New research might help people suffering from post-traumatic stress disorder

ScienceDaily (Aug. 2, 2011) — The discovery of a mechanism in the brain explains for the first time why people make particularly strong, long-lasting memories of stressful events in their lives and could help sufferers of post-traumatic stress disorder.

The study, carried out by researchers from the University of Bristol's Henry Wellcome Laboratories for Integrative Neuroscience & Endocrinology (HW-LINE) in the School of Clinical Sciences, and funded by the Biotechnology and Biological Sciences Research Council (BBSRC), is published online this week in the Proceedings of the National Academy of Sciences (PNAS).

The research found that stress hormones directly stimulate biochemical processes in neurons that play a role in learning and memory. The way these hormones stimulate these signalling and epigenetic processes in neurons is completely new and has never been shown before.

In the healthy brain these processes operate smoothly and help people to cope with and learn from stressful events in their lives. In vulnerable people or in strongly traumatized people (victims of rape or war), these processes may be disturbed and stressful events may result in the formation of highly traumatic memories such as those seen in patients suffering from post-traumatic stress disorder (PTSD). The discovery may lead to new ways to develop drugs to help these patients and to prevent PTSD in trauma victims.

Professor Johannes Reul, Professorial Research Fellow in Neuroscience at HW-LINE, said: "Making memories of events in our lives is of critical importance in order to cope properly with new situations and challenges in the future. This is of particular importance for emotional and traumatic life events. Our newly discovered mechanism should be regarded as an adaptive mechanism. We believe this mechanism could be disturbed in stress-related psychiatric disorders such as depression and anxiety.

"The new findings may be of particular significance for patients suffering from post-traumatic stress disorder (PTSD) as these patients are pained by pathological memories of an endured trauma (rape or war situations). We hope our discovery may help to generate a new class of drugs to help these patients."

The researchers found that stress-induced glucocorticoid hormones enhance memory formation through a direct, physical interaction of glucocorticoid-binding receptors ("glucocorticoid receptor") with a particular intracellular signalling pathway in a specific population of neurons of the hippocampus. This signalling pathway, the so-called ERK MAPK pathway, is known to be strongly involved in learning and memory processes but it was not known that it could interact with glucocorticoid receptors and that this would lead to an enhancement of memory formation.

This type of interaction has never been described before. The interaction has a major impact as the stimulated signalling cascade results in augmented epigenetic mechanisms in the nucleus of the affected neurons leading to enhanced expression of certain gene products. The induced gene products are known to evoke structural and functional changes in neurons allowing them to strengthen their role in the memory circuits of the brain.

It is well known that people make very strong memories of stressful, emotionally disturbing events in their lives. These so-called episodic memories are memories of the place (e.g. room, office) or surroundings where the event happened, how we felt at the time (mood), and the time of the day at which it happened. These kind of memories can last a lifetime.

The consolidation of such memories is taking place in a specific limbic brain region called the hippocampus -- part of the brain involved in memory and learning. Hormones secreted during stress like the glucocorticoid hormone cortisol (in rodents, corticosterone) act on the hippocampus to enhance the consolidation of these memories. However, until now it has been unknown how these hormones act on the hippocampus to enhance the formation of emotional event-related memories.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Bristol.

Journal Reference:

María Gutièrrez-Mecinas, Alexandra F. Trollope, Andrew Collins, Hazel Morfett, Shirley A. Hesketh, Flavie Kersanté, and Johannes M. H. M. Reul. Long-lasting behavioral responses to stress involve a direct interaction of glucocorticoid receptors with ERK1/2–MSK1–Elk-1 signaling. Proceedings of the National Academy of Sciences, August 1, 2011 DOI: 10.1073/pnas.1104383108

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here sciencedaily.com

Persons displaced by war at increased risk of posttraumatic stress disorder, depression, anxiety

ScienceDaily (Aug. 3, 2011) — Residents of Sri Lanka who were internally displaced during the civil conflict that occurred in their country from 1983 to 2009 have a higher prevalence of war-related mental health conditions that include depression, anxiety and posttraumatic stress disorder, according to a study in the August 3 issue of JAMA, a theme issue on violence and human rights.

