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Bipolar Disorder and PTSD
Affect Regulation-Self Esteem-Expecting Best-Preparing for Worst
Bipolar Disorder and Trauma
Bipolar Disorder DSM-IV
Bipolar I Disorder
Bipolar II Disorder
Cingulate Gyrus and Trauma
Circadiam Rhythm and PTSD
Circadian Rhythm and REM Behavior Disorder
Circadian Rhythm and Sleepwalking
Circadian Rhythm and Trauma
Circadian Rhythm DSM-IV
Corpus Callosum and PTSD
Cortisol and Dissociation
Cortisol and Trauma
Dissociation and Affect Dysregulation
Fornix and Trauma
Hippocampus Trauma and PTSD
Hypothalamus and PTSD
Limbic System and Trauma
MRI and Trauma
Neocortex and Trauma
NeuroImaging and DID
NeuroImaging and Trauma
NMRI and PTSD
Prefrontal Lobe and Trauma
ADHD and PTSD
ADHD and EMDR
ADHD and Dissociation
ADHD and DID
ADHD and Trauma
Affect Regulation
Attachment and Relational Trauma II
Affect Development and Attachment
Affect Regulation: Mentalization and the Development of the Self
Attachment and Affect Development
AffectDysregulation and Dissociation
Affect Dysregulation and Disorders of the Self
Affect Regulation and Attachment
Affect Dysregulation and Disorders of the Self
Affect Regulation and Attachment I
Affect Regulation and Attachment II
Affect Dysregulation
Affect Regulation and PTSD
Affect Regulation and Binge Drinking
Affect Regulation in Married Styles
Affect Regulation and Trauma
Affect Regulation-Delayed memories of Childhood
Affect Regulation-Mentalization and Development of The Self
Affect Regulaqtion-Recurrent Abortiona in Bulimics
Affect Regulation-Social Context on Childrens Affect Regulation
Affect Regulation-the Development of Psychopathology
Amygdala and Fear
Amygdala and PTSD
Aspergers Disorder and Adolescence
Aspergers Disorder and Childhood
Aspergers Disorder and Development
Aspergers Disorder and Infancy
Aspergers Disorder DSM-IV
Basal Ganglia and PTSD
Basal Ganglia and Trauma
Bipolar Disorder and DID
Sleepwalking and Trauma
Sleepwalking and PTSD
Sleep Disorders and PTSD
Sleep Disorders and Trauma
Sleep Disorders DSM-IV-R
Circadian Rhythm DSMIV-R
Sleep Terror Disorder
Self-Mutilization and Trauma
Self-Mutilization and Resilience
Self-Mutilization and PTSD
Self-Mutilization and DID
Human Stress Continuum

Psychological

and Physiological

Trauma Research

 

 

Seize Your Journeys

 

_______________________

Traumatic stress is found in many competent, healthy, strong, good people.  No one can completely protect themselves from traumatic experiences.  Many people have long-lasting problems following exposure to trauma.  Up to 8% of persons will have PTSD at some time in their lives. People who react to traumas are not going crazy.  What is happening to them is part of a set of common symptoms and problems that are connected with being in a traumatic situation, and thus, is a normal reaction to abnormal events and experiences.  Having symptoms after a traumatic event is NOT a sign of personal weakness.  Given exposure to a trauma that is bad enough, probably all people would develop PTSD.

By understanding trauma symptoms better, a person can become less fearful of them and better able to manage them. By recognizing the effects of trauma and knowing more about symptoms, a person will be better able to decide about getting treatment.

_______________________

 

FUNCTIONAL NEUROANATOMY

In order to best understand this atlas it is important to have a sense of the functional neuroanatomy of the brain. Over the next several pages there is a brief summary of the 5 major brain systems that relate to behavior, along with the general location seen on SPECT of these areas.


