Associations Among Posttraumatic Stress Disorder Symptoms, Substance Use, and Affective Attentional Processing in OEF/OIF/OND Veterans

Liverant, Gabrielle I.; Amick, Melissa M.; Black, Shimrit K.; Esterman, Michael; Wisco, Blair E.; Gibian, Molly C.; Marx, Brian P.; McGlinchey, Regina E.

doi:10.1097/nmd.0000000000000702

Cited by 3 publications

(2 citation statements)

References 53 publications

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“…La exposición a combates en relación con guerras y otros tipos de conflictos armados genera alteraciones de la FE, explicadas por la presencia de estrés postraumático persistente, o por trauma de cráneo leve, o por la exposición corporal a ondas explosivas difusas, sin que se pueda documentar, en este último evento, la presencia de traumas específicos focales [30][31][32] .…”

Section: Discussionunclassified

Sistemas de activación y de inhibición de conducta y su relación con el funcionamiento ejecutivo en excombatientes irregulares del conflicto armado colombiano

Arenas

Pareja

Valencia

et al. 2020

MedUPB

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Objetivo: Explorar la relación entre los sistemas de activación de conducta (SAC) / sistema de inhibición de conducta (SIC) y funciones ejecutivas (FE) en excombatientes del conflicto armado colombiano. Metodología: Estudio observacional, exploratorio, con muestra no aleatoria de 39 excombatientes del programa de la Alta Consejería de la Presidencia para la Reintegración, residentes en Antioquia-Colombia, edad 35±7.6 años, 87.2% hombres, y escolaridad 10±2.8 grados; comparados con un grupo control de 14 no combatientes (edad 33±6.1 años, 71.4% hombres y escolaridad 10±2.7 grados). Se les administró un cuestionario de SAC/SIC, usando la sensibilidad a la recompensa (SR) y la sensibilidad al castigo (SC). Para la FE se aplicó la prueba Ineco Frontal Screening (IFS). Resultados: Hubo alteraciones específicas de la FE: en la ejecución de instrucciones conflictivas (IC), memoria de trabajo verbal (MTV) y control inhibitorio verbal (CIV). Se evidenciaron correlaciones directas, con coeficientes de moderados a altos entre el SAC (SR) y la capacidad de abstracción CA, el control motor inhibitorio (CMI), la MTV, la memoria de trabajo espacial (MTE) y el funcionamiento ejecutivo global (IFSTOT). Conclusiones: Los excombatientes presentaron un rendimiento inferior en la memoria de trabajo verbal y el control inhibitorio verbal, lo que impacta las capacidades de anticipación, establecimiento de metas, diseño de planes, iniciación de conductas voluntarias y el control inhibitorio. Lo anterior puede generar la toma de decisiones equivocadas.

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Section: Discussionunclassified

Sistemas de activación y de inhibición de conducta y su relación con el funcionamiento ejecutivo en excombatientes irregulares del conflicto armado colombiano

Arenas

Pareja

Valencia

et al. 2020

MedUPB

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“…The Cambridge Neuropsychological Test Automated Battery [ 60 ] is a computerized and standardized assessment administered via tablet to measure the key cognitive processes of (1) information input into the brain, such as attention and processing speed; (2) information representation in the brain, such as memory; and (3) use of stored information to guide behavior, also known as executive function. The Cambridge Neuropsychological Test Automated Battery system has been used in other trials examining cognitive function in PTSD [ 61 - 69 ]. The tests are language-independent and suitable for cross-cultural experiments.…”

Section: Methodsmentioning

confidence: 99%

Advancing Posttraumatic Stress Disorder Diagnosis and the Treatment of Trauma in Humanitarian Emergencies via Mobile Health: Protocol for a Proof-of-Concept Nonrandomized Controlled Trial

Pinto¹,

Hunt²,

O’Toole³

2022

JMIR Res Protoc

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Background Decentralized health systems in low- and middle-income countries (LMICs) affected by humanitarian crises lack resources and a qualified workforce to attend to the overwhelming demand for mental health care in emergencies. Innovative approaches that are safe, cost-effective, and scalable are needed to address the burden of traumatic stress caused by emergencies. High mobile phone ownership rates combined with the precision of neural, cognitive, and biometric measures of trauma and their feasible integration with artificial intelligence makes digital app interventions a promising pathway to promote precision diagnosis and high-impact care. Objective This study aimed to advance methods for the objective diagnosis and treatment of trauma in emergencies across LMICs by examining neural, cognitive, and biometric markers and the efficacy of the eResilience app, a neuroscience-informed mobile health mental health app intervention, via changes in clinical symptomatology, cognitive performance, and brain activity. Methods Trauma-exposed African refugees residing in Australia were selected for this study. A research software version of the eResilience app with advanced monitoring capabilities was designed for this trial. Participants completed the eResilience app at home during a 7-day period. Clinical, cognitive, and electrophysiological data were collected at baseline, along with posttest measurements to examine biomarkers of trauma and the efficacy of the proposed digital intervention for the treatment of trauma and its potential outcomes, including depression, anxiety, physical symptoms, self-harm, substance misuse, and cognitive impairment. In addition, biofeedback, well-being, and subjective stress data points were collected via the app during the treatment week, followed by clinical interviews at 1, 3, 6, and 12 months after the intervention. Results Data collection was conducted between 2018 and 2020. A total of 100 participants exposed to war were screened; 75 (75%) were enrolled and assigned to a trauma-exposed control (38/75, 51%) or posttraumatic stress disorder condition (37/75, 49%); and 70 (70%) completed all baseline, treatment, and posttest assessments. A total of 89% (62/70) of those who completed the intervention opted to enroll in the 3-, 6-, and 12-month follow-ups. Data collection is complete. As of May 2022, the results of all proposed analyses are being prepared for publication. If proven efficacious, this proof-of-concept clinical trial will inform fully powered randomized clinical trials in LMICs to further develop artificial intelligence–powered, app-based diagnostic and prognostic features and determine the app’s cross-cultural efficacy for the treatment of trauma in emergency settings. Conclusions This protocol provides researchers with a comprehensive background of the study rationale, a detailed guideline for replication studies interested in examining the feasibility and efficacy of the eResilience app across varied demographics, and a robust framework for investigating low-cost objective diagnostic markers in mental health interventions. Methodological limitations and suggestions are also provided. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12616001205426; https://tinyurl.com/yckwc4d7 International Registered Report Identifier (IRRID) RR1-10.2196/38223

