Search Results (1,052)

Background/Objectives: Rodents provide a useful translational model of fear- and anxiety-related behaviors. Previously stressed animals exhibit physiological and behavioral stress responses that parallel those observed in anxious humans. Patients diagnosed with post-traumatic stress disorder (PTSD) present with a spectrum of debilitating anxiety symptoms that result from exposure to one or more traumatic events, with individuals exposed to early adverse experiences and women having increased vulnerability for diagnoses; however, the mechanisms of this increased vulnerability remain unknown. PTSD involves a complex network of highly interconnected brain regions, including the bed nucleus of the stria terminalis (BNST). Serotonin (5-HT) release into the BNST yields an increased expression of both fear and anxiety, specifically through 5-HT_2C receptor signaling. The present experiment addressed whether 5-HT_2C receptor signaling in the BNST is necessary for the acquisition of early-life stress (ELS)-induced enhancements in adult contextual fear learning. Methods: Rats received 0 or 15 footshocks on postnatal day 17, an established model of acute ELS (aELS) that yields enhanced adult fear learning. In adulthood, rats received bilateral infusions of a vehicle, a 5-HT_2C receptor antagonist (RS-102221), or a 5-HT_2C receptor agonist (MK-212) into the BNST 15 min prior to one-footshock contextual fear conditioning in a novel context. The next day, rats were returned to the fear-conditioning context to assess their fear memory (freezing). Results: Females demonstrated aELS-induced enhancement in contextual fear learning, while males did not. BNST infusions of RS-102221 reduced contextual fear conditioning, independent of aELS condition and sex. Infusions of MK-212 had no effect. Conclusions: Taken together, these data suggest that serotonergic signaling through 5-HT_2C receptors in the BNST contributes to contextual fear conditioning, but not aELS-induced stress-enhanced fear learning (SEFL). Full article

Background: Chronobiology has gained attention in the context of paediatric neurological and neuropsychiatric disorders, including migraine, epilepsy, autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD). Disruptions in circadian rhythms are associated with key symptoms such as sleep disturbances, mood dysregulation, and cognitive impairments, suggesting a potential for chronobiology-based therapeutic approaches. Methods: This narrative review employs a systematic approach to identify relevant studies through searches of three major scientific databases, NCBI/PubMed, ScienceDirect, and Scopus, up to July 2024. We used a combination of broad and condition-specific keywords, such as “chronobiology”, “biorhythm”, “pediatric”, “epilepsy”, “ADHD”, and “ASD”, among others. Articles in English that focused on clinical features, treatments, or outcomes related to circadian rhythms in paediatric populations were included, while non-peer-reviewed articles and studies lacking original data were excluded. Rayyan software was used for article screening, removing duplicates, and facilitating consensus among independent reviewers. Results: A total of 87 studies were included in the analysis. Findings reveal a consistent pattern of circadian rhythm disruptions across the disorders examined. Specifically, dysregulation of melatonin and cortisol secretion is observed in children with ASD, ADHD, and PTSD, with altered circadian timing contributing to sleep disturbances and mood swings. Alterations in core clock genes (CLOCK, BMAL1, PER, and CRY) were also noted in children with epilepsy, which was linked to seizure frequency and timing. Chronotherapy approaches showed promise in managing these disruptions: melatonin supplementation improved sleep quality and reduced ADHD symptoms in some children, while light therapy proved effective in stabilizing sleep–wake cycles in ASD and ADHD patients. Additionally, behaviour-based interventions, such as the Early Start Denver Model, showed success in improving circadian alignment in children with ASD. Conclusions: This review highlights the significant role of circadian rhythm disruptions in paediatric neurological and neuropsychiatric disorders, with direct implications for treatment. Chronobiology-based interventions, such as melatonin therapy, light exposure, and individualized behavioural therapies, offer potential for improving symptomatology and overall functioning. The integration of chronotherapy into clinical practice could provide a paradigm shift from symptom management to more targeted, rhythm-based treatments. Future research should focus on understanding the molecular mechanisms behind circadian disruptions in these disorders and exploring personalized chronotherapeutic approaches tailored to individual circadian patterns. Full article