Armed conflicts may result in displacement of persons seeking refuge in neighboring countries or secure areas of their own country (internal displacement). "Nearly 2.7 million individuals worldwide are internally displaced annually by armed conflict. The Sri Lankan conflict resulted in approximately 100,000 deaths and displacement of 800,000 people during the 26-year war," according to background information in the article. In the Jaffna District of Sri Lanka, a peninsula in the far north of the country, it has been estimated that 23 percent of the population had been internally displaced by July 2009. "Although overall patterns of psychiatric morbidity among conflict-affected populations have been documented, less is known about the psychological effect of forced displacement among individuals who remain within their national borders."

Farah Husain, D.M.D., M.P.H., of the Centers for Disease Control and Prevention, Atlanta, and colleagues conducted a health survey among residents of Jaffna District to assess the association between displacement status and the prevalence of common war-related mental health conditions. The survey was conducted between July and September 2009 among 1,517 Jaffna District households, including 2 internally displaced persons camps. The response rate was 92 percent (1,448 respondents, 1,409 eligible respondents). Two percent of participants (n = 80) were currently displaced, 29.5 percent (n = 539) were recently resettled, and 68.5 percent (n = 790) were long-term residents. A total of 376 (31.8 percent) participants experienced no trauma events; 578 (44.0 percent) reported experiencing 1 to 4 events; 336 (20.2 percent) experienced 5 to 9 events; and 72 (4.0 percent) experienced 10 or more events.

The overall prevalences of posttraumatic stress disorder (PTSD), anxiety, and depression symptoms were 7.0 percent, 32.6 percent, and 22.2 percent, respectively. After adjusting for variables, the researchers found that the odds of having symptoms of depression, anxiety, and PTSD were significantly higher among displaced camp-based individuals compared with long-term residents and that the odds of reporting PTSD symptoms among recently resettled participants was higher than that of long-term residents. Female respondents were more likely to report symptoms of anxiety and depression. Older age was associated with PTSD, anxiety, and depression symptoms. The authors also found that displacement was no longer associated with mental health symptoms after controlling for trauma exposure.

"Although the association between displacement status and symptoms of PTSD, depression, and anxiety was no longer significant after adjusting for trauma exposure in this study, the act of being displaced and the daily stressors associated with it may be considered traumatic in themselves and may be an indicator or proxy for recent trauma as well. Therefore, the relationship between displacement status and mental health symptoms may be driven by the underlying trauma events displaced persons have experienced, events that likely caused them to leave their homes," they write.

The researchers suggest that interventions in Sri Lanka should target the most vulnerable populations, especially those living in displacement camps. "Internally displaced persons outnumber refugees globally and initiatives addressing mental health needs, such as those developed by the Inter-Agency Standing Committee, should be considered. In Jaffna District, interventions should include support from family, friends, religious leaders, and traditional counselors. Finally, a longitudinal study of displaced populations would help determine how the intensity of events, the time since events, and other factors, such as coping skills, affect mental health symptoms. In this way, stakeholders could begin to understand the short- and long-term mental health implications of armed conflict and traumatic events associated with displacement."

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by JAMA and Archives Journals.

Journal Reference:

F. Husain, M. Anderson, B. Lopes Cardozo, K. Becknell, C. Blanton, D. Araki, E. Kottegoda Vithana. Prevalence of War-Related Mental Health Conditions and Association With Displacement Status in Postwar Jaffna District, Sri Lanka. JAMA: The Journal of the American Medical Association, 2011; 306 (5): 522 DOI: 10.1001/jama.2011.1052

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here sciencedaily.com

Virginia Tech shootings: Professors publish research on post-traumatic stress

ScienceDaily (Aug. 3, 2011) — In the months after the April 16, 2007, shootings at Virginia Tech, two professors administered a survey to assess posttraumatic stress among students. The findings have been published in the July 18, 2011 issue of the Journal of Psychological Trauma: Theory, Research, Practice, and Policy, published by the American Psychological Association.

According to researchers Michael Hughes, professor of sociology in the College of Liberal Arts and Human Sciences, and Russell T. Jones, professor of psychology in the College of Science, 15.4 percent of Virginia Tech students experienced high levels of posttraumatic stress three to four months following the shootings in which 49 students and faculty members at the university were shot, 32 of whom were killed.