 

The Deep Limbic System


side active view


underside surface view


underside active view

Functions

  • sets the emotional tone of the mind

  • filters external events through internal states (emotional coloring)

  • tags events as internally important

  • stores highly charged emotional memories

  • modulates motivation

  • controls appetite and sleep cycles

  • promotes bonding

  • directly processes the sense of smell

  • modulates libido

Problems

  • moodiness, irritability, clinical depression

  • increased negative thinking

  • perceive events in a negative way

  • decreased motivation

  • flood of negative emotions

  • appetite and sleep problems

  • decreased or increased sexual responsiveness

  • social isolation

The Basal Ganglia System


left side active view


underside active view

Functions

  • integrates feeling and movement

  • shifts and smoothes fine motor behavior

  • suppression of unwanted motor behaviors

  • sets the body's idle or anxiety level

  • enhances motivation

  • pleasure/ecstasy

Problems

  • anxiety, nervousness

  • panic attacks

  • physical sensations of anxiety

  • tendency to predict the worst

  • conflict avoidance

  • Gilles de la Tourette's Syndrome/tics

  • muscle tension, soreness

  • tremors

  • fine motor problems

  • headaches

  • low or excessive motivation

The Prefrontal Cortex


dorsal lateral prefrontal cortex
outside view


inferior orbital prefrontal cortex
outside view


side surface view
dorsal lateral prefrontal area


inferior orbital prefrontal area
inside view


underside surface view
inferior orbital prefrontal area


top-down surface view
dorsal lateral prefrontal area

Functions

  • attention span

  • perseverance

  • judgment

  • impulse control

  • organization

  • self-monitoring and supervision

  • problem solving

  • critical thinking

  • forward thinking

  • learning from experience

  • ability to feel and express emotions

  • influences the limbic system

  • empathy

Problems

  • short attention span

  • distractibility

  • lack of perseverance

  • impulse control problems

  • hyperactivity

  • chronic lateness, poor time management

  • disorganization

  • procrastination

  • unavailability of emotions

  • misperceptions

  • poor judgement

  • trouble learning from experience

  • short term memory problems

  • social and test anxiety

The Cingulate Gyrus


inside side view


side active view


active top-down view


active front-on view

  • allows shifting of attention

  • cognitive flexibility

  • adaptability

  • helps the mind move from idea to idea

  • gives the ability to see options

  • helps you go with the flow

  • cooperation

Problems

  • worrying

  • holds onto hurts from the past

  • stuck on thoughts (obsessions)

  • stuck on behaviors (compulsions)

  • oppositional behavior, argumentative

  • uncooperative, tendency to say no

  • addictive behaviors (alcohol or drug abuse, eating disorders, chronic pain)

  • cognitive inflexibility

  • obsessive compulsive disorder

  • OCD spectrum disorders

  • eating disorders, road rage

The Temporal Lobes


side view


side surface view


underside surface view


active side view

Functions

Dominant Side (usually the left)

  • understanding and processing language

  • intermediate term memory

  • long term memory

  • auditory learning

  • retrieval of words

  • complex memories

  • visual and auditory processing

  • emotional stability

Problems

Dominant Temporal Lobe

  • aggression, internally or externally driven

  • dark or violent thoughts

  • sensitivity to slights, mild paranoia

  • word finding problems

  • auditory processing problems

  • reading difficulties

  • emotional instability

Non-dominant Side (usually the right)

  • recognizing facial expression

  • decoding vocal intonation

  • rhythm

  • music

  • visual learning

  • difficulty recognizing facial expression

  • difficulty decoding vocal intonation

  • implicated in social skill struggles


Either/Both Temporal Lobe Problems

  • memory problems, amnesia

  • headaches or abdominal pain without a clear explanation

  • anxiety or fear for no particular reason

  • abnormal sensory perceptions, visual or auditory distortions

  • feelings of déjà vu or jamais vu

  • periods of spaciness or confusion

  • religious or moral preoccupation

  • hypergraphia, excessive writing

  • seizures

 

 

Secure Attachments as a Defense Against Trauma

 “All people mature and thrive in a social context that has profound effects on how they cope with life’s stresses.  Particularly early in life, the social context plays a critical role in fuffering an individual against stressful situations, and in building the psychological and biological capacities to deal with further stresses.  The primary function of parents can be thought of as helping children modulate their arousal by attuned and well-timed provision of playing, feeding, comforting, touching, looking, cleaning, and resting—in short, by teaching them skills that will gradually help them modulate their own arousal.  Secure attachment bonds serve as primary defenses against trauma-induced psychopathology in both children and adults (Finkelhor & Browne, 1984).  In children who have been exposed to severe stressors, the quality of the parental bond is probably the single most important determinant of long-term damage (McFarlane, 1988).”  van der Kolk, Bessel, Alexander C. McFarlane, and Lars Weisaeth, eds.  1996. Traumatic stress: The effects of overwhelming experience on mind, body, and society.  New York and London: Guilford Press. .p. 185

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Sleep Disorders

 

            “The sleep disorders are organized into four major sections according to presumed etiology.  Primary Sleep Disorders are those in which none of the etiologies listed below (i.e., another mental disorder, a general medical condition, or a substance) is responsible.  Primary Sleep Disorders are presumed to arise from endogenous abnormalities in sleep-wake generating or timing mechanisms, often complicated by conditioning factors.  Primary Sleep Disorders in turn are divided into Dyssomnias (characterized by abnormalities in the amount, quality, or timing of sleep) and Parasomnias (characterized by abnormal behavioral or physiological events occurring in association with sleep, specific sleep stages, or sleep-awake transitions).