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Advancing Posttraumatic Stress Disorder Diagnosis and the Treatment of Trauma in Humanitarian Emergencies via Mobile Health: Protocol for a Proof-of-Concept Nonrandomized Controlled Trial (Preprint)

Sydney¹,

Hunt²,

O’Toole³

2022

Preprint

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BACKGROUND Decentralised health systems in Low and Middle-Income Countries (LMICs) impacted by humanitarian crises lack resources and a qualified workforce to attend to the overwhelming demand for mental health care in emergencies. Innovative approaches that are safe, cost-effective, and scalable are needed to address the burden of traumatic stress brought by emergencies. High mobile phone ownership rates combined with the precision of neural, cognitive, and biometric measures of trauma and its feasible integration with Artificial Intelligence (AI) makes digital application (app) interventions a promising pathway to promote precision diagnosis and high-impact care. OBJECTIVE The aims of this study are to advance methods for the objective diagnosis and treatment of trauma in emergencies across LMICs by examining (i) neural, cognitive, and biometric markers and (ii) the efficacy of the eResilience App, a neuroscience-informed mobile health mental health app intervention, via changes in clinical symptomatology, cognitive performance, and brain activity. METHODS Trauma-exposed African refugees residing in Australia were selected for this study. A research software version of the eResilience App with advanced monitoring capabilities was designed for the trial. Participants completed the eResilience App at home during a seven-day period. Clinical, cognitive, and electrophysiological data were collected during baseline and post-test to examine biomarkers of trauma and the efficacy of the proposed digital intervention for the treatment of trauma and its potential outcomes including depression, anxiety, physical symptoms, self-harm, substance misuse, and cognitive impairment. In addition, biofeedback, wellbeing, and subjective stress data points were collected via the app during the treatment week, followed by clinical interviews at 1, 3, 6 and 12-months post-intervention. RESULTS Data collection was conducted between 2018 and 2020. A total n=100 participants exposed to war were screened, n= 75 were enrolled and assigned to a trauma-exposed control (n=38) or Posttraumatic Stress Disorder (PTSD) condition (n=37), and n= 70 completed all baseline, treatment, and post-test assessments. A total n=62 of the n=70 who completed the intervention opted to enrol in the 3, 6 and 12-month follow-ups. Data collection is complete, and results are being prepared for publication. If proven efficacious, this proof-of-concept clinical trial will inform fully powered randomised clinical trials in LMICs to further develop AI-powered, app-based diagnostic and prognostic features, and determine the app’s cross-cultural efficacy for the treatment of trauma in emergency settings. CONCLUSIONS This protocol provides researchers with a comprehensive background of the study rationale, a detailed guideline for replication studies interested in examining the feasibility and the efficacy of the eResilience App across varied demographics, and a robust framework for investigations of low-cost objective diagnostic markers in mental health interventions. Methodological limitations and suggestions are also provided. CLINICALTRIAL The study was approved by the Human Research Ethics Committees of the University of Sydney and University of the Sunshine Coast, Australia. It was conducted in compliance with ethics committee approval conditions, the National Health and Medical Research Council’s Statement on Ethical Conduct in Human Research (2007) and the Note for Guidance on Good Clinical Practice (CPMP/ICH-135/95). Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12616001205426. Universal Trial Number (UTN): U1111-1180-0347

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Associations Among Posttraumatic Stress Disorder Symptoms, Substance Use, and Affective Attentional Processing in OEF/OIF/OND Veterans

Cited by 3 publications

References 53 publications

Sistemas de activación y de inhibición de conducta y su relación con el funcionamiento ejecutivo en excombatientes irregulares del conflicto armado colombiano

Sistemas de activación y de inhibición de conducta y su relación con el funcionamiento ejecutivo en excombatientes irregulares del conflicto armado colombiano

Advancing Posttraumatic Stress Disorder Diagnosis and the Treatment of Trauma in Humanitarian Emergencies via Mobile Health: Protocol for a Proof-of-Concept Nonrandomized Controlled Trial

Advancing Posttraumatic Stress Disorder Diagnosis and the Treatment of Trauma in Humanitarian Emergencies via Mobile Health: Protocol for a Proof-of-Concept Nonrandomized Controlled Trial (Preprint)

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