBI -- including learning and memory problems -- can dissipate within just a few days. But blast-exposed veterans may continue to have problems performing simple auditory tasks that require them to focus attention on one sound source and ignore others, an ability known as "selective auditory attention."
In the task, three different melody streams, each comprised of two notes, were simultaneously presented to the subjects from three different perceived directions (this variation in directionality was achieved by differing the timing of the signals that reached the left and right ears). The subjects were then asked to identify the "shape" of the melodies (i.e., "going up," "going down," or "zig-zagging") while their brain activity was measured by electrodes on the scalp.
"Whenever a new sound begins, the auditory cortex responds, encoding the sound onset," Bressler explains. "Attentional focus, however, changes the strength of this response: when a listener is attending to a particular sound source, the neural activity in response to that sound is greater." This change of the neural response occurs because the brain's "executive control" regions, located in the brain's prefrontal cortex, send signals to the auditory sensory regions of the brain, modulating their response.
The researchers found that blast-exposed veterans with TBI performed worse on the task -- that is, they had difficulty controlling auditory attention -- "and in all of the TBI veterans who performed well enough for us to measure their neural activity, 6 out of our 10 initial subjects, the brain response showed weak or no attention-related modulation of auditory responses," Bressler says.
"Our hope is that some of our findings can be used to develop methods to assess and quantify TBI, identifying specific factors that contribute to difficulties communicating in everyday settings," he says. "By identifying these factors on an individual basis, we may be able to define rehabilitation approaches and coping strategies tailored to the individual."
http://www.sciencedaily.com/releases/2014/05/140509110159.htm
Tackling test anxiety may help prevent more severe problems
- May 8, 2014
Science Daily/Springer
Showing students how to cope with test anxiety might also help them to handle their built-up angst and fretfulness about other issues. The results of a new study show that anxiety intervention programs that focus on academic matters fit well into the demands of the school routine, and do not carry the same stigma among youth as general anxiety programs do.
Weems says that anxiety problems are among the most common emotional difficulties youths experience, and are often linked to exposure to disasters. If not addressed these feelings could lead to academic difficulties, the increased risk of developing depressive or anxiety disorders, and substance use problems in adulthood.
It is, however, an issue that often falls under the radar in school settings. Therefore Weems and his team turned their attention to teaching students how to handle test anxiety, as such nervousness is one way in which anxieties commonly manifest among school-aged youth.The article highlights the results of initial tests among students from grades three to 12 in five public schools in the gulf south region of the United States.
The research was conducted between three and six years after Hurricane Katrina struck in 2005. A group-administered, test-anxiety-reduction intervention was presented to 325 youths between the ages of eight- and 17-years-old who experienced elevated test anxiety. The intervention -- through which the learners were taught behavioral strategies such as relaxation techniques -- was conducted as part of each school's counseling curriculum.The wider age group who received the intervention found it to be useful, felt glad they had participated and effectively learned the intervention content.
Overall, the program was associated with decreases in test anxiety, anxiety disorder and depression symptoms, and especially helped the older students to feel more in control. In turn, decreases in test anxiety were linked with changes in symptoms of depression and anxiety , such as posttraumatic stress disorder (PTSD). The results suggest high participant satisfaction with the program.
"Test anxiety interventions may be a practical strategy for conducting emotion-focused prevention and intervention efforts because of a natural fit within the ecology of the school setting," believes Weems. He cautions that school-based test anxiety interventions should not be considered a first line approach to treating severe anxiety disorders such as PTSD, but could be employed preventatively to teach students how to handle anxious emotions and internalizing problems more generally.
http://www.sciencedaily.com/releases/2014/05/140508141837.htm
Domestic violence victims more likely to take up smoking
- May 5, 2014
Science Daily/Columbia University's Mailman School of Public Health
One-third of women around the world have experienced physical or sexual violence at the hands of their intimate partners with consequences from post-traumatic stress disorder, anxiety, and depression, to sexually transmitted diseases, including HIV. Now, in a new study in 29 low-income and middle-income countries, researchers have identified yet another serious health risk associated with intimate partner violence: smoking.