            Sleep Disorder Related to Another Mental Disorder involves a prominent complaint of sleep disturbance that results from a diagnosable mental disorder (often a Mood Disorder or Anxiety Disorder) but that is sufficiently severe to warrant independent clinical attention.  Presumably, the pathophysiological mechanisms responsible for the mental disorder also affect sleep-awake regulation. 

            Sleep Disorder Due to a General Medical Condition involves a prominent complaint of sleep disturbance that results from the direct physiological effects of a general medical condition on the sleep-wake system.

            Substance-Induced Sleep Disorder involves prominent complaints of sleep disturbance that result from the concurrent use, or recent discontinuation of use, of a substance (including medications).

            That systematic assessment in individuals who present with prominent complaints of sleep disturbance includes an evaluation of the specific type of sleep complaint and a consideration of concurrent mental disorders, general medical conditions, and substance (including medication) use that may be responsible for the sleep disturbance.

            Five distinct sleep stages can be measured by polysomnography:  rapid eye movement (REM) sleep and four stages of non-rapid eye movement (NREM) sleep (stages 1, 2, 3, and 4).  Stage 1 NREM sleep is a transition from wakefulness to sleep and occupies about 5% of time spent asleep in healthy adults.  Stage 2 NREM sleep, which is characterized by specific EEG waveforms (sleep spindles and K complexes), occupies about 50% of time spent asleep.  Stages 3 and 4 NREM sleep (also known collectively as slow-wave sleep) are the deepest levels of sleep and occupy about 10%-20% of sleep time.  REM sleep, during which the majority of typical storylike dreams occur, occupies about 20%-25% of total sleep.

            These sleep stages have a characteristic temporal organization across the night.  NREM stages 3 and 4 tend to occur in the first one-third to one-half of the night and increase in duration in response to sleep deprivation.  REM sleep occurs cyclically throughout the night, alternating with NREM sleep about every 80-100 minutes.  REM sleep periods increase in duration toward the morning.  Human sleep also varies characteristically across the life span.  After relative stability with large amounts of slow-wave sleep in childhood and early adolescence, sleep continuity and depth deteriorate across the adult age range.  This deterioration is reflected by increased wakefulness and stage 1 sleep and decreased stages 3 and 4 sleep.  Because of this, age must be considered in the diagnosis of a Sleep Disorder in any individual.

            Polysomnography is the monitoring of multiple electrophysiological parameters during sleep and generally includes measurement of EEG activity, electroculographic activity, and electromyographic activity.  Additional polysomnographic measures may include oral or nasal airflow, respiratory effort, chest and abdominal wall movement, oxyhemoglobin saturation, or exhaled carbon dioxide concentration; these measures are used to monitor respiration during sleep and to detect the presence and severity of sleep apnea.  Measurement of peripheral electromyographic activity may be used to detect abnormal movements during sleep.  Most polysomnographic studies are conducted during the person’s usual sleeping hours—that is, at night.  However, daytime polysomnographic studies also are used to quantify daytime sleepiness.  The most common daytime procedure is the Multiple Sleep Latency Test (MSLT), in which the individual is instructed to lie down in a dark room and not resist falling asleep; this protocol is repeated fives times during the day.  Sleep latency (the amount of time required to fall asleep) is measured on each trial and is used as an index of physiological sleepiness.  The converse of the MSLT is also used:  In the Repeated Test of Sustained Wakefulness (RTSW), the individual is placed in a quiet, dimly lit room and instructed to remain awake; this protocol is repeated several times during the day.  Again, sleep latency is measured, but is it used here as an index of the individual’s ability to maintain wakefulness.