These findings were from a web-based survey of students that was conducted during the summer and fall after the shootings. A total of 4,639 students from the population of 23,214 (20 percent) agreed to complete the survey, which included questions about exposure to the shootings and other trauma-related stressors.

Prevalence of posttraumatic stress was significantly higher among women (23.2 percent) than men (9.9 percent). "The research suggests that higher female-than-male posttraumatic stress was primarily due to greater female losses in secondary networks," Jones said. "These losses were in the form of deaths, injuries, and close calls of individuals who were not considered close friends or relatives. These findings could also be a function of other losses characterized by perceived danger or harm in the absence of information or extended periods of worry."

Exposure to trauma-related stressors varied greatly, from 4.6 percent who reported being in close proximity to the first shooting incident in Ambler-Johnston Hall to 64.5 percent unable to confirm the safety of friends. The stress exposures that were most strongly related to symptoms of posttraumatic stress were the death or injury of someone close and the inability to confirm the safety of friends during the two hours after the Norris Hall shootings. "It appears that the stressors most responsible for posttraumatic stress among Virginia Tech students had to do with social relationships -- deaths and injuries involving friends and anxiety about the safety of friends," said Hughes.

Because exposure to stressors was widespread among students on campus, the experience of symptoms of posttraumatic stress was also widespread, reaching well beyond those who had direct exposure to the actual shooting incidents. These findings have important implications for planning mental health treatment outreach. Widespread symptom prevalence made it difficult to target a small, highly exposed segment of students for mental health outreach. This low concentration of probable posttraumatic stress disorder will likely be a common feature of future mass trauma incidents, requiring broad-based outreach to find students needing mental health treatment intervention.

Hughes and Jones served as co-principal investigators on this research. The article was co-authored by Jones, Melissa Brymer (University of California, Los Angeles), Wai Tat Chiu (Harvard Medical School), John A. Fairbank (Duke University Medical Center), Robert S. Pynoos (University of California, Los Angeles), Virginia Rothwell (Longwood University), Alan Steinberg (University of California, Los Angeles), and Ronald C. Kessler (Harvard Medical School).

Major funding for this study was provided by an unrestricted grant from the Jed Foundation. Support was also provided through funding received by Virginia Tech from the U.S. Department of Education, Office of Safe and Drug Free Schools.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Virginia Tech, via EurekAlert!, a service of AAAS.

Journal Reference:

Michael Hughes, Melissa Brymer, Wai Tat Chiu, John A. Fairbank, Russell T. Jones, Robert S. Pynoos, Virginia Rothwell, Alan M. Steinberg, Ronald C. Kessler. Posttraumatic stress among students after the shootings at Virginia Tech. Psychological Trauma: Theory, Research, Practice, and Policy, 2011; DOI: 10.1037/a0024565

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here sciencedaily.com

New research might help people suffering from post-traumatic stress disorder

ScienceDaily (Aug. 2, 2011) — The discovery of a mechanism in the brain explains for the first time why people make particularly strong, long-lasting memories of stressful events in their lives and could help sufferers of post-traumatic stress disorder.

The study, carried out by researchers from the University of Bristol's Henry Wellcome Laboratories for Integrative Neuroscience & Endocrinology (HW-LINE) in the School of Clinical Sciences, and funded by the Biotechnology and Biological Sciences Research Council (BBSRC), is published online this week in the Proceedings of the National Academy of Sciences (PNAS).

The research found that stress hormones directly stimulate biochemical processes in neurons that play a role in learning and memory. The way these hormones stimulate these signalling and epigenetic processes in neurons is completely new and has never been shown before.

In the healthy brain these processes operate smoothly and help people to cope with and learn from stressful events in their lives. In vulnerable people or in strongly traumatized people (victims of rape or war), these processes may be disturbed and stressful events may result in the formation of highly traumatic memories such as those seen in patients suffering from post-traumatic stress disorder (PTSD). The discovery may lead to new ways to develop drugs to help these patients and to prevent PTSD in trauma victims.