The researchers examined the association between IPV and smoking among 231,892 women aged 15-29, using information collected in the Demographic and Health Surveys. Intimate partner violence is a serious problem in low- and middle-income countries. Reports of IPV in their study ranged from 9 to 63%. Employing a meta-analysis of country-level data that accounted for confounding factors like age, education, and household wealth, they found a 58% increased risk for smoking among the women who experienced IPV.
Women are thought to smoke tobacco to self-medicate to cope with stress from IPV. Many may be unaware of the serious health risks; tobacco kills half of its users, according to the World Health Organization.
The new study focused on low- and middle-income countries, where little research into the IPV-tobacco link has been done. However, the researchers say their results likely mean that the phenomenon is a global one. They cite among other papers, a 2008 study by Hee-Jin Jun et al that showed increased risk in American women.
http://www.sciencedaily.com/releases/2014/05/140505112540.htm
Zinc supplementation shows promise in reducing cell stress after blasts
- April 27, 2014
Science Daily/Federation of American Societies for Experimental Biology (FASEB)
Supplementation with zinc might reduce cell stress after the type of blast injury soldiers experience from IEDs, researchers say. Each year, approximately 2 million traumatic brain injuries (TBIs) occur in the USA, including with soldiers.
"We have nothing beyond ibuprofen for most TBIs," said Dr. Angus Scrimgeour, who has been investigating the effects of low zinc diets on cell stress following a blast injury. "The adult brain does not self-repair from this kind of trauma." Results of a new study suggest that zinc supplementation reduces blast-induced cell stress.
Scrimgeour works for the US Army Research Institute of Environmental Medicine and recently looked at the effects of 5-weeks of low and adequate zinc diets on a specific protein in muscle cells called MMP. The study recreated blast injuries in 32 rats similar to what soldiers experience from IEDs, including loss of consciousness. An equal number of rats served as a control group. Results suggest that zinc supplementation reduces blast-induced cell stress. He presented the results of his research at the American Society for Nutrition's Scientific Sessions & Annual Meeting at EB on Sunday, April 27.
"We know that soldiers' brain tissue cannot repair on low zinc diets," said Scrimgeour. "And they are losing zinc through diarrhea and sweating." The question moving forward is whether prevention through diet supplementation or post-blast treatment works best to repair behavioral deficits associated with mild TBI.
Scrimgeour added that further research is planned to investigate nutrient combinations for treating mild TBI, including omega-3, vitamin D, glutamine and/or zinc. Although the Army is conducting this research, the results can be applied outside of the military, according to Scrimgeour. "As the blast impact experienced by Soldiers are similar to those experienced during head injuries received in a car accident or during an NFL concussion, these findings could translate from the Soldier to the civilian population." Scrimgeour cautioned, however, that what works in animals doesn't always work in soldiers, which is why more research is needed.
http://www.sciencedaily.com/releases/2014/04/140427185159.htm
Almost half of homeless men had traumatic brain injury in their lifetime
- April 25, 2014
Science Daily/St. Michael's Hospital
Almost half of all homeless men who took part in a study had suffered at least one traumatic brain injury in their life and 87 percent of those injuries occurred before the men lost their homes. While assaults were a major cause of those traumatic brain injuries, or TBIs, (60 per cent) many were caused by potentially non-violent mechanisms such as sports and recreation (44 per cent) and motor vehicle collisions and falls (42 per cent).
While assaults were a major cause of those traumatic brain injuries, or TBIs, (60 per cent) many were caused by potentially non-violent mechanisms such as sports and recreation (44 per cent) and motor vehicle collisions and falls (42 per cent).
In men under age 40, falls from drug/alcohol blackouts were the most common cause of traumatic brain injury while assault was the most common in men over 40 years old.
Recognition that a TBI sustained in childhood or early teenage years could predispose someone to homelessness may challenge some assumptions that homelessness is a conscious choice made by these individuals, or just the result of their addictions or mental illness, said Dr. Topolovec-Vranic.
This study received funding from the Canadian Institutes of Health Research and the Ontario Neurotrauma Foundation.