            Standard terminology for polysomnographic measures is used throughout the test in this section.  Sleep continuity refers to the overall balance of sleep and wakefulness during a night of sleep.  “Better” sleep continuity indicates consolidated sleep and wakefulness; “worse” sleep continuity indicates disrupted sleep with more wakefulness.  Specific sleep continuity measures include sleep latency—the amount of time required to fall asleep (expressed in minutes); intermittent wakefulness—the amount of awake time after initial sleep onset (expressed in minutes); and sleep efficiency—the ratio of actual time spent asleep to time spent in bed (expressed as a percentage, with higher numbers indicating better sleep continuity).  Sleep architecture refers to the amount and distribution of specific sleep stages.  Sleep architecture measures include absolute amount of REM sleep and each NREM sleep stage (in minutes), relative amount of REM seep and NREM sleep stages (expressed as a percentage of total sleep time), and latency between sleep onset and the first REM period (REM latency).

            The text for each of the Sleep Disorders contains a section describing its relationship to corresponding disorders in The International Classification of Sleep Disorders:  (ICSD) diagnostic and Coding Manual, published in 1990 by the American Sleep Disorders Association.

_________________

 

Substance Dependence

“Features

The essential feature of Substance Dependence is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues use of the substance despite significant substance-related problems.  There is a pattern of repeated self-administration that can result in tolerance, withdrawal, and compulsive drug-taking behavior.  A diagnosis of Substance Dependence can be applied to every class of substances except caffeine.  The symptoms of Dependence are similar across the various categories of substances, but for certain classes some symptoms are less salient, and in a few instances not all symptoms apply (e.g., withdrawal symptoms are not specified for Hallucinogenic Dependence).  Although not specifically listed as a criterion item, “craving” (a strong subjective drive to use the substance) is likely to be experienced by most (if not all) individuals with Substance Dependence.  Dependence is defined as a cluster of three or more of the symptoms listed below occurring at any time in the same 12-month-period.

Tolerance (Criterion 1) is the need for greatly increased amounts of the substance to achieve intoxication (or the desired effect) or a markedly diminished effect with continued use of the same amount of the substance.  The degree to which tolerance develops varies greatly across substances.  Furthermore, for a specific drug, varied degrees of tolerance may develop for its different central nervous system effects.  For example, for opioids, tolerance to respiratory depression and tolerance to analgesia develop at different rates.  Individuals with heavy use of opioids and stimulants can develop substantial (e.g., 10-f0ld) levels of tolerance, often to a dosage that would be lethal to a nonuser.  Alcohol tolerance can also be pronounced, but is usually less extreme than for amphetamine.  Many individuals who smoke cigarettes consume more than 20 cigarettes a day, an amount that would have produced symptoms of toxicity when they first started smoking.  Individuals with heavy use of cannabis or phencyclidine (PCP) are generally not aware of having developed tolerance (although it has been demonstrated in animal studies and in some individuals).  Tolerance may be difficult to determine by history alone when the substance used is illegal and perhaps mixed with various diluents or with other substances.  In such situations, laboratory tests may be helpful (e.g., high blood levels of the substance coupled with little evidence of intoxication suggest that tolerance is likely).  Tolerance must also be distinguished from individual variability in the initial sensitivity to the effects of particular substances.  For example, some first-time drinkers show very little evidence of intoxication with three or four drink, whereas others of similar weight and drinking histories had slurred speech and incoordination.

Withdrawal (Criterion 2a) is a maladaptive behavioral change, with physiological and cognitive concomitants, that occurs when blood or tissue concentrations of a substance decline in an individual who had maintained prolonged heavy use of the substance.  After developing unpleasant withdrawal symptoms, the persons is likely to take the substance to relieve or to avoid those symptoms (Criterion 2b), typically using the substance throughout the day beginning soon after awakening.  Withdrawal symptoms, which are generally the opposite of the acute effects of the substance, vary greatly across the calluses of substances, and separate criteria sets for Withdrawal are provided for most of the classes.  Marked and generally easily measured physiological signs of withdrawal are common with alcohol, opioids, and sedatives, hypnotics, and anxiolytics.  Withdrawal signs and symptoms are often present, but may be less apparent, with stimulants such as amphetamines and cocaine, as well as with nicotine and cannabis.  No significant withdrawal is seen even after repeated use of hallucinogens.  Withdrawal from phencyclidine and related substances has not yet been described in humans (although it has been demonstrated in animals).  Neither tolerance nor withdrawal is necessary or sufficient for a diagnosis of Substance Dependence.  However, for most classes of substances, a past history of tolerance or withdrawals is associated with a more severe clinical course (i.e., an earlier onset of Dependence, higher levels of substance intake, and a greater number of substance-related problems).  Some individuals (e.g., those with Cannabis Dependence) show a pattern of compulsive use without obvious signs of tolerance or withdrawal.  Conversely, some general medical and postsurgical patients without Opioid Dependence may develop a tolerance to prescribed opioids and experience withdrawal symptoms without showing any signs of compulsive use.  The specifiers With Physiological Dependence and Without Physiological Dependence are provided to indicate the presence or absence of tolerance or withdrawal.