Background: It is known that being the adult child of a parent with an alcohol use disorder (ACoA) can confer a wide variety of increased health and psychological risks, including higher rates of anxiety, depression, and post-traumatic stress disorder symptoms. Additionally, ACoAs are at greater risk of developing alcohol/substance use disorders (AUDs/SUDs) than individuals from families without a history of AUDs. Methods: ACoA individuals with risky hazardous alcohol use (n = 14) and those not engaged in hazardous use (n = 14) were compared to a group of healthy controls. We examined structural brain differences and applied machine learning algorithms to predict biological brain and DNA methylation ages to investigate differences and determine any accelerated aging between these groups. Results: Hazardous and non-hazardous ACoA groups had lower predicted brain ages than the healthy control group (n = 100), which may result from neuro-developmental differences between ACoA groups and controls. Within specific brain regions, we observed decreased cortical volume within bilateral pars orbitalis and frontal poles, and the left middle temporal gyrus and entorhinal cortex within the hazardous alcohol ACoA group. When looking at the epigenetic aging data, the hazardous ACoA participants had increased predicted epigenetic age difference scores compared to the control group (n = 34) and the non-hazardous ACoA participant groups. Conclusions: The results demonstrate a decreased brain age in the ACoAs compared to control, concurrent with increased epigenetic age specifically in the hazardous ACoA group, laying the foundation for future research to identify individuals with an increased susceptibility to developing hazardous alcohol use. Together, these results provide a better understanding of the associations between epigenetic factors, brain structure, and alcohol use disorders. Full article

Canine-assisted interactions (CAIs) have been explored to offer therapeutic benefits to human participants in various contexts, from addressing cancer-related fatigue to treating post-traumatic stress disorder. Despite their widespread adoption, there are still unresolved questions regarding the outcomes for both humans and animals involved in these interactions. Previous attempts to address these questions have suffered from core methodological weaknesses, especially due to absence of tools for an efficient objective evaluation and lack of focus on the canine perspective. In this article, we present a first-of-its-kind system and study to collect simultaneous and continuous physiological data from both of the CAI interactants. Motivated by our extensive field reviews and stakeholder feedback, this comprehensive wearable system is composed of custom-designed and commercially available sensor devices. We performed a repeated-measures pilot study, to combine data collected via this system with a novel dyadic behavioral coding method and short- and long-term surveys. We evaluated these multimodal data streams independently, and we further correlated the psychological, physiological, and behavioral metrics to better elucidate the outcomes and dynamics of CAIs. Confirming previous field results, human electrodermal activity is the measure most strongly distinguished between the dyads’ non-interaction and interaction periods. Valence, arousal, and the positive affect of the human participant significantly increased during interaction with the canine participant. Also, we observed in our pilot study that (a) the canine heart rate was more dynamic than the human’s during interactions, (b) the surveys proved to be the best indicator of the subjects’ affective state, and (c) the behavior coding approaches best tracked the bond quality between the interacting dyads. Notably, we found that most of the interaction sessions were characterized by extended neutral periods with some positive and negative peaks, where the bonded pairs might display decreased behavioral synchrony. We also present three new representations of the internal and overall dynamics of CAIs for adoption by the broader field. Lastly, this paper discusses ongoing options for further dyadic analysis, interspecies emotion prediction, integration of contextually relevant environmental data, and standardization of human–animal interaction equipment and analytical approaches. Altogether, this work takes a significant step forward on a promising path to our better understanding of how CAIs improve well-being and how interspecies psychophysiological states can be appropriately measured. Full article