Separately, a recent study by Dr. Stephen Hwang of the hospital's Centre for Research on Inner City Health, found the number of people who are homeless or vulnerably housed and who have also suffered a TBI may be as high as 61 per cent -- seven times higher than the general population.
http://www.sciencedaily.com/releases/2014/04/140425104714.htm
Inflammation in those with PTSD linked to changes in microRNA
- April 24, 2014
Science Daily/University of South Carolina
With a new generation of military veterans returning home from Iraq and Afghanistan, post-traumatic stress disorder (PTSD) has become a prominent concern in American medical institutions and the culture at-large. Estimates indicate that as many as 35 percent of personnel deployed to Iraq and Afghanistan suffer from PTSD. New research is shedding light on how PTSD is linked to other diseases in fundamental and surprising ways.
The rise in PTSD has implications beyond the impact of the psychiatric disorder and its immediate consequences, which include elevated suicide risk and inability to lead a normal life, that result in approximately $3 billion in lost productivity every year. Over time, these PTSD patients will continue to experience increased risks of a myriad of medical conditions like cardiovascular disease, diabetes, gastrointestinal disease, fibromyalgia, musculoskeletal disorders and others, all of which share chronic inflammation as a common underlying cause.
Dr. Mitzi Nagarkatti sums up the significance of this study as follows: "We are very excited about these results. Thus far, no one had looked at the role of microRNA in the blood of PTSD patients. Thus, our finding that the alterations in these small molecules are connected to higher inflammation seen in these patients is very interesting and helps establish the connection between war trauma and microRNA changes."
In addition to the alterations in microRNA expression, the study also found that PTSD patients had higher levels of inflammation caused by certain types of immune cells called T cells. These T cells produced higher levels of inflammatory mediators called cytokines, specifically interferon-gamma and interleukin-17. This finding was especially interesting because one of the inflammation-associated microRNAs, miR-125a, which specifically targets increased production of interferon-gamma, was found to have decreased expression in the PTSD patients studied. Overall, these results suggested that trauma may cause alterations in the expression of microRNA which promote inflammation in PTSD patients.
Commenting on this, Dr. Prakash Nagarkatti said, "These studies form the foundation to further analyze the role of microRNA in PTSD. Trauma experienced during war may trigger changes in microRNA which may in turn cause various clinical disorders seen in PTSD patients. Our long-term goal is to identify whether PTSD patients express a unique signature profile of microRNA which can be used towards early detection, prevention and treatment of PTSD."
http://www.sciencedaily.com/releases/2014/04/140424102843.htm
Life stressors trigger neurological disorders
April 22, 2014
Science Daily/Children's National Medical Center
When mothers are exposed to trauma, illness, alcohol or other drug abuse, these stressors may activate a single molecular trigger in brain cells that can go awry and activate conditions such as schizophrenia, post-traumatic stress disorder and some forms of autism.
Until now, it has been unclear how much these stressors have impacted the cells of a developing brain. Past studies have shown that when an expectant mother exposes herself to alcohol or drug abuse or she experiences some trauma or illness, her baby may later develop a psychiatric disorder later in life. But the new findings identify a molecular mechanism in the prenatal brain that may help explain how cells go awry when exposed to certain environmental conditions.
While it has been generally accepted that exposure to harmful environmental factors increase the susceptibility of the brain to neurological and psychiatric disorders, new types of environmental agents are continuingly added to the mix, requiring evolving studies, Hasimoto-Torii says.
Hashimoto-Torii notes that autism rates have increased substantially and "more people are having these exposures to environmental stressors," she says. While there have been many studies that have identified singular stressors, such as alcohol, there have not been enough studies to focus on many different environmental factors and their impacts, such as heavy metals as well as alcohol and other toxic exposure, she adds.
Identifying many risk factors helped Hashimoto-Torii and other researchers identify the gene that may be linked to neurological problems. "Different stressors may have different stress responses," she says. She examined risk factors specifically involving epilepsy, ADHD, autism and schizophrenia. Eventually, it may open the door "to provide therapy in the future to reduce the risk" and protect vulnerable cells.
http://www.sciencedaily.com/releases/2014/04/140422113430.htm
Domestic abuse linked to mental health problems in new mothers
- April 14, 2014
Science Daily/North Carolina State University
Domestic abuse is closely linked to postpartum mental health problems, including depression and post-traumatic stress disorder, in mothers, new research confirms. The research also found that specific types of abuse are associated with specific mental health problems. "The sheer scope of the mental health problems and types of abuse that we found tells us that we need to take a broader approach to tackling these issues," states a co-author. "And this is clearly not a 'lower class' problem -- medical professionals everywhere need to pay attention."