The following items describe the pattern of compulsive substance use that is characteristic of Dependence.  The individual may take the substance in larger amounts or over a longer period than was originally intended (e.g., continuing to drink until severely intoxicated despite having set a limit of only one drink) (Criterion 3).  The individual may express a persistent desire to cut down or regulate substance use.  Often, there have been many unsuccessful efforts to decrease or discontinue use (Criterion 4).  The individual may spend a great deal of time obtaining the substance, using the substance, or recovering from its effects (Criterion 5).  In some instances of Substance Dependence, virtually all of the person’s daily activities revolve around the substance.  Important social, occupational, ore recreational activities may be given up or reduced because of substance use (Criterion 6).  The individual may withdraw from family activities and hobbies in order to use the substance in private or to spend more time with substance-using friends.  Despite recognizing the contributing role of the substance to a psychological or physical problem (e.g., sever depressive symptoms or damage to organ systems), the person continues to use the substance (Criterion 7).  The key issue in evaluating this criterion is not eh existence of the problem, but rather the individual’s failure to abstain from using the substance despite having evidence of the difficulty it is causing.

 

Specifiers

            Tolerance and withdrawal may be associated with a higher risk for immediate general medical problems and a higher relapse rate.  Specifiers are provided to note their presence or absence:

With Physiological Dependence.  This specifier should be used when Substance Dependence is accompanied by evidence of tolerance (Criterion 1) or withdrawal (Criterion 2).

Without Physiological Dependence.  This specifier should be used when there is no evidence of tolerance (Criterion 1) or withdrawal (Criterion 2).  In these individuals, Substance Dependence is characterized by a pattern of compulsive use (at least three items from Criteria 3-7).”

 

Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association. P. 193-195.

 

 

 

_______________________

 

PTSD, DID, and EMDR

Posttraumatic Stress Disorder

"The essential feature of Posttraumatic Stress Disorder us the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criteria A1).  The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2).  The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F).

Traumatic events that are experienced directly include, but are not limited to, military combat, violent personal assault (sexual assault, physical attack, robbery, mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness.  For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury.  Witnessed events include, but are not limited to, observing the serious injury or unnatural death of another person due to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts.  Events experienced by others that are learned about include, but are not limited to, violent personal assault, serious accident, or serious injury experienced y a family member or a close friend; learning about the sudden, unexpected death of a family member or a close friend; or learning that one's child has a life threatening disease.  The disorder may be especially sever or long lasting when the stressor is of human design (e.g., torture, rape). the likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase.

The traumatic event can be reexperienced in various ways.  Commonly the person has recurrent and intrusive recollections of the event (Criterion B1) or recurrent distressing dreams during which the event can be replayed or otherwise represented (Criterion B2). In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment (Criterion B3).  These episodes, often referred to as "flashbacks," are typically brief but can be associated with prolonged distress and heightened arousal.  Intense psychological distress (Criterion B4) or physiological reactivity (Criterion B5) often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event (e.g., anniversaries of the traumatic event; cold, snowy weather or uniformed guards for survivors of death camps in cold climates; hot, humid weather for combat veterans of the South Pacific; entering any elevator for an woman who was reaped in an elevator).

Stimuli associated with the trauma are persistently avoided.  The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who around recollections of it (Criterion C2).  This avoidance of reminders may include amnesia for an important aspect of the traumatic event (Criterion C3).  Diminished responsiveness to the external work, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event.  The individual may complain of having markedly diminished interest or participation in previously enjoyed activities (Criterion C4), of feeling detached or estranged from other people (Criterion C5), or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality) (Criterion C6).  The individual may have a sense of a foreshortened future (e.g., not expecting to have a career, marriage, children, or a normal life span) (Criterion C7).

The individual has persistent symptoms of anxiety or increased arousal that were not present before the trauma.  these symptoms may include difficulty falling or staying asleep that may be to recurrent nightmares during which the traumatic event is relived (Criterion D1), hypervigilance (Criterion D4), and exaggerated startle response (Criterion D5).  Some individuals report irritability or outburst of anger (Criterion D2) or difficulty concentrating or completing tasks (Criterion D3)."