Professor Johannes Reul, Professorial Research Fellow in Neuroscience at HW-LINE, said: "Making memories of events in our lives is of critical importance in order to cope properly with new situations and challenges in the future. This is of particular importance for emotional and traumatic life events. Our newly discovered mechanism should be regarded as an adaptive mechanism. We believe this mechanism could be disturbed in stress-related psychiatric disorders such as depression and anxiety.

"The new findings may be of particular significance for patients suffering from post-traumatic stress disorder (PTSD) as these patients are pained by pathological memories of an endured trauma (rape or war situations). We hope our discovery may help to generate a new class of drugs to help these patients."

The researchers found that stress-induced glucocorticoid hormones enhance memory formation through a direct, physical interaction of glucocorticoid-binding receptors ("glucocorticoid receptor") with a particular intracellular signalling pathway in a specific population of neurons of the hippocampus. This signalling pathway, the so-called ERK MAPK pathway, is known to be strongly involved in learning and memory processes but it was not known that it could interact with glucocorticoid receptors and that this would lead to an enhancement of memory formation.

This type of interaction has never been described before. The interaction has a major impact as the stimulated signalling cascade results in augmented epigenetic mechanisms in the nucleus of the affected neurons leading to enhanced expression of certain gene products. The induced gene products are known to evoke structural and functional changes in neurons allowing them to strengthen their role in the memory circuits of the brain.

It is well known that people make very strong memories of stressful, emotionally disturbing events in their lives. These so-called episodic memories are memories of the place (e.g. room, office) or surroundings where the event happened, how we felt at the time (mood), and the time of the day at which it happened. These kind of memories can last a lifetime.

The consolidation of such memories is taking place in a specific limbic brain region called the hippocampus -- part of the brain involved in memory and learning. Hormones secreted during stress like the glucocorticoid hormone cortisol (in rodents, corticosterone) act on the hippocampus to enhance the consolidation of these memories. However, until now it has been unknown how these hormones act on the hippocampus to enhance the formation of emotional event-related memories.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Bristol.

Journal Reference:

María Gutièrrez-Mecinas, Alexandra F. Trollope, Andrew Collins, Hazel Morfett, Shirley A. Hesketh, Flavie Kersanté, and Johannes M. H. M. Reul. Long-lasting behavioral responses to stress involve a direct interaction of glucocorticoid receptors with ERK1/2–MSK1–Elk-1 signaling. Proceedings of the National Academy of Sciences, August 1, 2011 DOI: 10.1073/pnas.1104383108

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here sciencedaily.com

Virginia Tech shootings: Professors publish research on post-traumatic stress

ScienceDaily (Aug. 3, 2011) — In the months after the April 16, 2007, shootings at Virginia Tech, two professors administered a survey to assess posttraumatic stress among students. The findings have been published in the July 18, 2011 issue of the Journal of Psychological Trauma: Theory, Research, Practice, and Policy, published by the American Psychological Association.

According to researchers Michael Hughes, professor of sociology in the College of Liberal Arts and Human Sciences, and Russell T. Jones, professor of psychology in the College of Science, 15.4 percent of Virginia Tech students experienced high levels of posttraumatic stress three to four months following the shootings in which 49 students and faculty members at the university were shot, 32 of whom were killed.

These findings were from a web-based survey of students that was conducted during the summer and fall after the shootings. A total of 4,639 students from the population of 23,214 (20 percent) agreed to complete the survey, which included questions about exposure to the shootings and other trauma-related stressors.

Prevalence of posttraumatic stress was significantly higher among women (23.2 percent) than men (9.9 percent). "The research suggests that higher female-than-male posttraumatic stress was primarily due to greater female losses in secondary networks," Jones said. "These losses were in the form of deaths, injuries, and close calls of individuals who were not considered close friends or relatives. These findings could also be a function of other losses characterized by perceived danger or harm in the absence of information or extended periods of worry."

Exposure to trauma-related stressors varied greatly, from 4.6 percent who reported being in close proximity to the first shooting incident in Ambler-Johnston Hall to 64.5 percent unable to confirm the safety of friends. The stress exposures that were most strongly related to symptoms of posttraumatic stress were the death or injury of someone close and the inability to confirm the safety of friends during the two hours after the Norris Hall shootings. "It appears that the stressors most responsible for posttraumatic stress among Virginia Tech students had to do with social relationships -- deaths and injuries involving friends and anxiety about the safety of friends," said Hughes.