Flash floods are a concerning social issue that affect urban areas all over the world. Flash floods can disrupt vital services, damage infrastructure, have socio-economic impacts on the earth’s surface, and significantly impact the community near the water body. Household and commercial damage, physical health issues from contaminated floodwater, mental health issues including post-traumatic stress disorder, and even fatalities are some of these common effects. Additionally, it is anticipated that climate change, continuous population growth, and urbanisation will increase flood events and flood risk exposure. Nature-based solutions (NbS) for flood management that lower flood risks include sustainable, economical methods that improve biodiversity, ecosystem resilience, and community well-being. This in-depth study analyses research and literature that previous researchers conducted related to flood management around ASEAN countries, as all these countries are closely located and share similarities in climate and temperature. This survey focuses on identifying the most suitable and effective NbS to overcome the problem and appropriate non-structural measures to support it in solving the flood problem in Malaysia. NbS provide a multi-benefit approach by improving ecosystem resilience, cutting costs, and offering co-benefits, including biodiversity conservation and better water quality, in contrast to conventional methods that put infrastructure before environmental sustainability. This survey also looks at the weaknesses in the existing flood management system and provides recommendations to overcome these problems. Additionally, this survey offers practical policy suggestions to help incorporate NbS into regional and national flood control frameworks, guaranteeing that the solutions are not only socially just but also ecologically sound. Full article

Introduction: Post-Traumatic Stress Disorder (PTSD) is a highly prevalent disorder and a highly debilitating condition. Although current theories focused on depressed mood and intrusion as critical dimensions, the mechanism through which depression increases the risk of PTSD remains unclear. Research usually concentrates on the hyperactive negative valence system (NVS) (e.g., increased fear and threat responses), but some evidence suggests a significant role for the hypoactive positive valence system (PVS) (e.g., less neural activation towards rewards). Method: The main aim of the present research was to investigate whether probable PTSD leads to a different evaluation of the implicit processing in a refugee’s sample. Ratings of arousal, dominance, and valence from 60 International Affective Picture System (IAPS) pictures (positive, neutral, and negative) were collected from 42 individuals with probable PTSD, and a group of 26 trauma-exposed individuals (M_age = 28.49 years, SD = ±7.78). Results: ANOVA results revealed a main group effect (η2p = 0.379) on arousal, dominance, valence dimensions, and pictures’ categories (η2p = 0.620), confirming evidence according to which PTSD origins a state of maladaptive hyperarousal and troubles the regulation of emotions, and not supporting the view that such difficulties arise only with negative stimuli. Participants with probable PTSD deemed negative stimuli as more threatening than they really are, reacting to unpleasant images with greater negative emotionality (i.e., enhanced arousal and lower valence ratings) compared with individuals without PTSD. Moreover, they rated positive stimuli as less pleasant. Furthermore, arousal ratings were negatively correlated with valence (r = −0.709, p < 0.01) indicating that pictures with high arousal (negative) were associated with lower valence. Discussion: Our findings supported evidence according to which PTSD caused a constant state of hyperarousal and difficulties in regulating emotions facing environmental stimuli. Positive stimuli are considered less pleasant, and this inhibits from completely benefiting from them. Conclusion: Our study provides evidence for a differential and potentially complementary involvement of NVS and PVS in PTSD development. Intervention for PTSD may, thus, target both negative and positive valence processing. Full article