 

Dissociative Identity Disorder (DID)

"The essential feature of Dissociative identity Disorder is the presence of two or more distinct identities or personality states (Criterion A) that recurrently take control of behavior (Criterion B).  There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (Criterion C).  The disturbance is not due tot eh direct physiological effects of a substance or a general medical condition (Condition D.).  In children, the symptoms cannot be attributed to imaginary playmates or other fantasy play.

Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness.  Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name.  Usually there is a primary identity that carries the individual's given name and is passive, dependent, guilty, and depressed.  The alternate identities frequently have different names and characteristics that contrast with the primary identity (e.g., are hostile, controlling, and self-destructive).  Particular identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect.  Alternate identities are experienced as taking control in sequence, ore at the expense of the other, and may deny knowledge of one another, be critical of one another, or appear to be in open conflict.  Occasionally, one or more powerful identities allocate time to the others.  Aggressive or hostile identities may at times interrupt activities or place the others in uncomfortable situations.

Individuals with this disorder experience frequent gaps in memory for personal history, both remote and recent.  The amnesia is frequently asymmetrical.  The more passive identities tend to have more constricted memories, whereas the more hostile, controlling, or "protector" identities have more complete memories.  An identity that is not in control may nonetheless gain access to consciousness by producing auditory or visual hallucinations (e.g., a voice giving instructions).  Evidence of amnesia may be uncovered by reports from others who have witnessed behavior that is disavowed by the individual or by the individual's own discoveries (e.g., finding items of clothing at home that the individual cannot remember having bought).  There may be loss of memory not only for recurrent periods of time, but also an overall loss of biographical memory for some extended period of childhood, adolescence, or even adulthood.  Transitions among identities are often triggered by psychosocial stress.  The time required to switch from one identity to another is usually a matter of seconds, but, less frequently, may b gradual.  Behavior that may be frequently associated with identity switches include rapid blinking, facial changes, changes in voice or demeanor, or disruption in the individual's train of thoughts.  The number of identities reported ranges from 2 to more than 100.  Half of reported cases include the individuals with 10 or fewer identities."

Diagnostic and Statistical Manual of Mental Disorders. 2000.  4th ed. Washington, D.C.: American Psychiatric Association.

EMDR

Eye Movement Desensitization and Reprocessing

"Eye Movement Desensitization and Reprocessing (EMDR)1 integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2. EMDR is an information processing therapy and uses an eight phase approach.

During EMDR1 the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of dual attention. This sequence of dual attention and personal association is repeated many times in the session.

Eight Phases of Treatment

The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations.

During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete.

In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions.

After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Athough eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced.

In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two.

The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system.

After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures." www.emdr.com

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Major Depressive Disorder

“Diagnostic Features

The essential feature of Major Depressive Disorder is a clinical course that is characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes (Criteria A and C).  Episodes of Substance-Induced Mood Disorder (due to the direct physiological effects of a drug of abuse, a medication, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Major Depressive Disorder.  In addition, the episodes must not be better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified (Criterion B).

            The fourth digit in the diagnostic code for Major Depressive Disorder indicates whether it is a Single Episode (used only for first episodes) or Recurrent.  It is sometimes difficult to distinguish between a single episode with waxing and waning symptoms and two separate episodes.  For purposes of this manual, an episode is considered to have ended when the full criteria for eh Major Depressive Episode have not been met for at least 2 consecutive months.  During this 2-month period, there is either complete resolution of symptoms or the presence of depressive symptoms that no longer meet the full criteria for a Major Depressive Episode (In Partial Remission).

            The fifth digit in the diagnostic code for Major Depressive Disorder indicates the current state of the disturbance.  If the criteria for a Major Depressive Disorder are met, the severity of the episode is notes as Mild, Moderate, Severe Without Psychotic Features, or Severe With Psychotic Features.  If the criteria for a Major Depressive Episode are not currently met, the fifth digit is used to indicate whether the disorder is In Partial Remission or In Full Remission.

