Latent factor structure of PTSD symptoms in veterans with a history of mild traumatic brain injury and close-range blast exposure.

Rosenblatt, Alberto; Li, Ruosha; Fortier, Catherine B.; Liu, Xiangyu; Fonda, Jennifer R.; Villalon, Audri; McGlinchey, Regina E.; Jorge, Ricardo E.

doi:10.1037/tra0000399

Cited by 7 publications

(4 citation statements)

References 48 publications

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“…This core group of PTSD symptoms might be related to disruption of the fear-processing system, particularly with respect to the discrimination of threat and safety cues and the consolidation of traumatic memories. Furthermore, some evidence shows that this cluster of symptoms is also prominent among veterans with blast-related neurotrauma, years after the traumatic events 5 . It is conceivable that alterations in prefrontal regulation associated with traumatic brain injury (TBI) contribute to the enhancement and persistence of this symptomatic core 6 …”

Section: Definition and Symptom Structure Of Posttraumatic Stress Dis...mentioning

confidence: 99%

“…Furthermore, some evidence shows that this cluster of symptoms is also prominent among veterans with blast-related neurotrauma, years after the traumatic events. 5 It is conceivable that alterations in prefrontal regulation associated with traumatic brain injury (TBI) contribute to the enhancement and persistence of this symptomatic core. 6 PTSD is a heterogeneous disorder with subtypes possessing distinct pathophysiologic mechanisms requiring specific therapeutic approaches.…”

Section: Commentmentioning

confidence: 99%

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Posttraumatic Stress Disorder and Anxiety-Related Conditions

Jaffee¹,

Jorge²

2021

CONTINUUM: Lifelong Learning in Neurology

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PURPOSE OF REVIEW This article provides a synopsis of current assessment and treatment considerations for posttraumatic stress disorder (PTSD) and related anxiety disorder characteristics. Epidemiologic and neurobiological data are reviewed as well as common associated symptoms, including sleep disruption, and treatment approaches to these conditions. RECENT FINDINGS PTSD is no longer considered an anxiety-related disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition classification and instead is associated with trauma/stressor-related disorders. PTSD symptoms are clustered into four domains including intrusive experiences, avoidance, mood, and arousal symptoms. Despite this reclassification, similarities exist in consideration of diagnosis, treatment, and comorbidities with anxiety disorders. PTSD and anxiety-related disorders are heterogeneous, which is reflected by the neural circuits involved in the genesis of symptoms that may vary across symptom domains. Treatment is likely to benefit from consideration of this heterogeneity. Research in animal models of fear and anxiety, as well as in humans, suggests that patients with PTSD and generalized anxiety disorder have difficulty accurately determining safety from danger and struggle to suppress fear in the presence of safety cues. Empirically supported psychotherapies commonly involved exposure (fear extinction learning) and are recommended for PTSD. Cognitive-behavioral therapy has been shown to be effective in other anxiety-related disorders. Selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) are commonly used in the treatment of PTSD and anxiety disorders in which pharmacologic intervention is supported. Treating sleep disruption including sleep apnea (continuous positive airway pressure [CPAP]), nightmares, and insomnia (preferably via psychotherapy) may improve symptoms of PTSD, as well as improve mood in anxiety disorders. SUMMARY PTSD has a lifetime prevalence that is close to 10% and shares neurobiological features with anxiety disorders. Anxiety disorders are the most common class of mental conditions and are highly comorbid with other disorders; treatment considerations typically include cognitive-behavioral therapy and pharmacologic intervention. Developing technologies show some promise as treatment alternatives in the future.

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Section: Definition and Symptom Structure Of Posttraumatic Stress Dis...mentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Posttraumatic Stress Disorder and Anxiety-Related Conditions

Jaffee¹,

Jorge²

2021

CONTINUUM: Lifelong Learning in Neurology

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“…Type of deployment-related injury and type of PTSD assessment also make a difference in symptoms displayed. PTSD, depression, and traumatic brain injury are a triad of functional disability and unemployment (Rosenblatt et al, 2019).…”

Section: Symptoms and Comorbiditymentioning

confidence: 99%

Emerging findings on trauma in the military.

Kendall–Tackett

2019

Psychological Trauma: Theory, Research, Practice, and Policy

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“…Many veterans from the recent conflicts in Iraq and Afghanistan suffer from chronic neurobehavioral syndromes that include post-traumatic stress disorder (PTSD) [ 31 ]. Indeed, a striking feature in veterans from the most recent war theaters has been the overlap between a history of blast-related mild TBI (mTBI) and PTSD [ 17 , 31 , 115 , 134 , 140 , 141 ]. While these symptoms may improve, they frequently persist and may worsen with declines driven mainly by worsening PTSD and depression [ 83 ].…”

Section: Introductionmentioning

confidence: 99%

Low-level blast exposure induces chronic vascular remodeling, perivascular astrocytic degeneration and vascular-associated neuroinflammation

Sosa

Gasperi

Pryor

et al. 2021

acta neuropathol commun

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Cerebral vascular injury as a consequence of blast-induced traumatic brain injury is primarily the result of blast wave-induced mechanical disruptions within the neurovascular unit. In rodent models of blast-induced traumatic brain injury, chronic vascular degenerative processes are associated with the development of an age-dependent post-traumatic stress disorder-like phenotype. To investigate the evolution of blast-induced chronic vascular degenerative changes, Long-Evans rats were blast-exposed (3 × 74.5 kPa) and their brains analyzed at different times post-exposure by X-ray microcomputed tomography, immunohistochemistry and electron microscopy. On microcomputed tomography scans, regional cerebral vascular attenuation or occlusion was observed as early as 48 h post-blast, and cerebral vascular disorganization was visible at 6 weeks and more accentuated at 13 months post-blast. Progression of the late-onset pathology was characterized by detachment of the endothelial and smooth muscle cellular elements from the neuropil due to degeneration and loss of arteriolar perivascular astrocytes. Development of this pathology was associated with vascular remodeling and neuroinflammation as increased levels of matrix metalloproteinases (MMP-2 and MMP-9), collagen type IV loss, and microglial activation were observed in the affected vasculature. Blast-induced chronic alterations within the neurovascular unit should affect cerebral blood circulation, glymphatic flow and intramural periarterial drainage, all of which may contribute to development of the blast-induced behavioral phenotype. Our results also identify astrocytic degeneration as a potential target for the development of therapies to treat blast-induced brain injury.

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Latent factor structure of PTSD symptoms in veterans with a history of mild traumatic brain injury and close-range blast exposure.

Abstract: Factors including mTBI and blast exposure and type of assessment tools must be considered when determining preferable PTSD latent factor structure models. (PsycINFO Database Record

Cited by 7 publications

References 48 publications

Posttraumatic Stress Disorder and Anxiety-Related Conditions

Posttraumatic Stress Disorder and Anxiety-Related Conditions

Emerging findings on trauma in the military.

Low-level blast exposure induces chronic vascular remodeling, perivascular astrocytic degeneration and vascular-associated neuroinflammation

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