Background and Objectives: Post-traumatic stress disorder (PTSD) is a debilitating condition worldwide. The limited effectiveness of current psychological and pharmacological treatments has motivated studies on meditation techniques. This study is a comprehensive, multiple-treatments meta-analysis comparing the effectiveness of different categories of meditation in treating PTSD. Methods and Materials: We followed Prisma guidelines in our published protocol to search major databases and to conduct a meta-analysis of the studies. Results: We located 61 studies with 3440 subjects and divided them logically into four treatment groups: Mindfulness-Based Stress Reduction (MBSR, 13 studies); Mindfulness-Based Other techniques (MBO, 16 studies), Transcendental Meditation (TM, 18 studies), and Other Meditations that were neither mindfulness nor TM (OM, 14 studies). Trauma populations included war veterans, war refugees, earthquake and tsunami victims, female survivors of interpersonal violence, clinical nurses, male and female prison inmates, and traumatized students. Of those offered, 86% were willing to try meditation. The baseline characteristics of subjects were similar across meditation categories: mean age = 52.2 years, range 29–75; sample size = 55.4, range 5–249; % males = 65.1%, range 0–100; and maximum study duration = 13.2 weeks, range 1–48. There were no significant differences between treatment categories on strength of research design nor evidence of publication bias. The pooled mean effect sizes in Hedges’s g for the four categories were MBSR = −0.52, MBO = −0.66, OM = −0.63, and TM = −1.13. There were no appreciable differences in the study characteristics of research conducted on different meditations in terms of the types of study populations included, outcome measures, control conditions, gender, or length of time between the intervention and assessment of PTSD. TM’s effect was significantly larger than for each of the other categories, which did not differ from each other. No study reported serious side effects. Conclusions: All categories of meditation studied were helpful in mitigating symptoms of PTSD. TM produced clinically significant reductions in PTSD in all trauma groups. We recommend a multisite Phase 3 clinical trial to test TM’s efficacy compared with standard treatment. Full article

Background: glucocorticoids may play an important role in the formation of fear memory, which is relevant to the neurobiology of post-traumatic stress disorder (PTSD). In our previous study, we showed the glucocorticoid receptor (GR) forms a protein complex with FKBP51, which prevents translocation of GR into the nucleus to affect gene expression; this complex is elevated in PTSD patients and by fear-conditioned learning in mice, and disrupting this complex blocks the storage and retrieval of fear-conditioned memories. The timing of release of glucocorticoid relative to the formation of a traumatic memory could be important in this process, and remains poorly understood. Methods and Results: we mapped serum corticosterone over time after fear conditioning in cardiac blood samples from male and female mice, as well as adult and aged mice using ELISA. We show a significant alteration in serum corticosterone after conditioning; notably, levels spike after 30 min but drop lower than unconditioned controls after 24 h. We further investigate the effect of glucocorticoid on GR phosphorylation and localization in HEK 293T cells by Western blot. Hydrocortisone treatment promotes phosphorylation and nuclear translocation of GR. Conclusions: these data contribute to our understanding of the processes linking stress responses to molecular signals and fear memory, which is relevant to understanding the shared mechanisms related to PTSD. Full article

Post-Traumatic Stress Disorder (PTSD) is a multifaceted psychiatric disorder triggered by traumatic events, leading to prolonged psychological distress and varied symptoms. Rat models have been extensively used to explore the biological, behavioral, and neurochemical underpinnings of PTSD. This review critically examines the strengths and limitations of commonly used rat models, such as single prolonged stress (SPS), stress–re-stress (S-R), and predator-based paradigms, in replicating human PTSD pathology. While these models provide valuable insights into neuroendocrine responses, genetic predispositions, and potential therapeutic targets, they face challenges in capturing the full complexity of PTSD, particularly in terms of ethological relevance and translational validity. We assess the degree to which these models mimic the neurobiological and behavioral aspects of human PTSD, highlighting areas where they succeed and where they fall short. This review also discusses future directions in refining these models to improve their utility for translational research, aiming to bridge the gap between preclinical findings and clinical applications. Full article