"We wanted to see whether and how intimate partner abuse -- physical, psychological and sexual -- influenced postpartum mental health in women, including problems such as depression, stress, anxiety, obsessive-compulsive disorder (OCD), and PTSD," says Dr. Sarah Desmarais, an assistant professor of psychology at NC State and lead author of a paper on the work.
The researchers interviewed 100 women from British Columbia who were largely from higher socioeconomic backgrounds and were not considered at high risk of postpartum mental health problems. The study participants were recruited to participate in a broad health and wellness study, which was not specifically focused on domestic abuse.
Sixty-one percent of the study participants reported symptoms of postpartum mental health problems within the first three months after childbirth. And 47 percent of the 100 women reported symptoms at "clinical" levels, meaning the symptoms were of at least moderate severity.
Eighty-four percent of the participants reported experiencing physical, psychological or sexual abuse at the hands of a partner prior to becoming pregnant. Seventy percent of the 100 participants reported some form of abuse by their romantic partner during pregnancy. These forms of abuse ranged from name-calling to rape and physical assault with a weapon.
"We found that women who had experienced abuse were more likely to suffer from postpartum mental health problems, and were much more likely to suffer from those problems if the abuse occurred during pregnancy," Desmarais says. "In addition, the more types of abuse they experienced, the more severe the mental health symptoms they reported. We also found that specific types of abuse were associated with specific problems."
The researchers found that psychological abuse -- verbal and emotional abuse -- was associated with stress and PTSD. Physical abuse was associated with depression, OCD and PTSD. Sexual abuse was associated with stress, depression and PTSD.
This means that some mental health problems could stem from any of the forms of abuse. For example, PTSD is associated with all three forms of abuse, but could be caused by any one of them; psychological abuse alone could lead to PTSD.
"This highlights the need for increased awareness of the prevalence of these issues, and the need for increased screening for abuse and mental health problems for pregnant women and new mothers," Desmarais says.
"The sheer scope of the mental health problems and types of abuse that we found tells us that we need to take a broader approach to tackling these issues," Desmarais adds. "And this is clearly not a 'lower class' problem -- medical professionals everywhere need to pay attention. But to do this effectively, we need to train doctors, nurses, and hospital staff in how to identify and respond to potential problems in this area."
http://www.sciencedaily.com/releases/2014/04/140414112439.htm
Hereditary trauma: Inheritance of traumas and how they may be mediated
April 13, 2014
Science Daily/ETH Zurich
Extreme and traumatic events can change a person -- and often, years later, even affect their children. Researchers of the University of Zurich and ETH Zurich have now unmasked a piece in the puzzle of how the inheritance of traumas may be mediated.
The phenomenon has long been known in psychology: traumatic experiences can induce behavioural disorders that are passed down from one generation to the next. It is only recently that scientists have begun to understand the physiological processes underlying hereditary trauma. "There are diseases such as bipolar disorder, that run in families but can't be traced back to a particular gene," explains Isabelle Mansuy, professor at ETH Zurich and the University of Zurich. With her research group at the Brain Research Institute of the University of Zurich, she has been studying the molecular processes involved in non-genetic inheritance of behavioural symptoms induced by traumatic experiences in early life.
Mansuy and her team have succeeded in identifying a key component of these processes: short RNA molecules. These RNAs are synthetized from genetic information (DNA) by enzymes that read specific sections of the DNA (genes) and use them as template to produce corresponding RNAs. Other enzymes then trim these RNAs into mature forms. Cells naturally contain a large number of different short RNA molecules called microRNAs. They have regulatory functions, such as controlling how many copies of a particular protein are made.
"With the imbalance in microRNAs in sperm, we have discovered a key factor through which trauma can be passed on," explains Mansuy. However, certain questions remain open, such as how the dysregulation in short RNAs comes about. "Most likely, it is part of a chain of events that begins with the body producing too much stress hormones."