            If Manic, Mixed, or Hypomanic Episodes develop in the course of Major Depressive Disorder, the diagnosis is changed to a Bipolar Disorder.  However, if manic or hypomanic symptoms occur as a direct effect of antidepressant treatment, use of other medications, substance use, or toxin exposure, the diagnosis of Major Depressive Disorder remains appropriate and an addition diagnosis of Substance-induced Mood Disorder, With Manic features (or With Mixed Features), should be noted.  Similarly, if manic or hypomanic symptoms occur as a direct effect of a general medical condition, the diagnosis of Major Depressive Disorder remains appropriate and an additional diagnosis of Mood Disorder Due to a General Medical Condition, With Manic Features (or With Mixed Features), should be noted.” p. 369

“Course

Major Depressive Disorder may begin at any age, with an average age at onset in the mid-20s.  Epidemiological data suggest that the age at onset is decreasing for those born more recently.  The course of Major Depressive Disorder, Recurrent, is variable.  Some people have isolated episodes that are separated by many years without any depressive symptoms, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older.  Some evidence suggests that the periods of remission generally last longer early in the course of the disorder.  The number of prior episodes predicts the likelihood of developing a subsequent Major Depressive Episode.  At least 60% of individuals with Major Depresssive Disorder, Single Episode, can be expected to have a second episode.  Individuals who have had tow episodes have a 70% chance of having a third, and individuals who have had three episodes have a 90% chance  of having a fourth.  About 5%-10% of individuals with Major Depressive Disorder, single Episode, subsequently develop a Manic Episode (i.e., develop Bipolar I Disorder).

            Major Depressive Episodes may end completely (in about two-thirds of cases), or only partially or not at all (in about one-third of cases).  For individuals who have only partial remission, there is a greater likelihood of developing additional episodes and of continuing the pattern of partial interepisode recovery.  The longitudinal course specifiers With Full Interepisode Recovery and Without Full Interepisode Recovery may therefore have prognostic value.  A number of individuals have pre-existing Dysthymic Disorder prior to the onset of Major Depressive Disorder, single Episode.  Some evidence suggests that these individuals are more likely to have additional Major Depressive Episodes, have poorer interepisode recovery, and may require additional acute-phase treatment and a longer period of continuing treatment to attain and maintain a more thorough and longer-lasting euthymic state.

            Follow-up naturalistic studies suggested that 1 year after the diagnosis of a major Depressive Episode, 40% of individuals still have symptoms that are sufficiently severe to meet criteria for a full Major Depressive Episode, roughly 20% continue to have some symptoms that no longer meet full criteria for a Major Depressive Episode (i.e., major Depressive Disorder, In Partial Remission), and 40% have no Mood Disorder.  The severity of the initial Major Depressive Episode appears to predict persistence.  Chronic general medical conditions are also a risk factor for more persistent episodes.

            Episodes of Major Depressive Disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce.  Studies suggest that psychosocial events 9stressors) may play a more significant role in the precipitation of the first or second episodes of Major Depressive Disorder and may play less of a role in the onset of subsequent episodes.  Chronic general medical conditions and Substance Dependence (particularly Alcohol or Cocaine Dependence) may contribute to the onset or exacerbation of Major Depressive Disorder.

            It is difficult to predict whether the first episode of a Major Depressive Disorder in a young person will ultimately evolve into a Bipolar Disorder.  Some data suggest that the acute onset of severe depression, especially with psychotic features and psychomotor retardation, in a young person without prepubertal psychopathology is more likely to predict a bipolar disorder.  A family history of Bipolar Disorder may also be suggestive of subsequent development of Bipolar Disorder.” p. 372-373

 

Diagnostic and statistical manual of mental disorders. 2000. 4th ed.  Washington, D.C.: American Psychiatric Association.

 

________________

Major Depressive Disorder

 “Diagnostic Features

The essential feature of Major Depressive Disorder is a clinical course that is characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes (Criteria A and C).  Episodes of Substance-Induced Mood Disorder (due to the direct physiological effects of a drug of abuse, a medication, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Major Depressive Disorder.  In addition, the episodes must not be better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified (Criterion B).

            The fourth digit in the diagnostic code for Major Depressive Disorder indicates whether it is a Single Episode (used only for first episodes) or Recurrent.  It is sometimes difficult to distinguish between a single episode with waxing and waning symptoms and two separate episodes.  For purposes of this manual, an episode is considered to have ended when the full criteria for eh Major Depressive Episode have not been met for at least 2 consecutive months.  During this 2-month period, there is either complete resolution of symptoms or the presence of depressive symptoms that no longer meet the full criteria for a Major Depressive Episode (In Partial Remission).