Background/Objectives: Comorbid post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) patients are at a significantly higher risk of adverse outcomes, including opioid use disorder, depression, suicidal behaviors, and death, yet limited treatment options exist for this population. This study aimed to build on previous research by incorporating drug target information into a novel deep learning model, T-DeepBiomarker, to predict adverse outcomes and identify potential therapeutic medications. Methods: We utilized electronic medical record (EMR) data from the University of Pittsburgh Medical Center (UPMC), analyzing 5565 PTSD + AUD patients. T-DeepBiomarker was developed by integrating multimodal data, including lab results, drug target information, comorbidities, neighborhood-level social determinants of health (SDoH), and individual-level SDoH (e.g., psychotherapy and veteran status). The model was trained to predict adverse events, including opioid use disorder, suicidal behaviors, depression, and death, within three months following any clinical encounter. Candidate medications targeting significant proteins were identified through literature reviews. Results: T-DeepBiomarker achieved high predictive performance with an AUROC of 0.94 for adverse outcomes in PTSD + AUD patients. Several medications, including OnabotulinumtoxinA, Dronabinol, Acamprosate, Celecoxib, Exenatide, Melatonin, and Semaglutide, were identified as potentially reducing the risk of adverse events by targeting significant proteins. Conclusions: T-DeepBiomarker demonstrates high accuracy in predicting adverse outcomes in PTSD + AUD patients and highlights candidate drugs with potential therapeutic effects. These findings advance pharmacotherapy for this high-risk population and identify medications that warrant further investigation. Full article

This report presents the follow-up treatment course of a previously published case that demonstrated the effectiveness of prolonged exposure (PE) therapy for a disaster relief worker. The patient, a municipal employee in Fukushima Prefecture, developed post-traumatic stress disorder (PTSD) and mood disorders after the 2011 Great East Japan Earthquake and subsequent disasters. This follow-up focuses on the period from 2021 to early 2024, during which the patient experienced symptom recurrence after his father’s death. This event revealed psychological patterns similar to his disaster-related responses. Schema therapy was introduced to address over-adaptive work behaviors and vulnerabilities in relationships, identified as relapse risk factors. Combined with antidepressants, schema therapy achieved sustained improvement. This longitudinal perspective demonstrates schema therapy’s effectiveness in addressing underlying vulnerabilities when symptoms re-emerge after trauma-focused treatment. The findings underscore how initial trauma responses may interact with subsequent life events and suggest schema therapy’s potential as a secondary intervention for disaster relief workers facing complex challenges. Full article

Background/Objectives: Like in the general population, the prevalences of eating- and weight-related health issues in the armed forces are increasing. Relevant medical conditions include the eating disorders (EDs) anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant restrictive food intake disorder (ARFID), as well as body dysmorphic disorder, muscle dysmorphia, and the relative energy deficiency in sport (RED-S) syndrome. Methods: We performed a narrative literature review on eating- and weight-related disorders in the armed forces. Results: Entry standards might exclude people with obesity, with EDs, or at high risk for EDs from entering the armed forces for military reasons and to protect the individual’s health. Relevant potential risk factors of eating- and weight-related disorders in the military are the emphasis on appearance and fitness in the military, high levels of stress, military sexual trauma, post-traumatic stress disorder, deployment, relocation, long commutes, consumption of ultra-processed foods and beverages, limitations on food selection and physical exercise, and intensive combat training and field exercises. Eating- and weight-related disorders negatively impact professional military appearance and lead to problems with cardiorespiratory and neuromuscular fitness; daytime sleepiness; and a higher risk of musculoskeletal injuries, and other physical and mental health problems. Current and potential future therapeutic options include occupational health measures, psychosocial therapies, neuromodulation, and drug treatments. Conclusions: Even though randomized controlled trials (RCTs) have been performed to test treatments for obesity in the armed forces, RCTs for the treatment of EDs, body dysmorphic disorder, muscle dysmorphia, and RED-S syndrome are lacking in the military context. Full article