Importantly, acquired traits other than those induced by trauma could also be inherited through similar mechanisms, the researcher suspects. "The environment leaves traces on the brain, on organs and also on gametes. Through gametes, these traces can be passed to the next generation. The scientists hope that their results may be useful to develop a blood test for diagnostics.
http://www.sciencedaily.com/releases/2014/04/140413135953.htm
One in three intensive care survivors develop depression that typically manifests as physical symptoms
- April 6, 2014
Science Daily/The Lancet
A third of intensive care patients develop depression that typically manifests as physical, or somatic, symptoms such as weakness, appetite change, and fatigue, rather than psychological symptoms, according to one of the largest studies to investigate the mental health and functional outcomes of survivors of critical care.
The study suggests that intensive care unit (ICU) survivors could be three times more likely to experience depression than the general population, and that depression is four times more common than post-traumatic stress disorder (PTSD) after critical illness.
"Considering that each year, at least 5 million individuals are admitted to ICU in North America alone -- more than are diagnosed with cancer -- and about 80% survive, it's a significant public health issue", explains study leader Dr James Jackson, psychologist and assistant professor of medicine at Vanderbilt University Medical Center in the USA.
"We need to pay more attention to preventing and treating the physical rather than psychological symptoms of depression in ICU survivors," says Dr Jackson. "The physical symptoms of depression are often resistant to standard treatment with antidepressant drugs and we need to determine how best to enhance recovery with a new focus on physical and occupational rehabilitation."
According to Dr Jackson, "Substantial time and energy has been invested in addressing PTSD in survivors of critical illness, but our findings suggest that it is less pervasive than depression. Patients of all ages are at risk of developing post-ICU mental health and functional disabilities and more needs to be done to ensure that these impairments don't become permanent."
"These findings have important implications. When depression manifests as physical symptoms, patients are less likely to receive a diagnosis. If they are diagnosed, they are less likely to respond to treatment…Traditional pharmacological therapies for depression might be less likely to provide significant benefit alone (or at all). Instead, doctors might need to address the many diagnoses that contribute to poor sleep, impaired concentration, weakness, and fatigue."
http://www.sciencedaily.com/releases/2014/04/140406214411.htm
Japanese Town: Half the survivors of mega-earthquake, tsunami, have PTSD symptoms
- March 6, 2014
Science Daily/Brigham Young University
A new study shows that more than half the survivors in one Japanese town exhibited 'clinically concerning' symptoms of PTSD following the country's mega-earthquake and tsunami. Two-thirds of survivors also reported symptoms of depression. Having work to do has proven important in increasing resilience.
One year after the quake, Brigham Young University professor Niwako Yamawaki and scholars from Saga University evaluated the mental health of 241 Hirono citizens. More than half of the people evaluated experienced "clinically concerning" symptoms of post-traumatic stress disorder. Two-thirds of the sample reported symptoms of depression.
Those rates exceed levels seen in the aftermath of other natural disasters, but what happened in Japan wasn't just a natural disaster. Leaked radiation from nuclear power plants forced residents of Hirono to relocate to temporary housing far from home.
"This was the world's fourth-biggest recorded earthquake, and also the tsunami and nuclear plant and losing their homes -- boom boom boom boom within such a short time," said Yamawaki, a psychology professor at BYU. "The prevalence one year after is still much higher than other studies of disasters that we found even though some time had passed."
Yamawaki got the idea for this study while shoveling mud from a damaged Japanese home one month after the tsunami flooded coastal towns. She had just arrived for a previously scheduled fellowship at Saga University. During her off-time, she traveled to the affected area and volunteered in the clean-up effort. One seemingly stoic homeowner broke down in tears when Yamawaki and her husband thanked her for the chance to help.
"She said 'This is the first time I have cried since the disaster happened,'" Yamawaki said. "She just said 'Thank you. Thank you for letting me cry.'"
"Having something to do after a disaster really gives a sense of normalcy, even volunteer work," Yamawaki said.
As the researchers got to know survivors, they heard from so many that they missed seeing their former neighbors. The mass relocation outside the radiation zone broke up many neighborhood ties.
"Japanese are very collectivistic people and their identity is so intertwined with neighbors," Yamawaki said. "Breaking up the community has so much impact on them."
While it's hard to fathom the scope of the devastation in the coastal region of Fukushima, most survivors believe something like this will happen again. If so, this new study provides a blueprint for how to help them put their lives back together again.
http://www.sciencedaily.com/releases/2014/03/140306095526.htm