Because exposure to stressors was widespread among students on campus, the experience of symptoms of posttraumatic stress was also widespread, reaching well beyond those who had direct exposure to the actual shooting incidents. These findings have important implications for planning mental health treatment outreach. Widespread symptom prevalence made it difficult to target a small, highly exposed segment of students for mental health outreach. This low concentration of probable posttraumatic stress disorder will likely be a common feature of future mass trauma incidents, requiring broad-based outreach to find students needing mental health treatment intervention.

Hughes and Jones served as co-principal investigators on this research. The article was co-authored by Jones, Melissa Brymer (University of California, Los Angeles), Wai Tat Chiu (Harvard Medical School), John A. Fairbank (Duke University Medical Center), Robert S. Pynoos (University of California, Los Angeles), Virginia Rothwell (Longwood University), Alan Steinberg (University of California, Los Angeles), and Ronald C. Kessler (Harvard Medical School).

Major funding for this study was provided by an unrestricted grant from the Jed Foundation. Support was also provided through funding received by Virginia Tech from the U.S. Department of Education, Office of Safe and Drug Free Schools.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Virginia Tech, via EurekAlert!, a service of AAAS.

Journal Reference:

Michael Hughes, Melissa Brymer, Wai Tat Chiu, John A. Fairbank, Russell T. Jones, Robert S. Pynoos, Virginia Rothwell, Alan M. Steinberg, Ronald C. Kessler. Posttraumatic stress among students after the shootings at Virginia Tech. Psychological Trauma: Theory, Research, Practice, and Policy, 2011; DOI: 10.1037/a0024565

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here sciencedaily.com

Eight-question survey can help predict post-traumatic stress disorder

ScienceDaily (July 18, 2011) — A simple eight-question survey administered soon after injury can help predict which of the 30 million Americans seeking hospital treatment for injuries each year may develop depression or post-traumatic stress, report Therese S. Richmond, PhD, CRNP, associate professor at the University of Pennsylvania School of Nursing, and her colleagues in General Hospital Psychiatry.

"Depression and PTSD exert a significant, independent, and persistent effect on general health, work status, somatic symptoms, adjustment to illness, and function after injury," the authors wrote, also emphasizing that even minor injuries can lead to traumatic stress responses. The findings allow healthcare providers to identify patients at highest risk for developing these disorders and to target appropriate resources to this vulnerable group.

This screening tool -- reportedly one of the first of its kind for adults in the U.S. -- could have a great impact on the judicious allocation of costly mental health resources.

Using an eight-question survey, all injured patients can be rapidly assessed for risk in the hospital. Healthcare providers can then provide patients classed as high-risk for developing depression or PTSD with information about symptoms to look for and advise them to contact their primary care provider should symptoms surface. This intervention can facilitate early diagnosis of these disabling disorders.

The study reported nearly 100 percent accuracy in negative results. Only five percent of injured patients who tested negative for risk of depression on the screening survey developed depression and no patients who tested negative for PTSD risk developed PTSD. At the same time, not all patients who screen positive will develop these disorders. The researchers do not suggest that all patients who screen positive receive mental health services, but rather that this finding prompt systematic provision of information and additional follow-up.

The authors caution that while the findings of this initial study are most promising, they need to be replicated in an independent sample.

With Dr. Richmond, the study authors are: Josef Ruzek, PhD; Theimann Ackerson, MSSW; Douglas J. Wiebe, PhD; Flaura Winston, MD, PhD; Nancy Kassam-Adams, PhD.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Pennsylvania School of Nursing, via EurekAlert!, a service of AAAS.

Journal Reference:

Therese S. Richmond, Josef Ruzek, Theimann Ackerson, Douglas J. Wiebe, Flaura Winston, Nancy Kassam-Adams. Predicting the future development of depression or PTSD after injury. General Hospital Psychiatry, 2011; DOI: 10.1016/j.genhosppsych.2011.05.003

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here