Background/Objectives: The COVID-19 pandemic has led to increased mental health issues, particularly among long-COVID patients, who experience persistent symptoms post-recovery, potentially leading to chronic conditions. The psychological impact of long-COVID is still largely unknown, but it may contribute to mental disorders like Post-Traumatic Stress Disorder (PTSD). Given the global rise in anxiety and depression, exploring therapies like Eye Movement Desensitization and Reprocessing (EMDR) for long-COVID traumatic disorders is crucial. This study explores the effectiveness of remote EMDR therapy for PTSD-like symptoms in long-COVID conditions (LCC), assessing their emergence, the impact of LCC on mental health, and identifying key commonalities. It also examines the potential advantages of an artificial intelligence (AI)-powered platform for EMDR treatments for both therapists and patients, evaluating the response differences between remote and in-person treatment. Methods: We enrolled a total of 160 participants divided into two groups of 80, with the experimental group receiving EMDR treatment for PTSD-like symptoms via a remote AI-powered platform, and the control group receiving traditional in-person therapy. We compared the ANOVA for Subjective Units of Disturbance (SUDs) scores, PTSD Checklist for DSM-5 (PCL-5) scores, and Impact of Event Scale-Revised (IES-R) scores between our two groups for three cases: pre-treatment, post-treatment, and decrement. Results: Statistical significance analysis showed a consistent absence of significant differences between online AI-powered platforms and traditional in-presence sessions. This effectively confirms our hypothesis and highlights that no significant differences were observed between the two groups. Conclusions: The AI-supported remote platform demonstrates comparable efficacy in delivering EMDR therapy, confirming its potential as an effective alternative to traditional in-person methods while providing added advantages in accessibility and adaptability (e.g., remote areas, hikikomori, natural disasters). Full article

Background/Objectives: The aim of this study was to determine if performing ultrasound-guided, bilateral, two-level cervical sympathetic chain blocks (2LCSBs) (performed on subsequent days) improves symptoms associated with traumatic brain injury (TBI) that do not overlap with posttraumatic stress disorder (PTSD). Methods: A retrospective chart review was conducted between August 2022 and February 2023. We identified twenty patients who received bilateral 2LCSBs for PTSD and anxiety symptoms and who also had a history of TBI. Neurobehavioral Symptom Inventory (NSI) scores were collected at baseline, one week, and one month post treatment in 13 males and 7 females. A sub-analysis of the first ten questions of the NSI, which we identified as not overlapping with PTSD or anxiety symptoms, generated an NSI sub-score. Results: Out of 20 patients, all showed improvement in their NSI scores and NSI sub-scores. The NSI sub-scores had a baseline average of 15.45 (on a 40-point scale); the average score at one week post treatment was 8.30; and that at one month post treatment was 7.80. This represents a 49.51% improvement in TBI symptoms which did not overlap with PTSD or anxiety symptoms between baseline and one month. Conclusions: The use of bilateral 2LCSBs may be helpful in treating patients with TBI, regardless of the presence of comorbid PTSD symptoms. Full article

Adverse childhood experiences (ACEs) have already been associated, in some studies, with various diverse psychosocial abnormalities in later life. However, it is still unclear whether ACEs reported by biological parents differ from ACE scores in community samples. Background/Objectives: The aim of this study was to investigate the extent to which parents of a patient sample differ from a community sample in terms of reporting childhood experiences. In addition, the connection between parental negative traumatic experiences and their children’s reporting of these experiences should be examined in more detail. Methods: In total, 256 child psychiatric patients (73.8% female and 26.2% male) aged 4–18 years (mean [M] = 13.26 years, standard deviation [SD] = 2.73) were retrospectively examined for post-traumatic stress symptoms (using the CATS questionnaire). In addition, 391 caregivers, 316 of whom were biological parents, completed the ACE questionnaire on adverse childhood experiences. The frequencies of ACEs of the parents, the traumatic experiences of the patients and their cumulative occurrence were evaluated descriptively. Results: A total of 139 (73%) mothers reported at least one negative experience in childhood. In contrast, 65 fathers (52%) reported at least one negative experience in childhood. Mothers most frequently mentioned separation from a parent (38.7%), while fathers cited emotional abuse as the most frequent negative experience. These ACE scores were significantly higher than those reported from community samples. Post-traumatic stress disorder was diagnosed in 75 (29.3%) of the 256 patients. A total of 44.6% of children of mothers and 53.8% of children of fathers reporting at least one ACE showed a CATS score above the cut-off. Conclusions: Parents of child psychiatric patients show higher scores of adverse childhood experiences than a community sample with the same population background. Further empirical studies in parents of child psychiatric patients and a larger sample seem mandatory in the face of these results. Full article