Childhood factors and war zone stress in chronic PTSD

Donovan, Beverly; Padin-Rivera, Edgardo; Dowd, Thomas; Blake, Dudley David

doi:10.1007/bf02110668

Cited by 20 publications

(12 citation statements)

References 15 publications

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“…Research also should be devoted to examining possible factors that predict whether veterans will be at risk for experiencing subthreshold versus diagnostic levels of PTSD symptoms following combat. Level of combat exposure did not distinguish between veterans reporting subthreshold-PTSD and PTSD in the current study; however, other factors may include pre-existing trauma exposure (see Donovan, Padin-Rivera, Dowd, & Blake, 1996) or intelligence level (see Macklin et al, 1998).…”

Section: Discussionmentioning

confidence: 82%

Anger, hostility, and aggression among Iraq and Afghanistan war veterans reporting PTSD and subthreshold PTSD

Jakupcak¹,

Conybeare²,

Phelps³

et al. 2007

Journal of Traumatic Stress

413

343

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Iraq and Afghanistan War veterans were grouped by level of posttraumatic stress disorder (PTSD) symptomatology and compared on self-report measures of trait anger, hostility, and aggression. Veterans who screened positive for PTSD reported significantly greater anger and hostility than those in the subthreshold-PTSD and non-PTSD groups. Veterans in the subthreshold-PTSD group reported significantly greater anger and hostility than those in the non-PTSD group. The PTSD and subthreshold-PTSD groups did not differ with respect to aggression, though both groups were significantly more likely to have endorsed aggression than the non-PTSD group. These findings suggest that providers should screen for anger and aggression among Iraq and Afghanistan War veterans who exhibit symptoms of PTSD and incorporate relevant anger treatments into early intervention strategies.

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Section: Discussionmentioning

confidence: 82%

Anger, hostility, and aggression among Iraq and Afghanistan war veterans reporting PTSD and subthreshold PTSD

Jakupcak¹,

Conybeare²,

Phelps³

et al. 2007

Journal of Traumatic Stress

413

343

View full text Add to dashboard Cite

show abstract

“…Because PTSD is influenced by environmental factors that predate exposure to a focal traumatic event, epigenetic mechanisms may be highly relevant. There is good evidence in the animal literature that DNA methylation is a mechanism operative in programming the activity of genes regulating HPA activity by early life events (i.e., differences in maternal care) [57][58][59][60][61][62] that parallel observations that early life events are associated both with the development of PTSD and the HPA axis alterations described in this condition [63][64][65][66][67][68][69]. Such changes result in permanent changes in hippocampal GR expression and HPA function and provide a clear molecular link between early environment and gene expression and function.…”

Section: Environmental Exposures Can Results In Epigenetic Alterationsmentioning

confidence: 99%

The Role of Genes in Defining a Molecular Biology of PTSD

Yehuda

Koenen²,

Galea

et al. 2011

Disease Markers

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Abstract. Because environmental exposure to trauma is the sine qua non for the development of Post Traumatic Stress Disorder (PTSD), the recent focus on genetic studies has been noteworthy. The main catalyst for such studies is the observation from epidemiological studies that not all trauma survivors develop this disorder. Furthermore, neuroendocrine findings suggest preexisting hormonal alterations that confer risk for PTSD. This paper presents the rationale for examining genetic factors in PTSD and trauma exposure, but suggests that studies of genotype may only present a limited picture of the molecular biology of this disorder. We describe the type of information that can be obtained from candidate gene and genomic studies that incorporate environmental factors in the design (i.e., gene -environment interaction and gene-environment correlation studies) and studies that capitalize on the idea that environment modifies gene expression, via epigenetic or other molecular mechanisms. The examination of epigenetic mechanisms in tandem with gene expression will help refine models that explain how PTSD risk, pathophysiology, and recovery is mediated by the environment. Since inherited genetic variation may also influence the extent of epigenetic or gene expression changes resulting from the environment, such studies should optimally be followed up by studies of genotype. If PTSD is a condition precipitated by environmental exposure, why examine genes?For at least two decades after the diagnosis of PTSD was established in 1980, it would have been unheard of to propose that genes might be involved in the etiology or pathogenesis of this condition. PTSD was initially defined as a disorder that resulted from exposure to a traumatic environmental event. The diagnosis was designed to describe universal effects of extreme stress that linger even after the stressor is removed. The theoretical contribution that this made to the biopsychosocial model of mental illness was the realization that the effects of an environmental event are not limited to initial exposure to the event, but can also persist for years and even decades. These long-term effects were conceptualized as being a function of the intensi- * Corresponding author. E-mail: Rachel.Yehuda@va.gov. ty and severity of the event that precipitated the initial symptoms.The implication of the PTSD diagnosis was that the adverse effects of exposure to chronic stressors (e.g., illness, family conflict, or financial pressures) could be alleviated or even eliminated if the challenge to the person was removed (and hence were not precipitants of PTSD). In contrast, the effects of exposure to lifethreatening events like interpersonal violence, combat, and accidents that caused intense fear, helplessness and horror were not only persistent, but were of a specific and universal nature. The basic phenomenology of PTSD asserted that following trauma exposure, the survivor experiences unwanted, uncontrollable memories of the event that generate physical and emotional responses resem...

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“…In addition, longer or more intensive trauma exposure is associated with more severe symptoms (Vernberg & Varela, 2001). For instance, Vietnam veterans who reported childhood physical abuse had higher rates of combat-related PTSD (Bremner et al, 1995;Donovan, Padin-Rivera, Dowd, & Blake, 1996). Bremner et al (1995) suggested that living in a chaotic, stressful environment in childhood increases one's risk of developing PTSD when exposed to severe trauma later in life.…”

Section: Childhood Trauma Exposurementioning

confidence: 96%