            The fifth digit in the diagnostic code for Major Depressive Disorder indicates the current state of the disturbance.  If the criteria for a Major Depressive Disorder are met, the severity of the episode is notes as Mild, Moderate, Severe Without Psychotic Features, or Severe With Psychotic Features.  If the criteria for a Major Depressive Episode are not currently met, the fifth digit is used to indicate whether the disorder is In Partial Remission or In Full Remission.

            If Manic, Mixed, or Hypomanic Episodes develop in the course of Major Depressive Disorder, the diagnosis is changed to a Bipolar Disorder.  However, if manic or hypomanic symptoms occur as a direct effect of antidepressant treatment, use of other medications, substance use, or toxin exposure, the diagnosis of Major Depressive Disorder remains appropriate and an addition diagnosis of Substance-induced Mood Disorder, With Manic features (or With Mixed Features), should be noted.  Similarly, if manic or hypomanic symptoms occur as a direct effect of a general medical condition, the diagnosis of Major Depressive Disorder remains appropriate and an additional diagnosis of Mood Disorder Due to a General Medical Condition, With Manic Features (or With Mixed Features), should be noted.” p. 369

 “Course

Major Depressive Disorder may begin at any age, with an average age at onset in the mid-20s.  Epidemiological data suggest that the age at onset is decreasing for those born more recently.  The course of Major Depressive Disorder, Recurrent, is variable.  Some people have isolated episodes that are separated by many years without any depressive symptoms, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older.  Some evidence suggests that the periods of remission generally last longer early in the course of the disorder.  The number of prior episodes predicts the likelihood of developing a subsequent Major Depressive Episode.  At least 60% of individuals with Major Depresssive Disorder, Single Episode, can be expected to have a second episode.  Individuals who have had tow episodes have a 70% chance of having a third, and individuals who have had three episodes have a 90% chance  of having a fourth.  About 5%-10% of individuals with Major Depressive Disorder, single Episode, subsequently develop a Manic Episode (i.e., develop Bipolar I Disorder).

            Major Depressive Episodes may end completely (in about two-thirds of cases), or only partially or not at all (in about one-third of cases).  For individuals who have only partial remission, there is a greater likelihood of developing additional episodes and of continuing the pattern of partial interepisode recovery.  The longitudinal course specifiers With Full Interepisode Recovery and Without Full Interepisode Recovery may therefore have prognostic value.  A number of individuals have pre-existing Dysthymic Disorder prior to the onset of Major Depressive Disorder, single Episode.  Some evidence suggests that these individuals are more likely to have additional Major Depressive Episodes, have poorer interepisode recovery, and may require additional acute-phase treatment and a longer period of continuing treatment to attain and maintain a more thorough and longer-lasting euthymic state.

            Follow-up naturalistic studies suggested that 1 year after the diagnosis of a major Depressive Episode, 40% of individuals still have symptoms that are sufficiently severe to meet criteria for a full Major Depressive Episode, roughly 20% continue to have some symptoms that no longer meet full criteria for a Major Depressive Episode (i.e., major Depressive Disorder, In Partial Remission), and 40% have no Mood Disorder.  The severity of the initial Major Depressive Episode appears to predict persistence.  Chronic general medical conditions are also a risk factor for more persistent episodes.

            Episodes of Major Depressive Disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce.  Studies suggest that psychosocial events 9stressors) may play a more significant role in the precipitation of the first or second episodes of Major Depressive Disorder and may play less of a role in the onset of subsequent episodes.  Chronic general medical conditions and Substance Dependence (particularly Alcohol or Cocaine Dependence) may contribute to the onset or exacerbation of Major Depressive Disorder.

            It is difficult to predict whether the first episode of a Major Depressive Disorder in a young person will ultimately evolve into a Bipolar Disorder.  Some data suggest that the acute onset of severe depression, especially with psychotic features and psychomotor retardation, in a young person without prepubertal psychopathology is more likely to predict a bipolar disorder.  A family history of Bipolar Disorder may also be suggestive of subsequent development of Bipolar Disorder.” p. 372-373

 Diagnostic and statistical manual of mental disorders. 2000. 4th ed.  Washington, D.C.: American Psychiatric Association.

________________

DID-PTSD-EMDR

Dissociative Identity Disorder (DID)

"The essential feature of Dissociative identity Disorder is the presence of two or more distinct identities or personality states (Criterion A) that recurrently take control of behavior (Criterion B).  There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (Criterion C).  The disturbance is not due tot eh direct physiological effects of a substance or a general medical condition (Condition D.).  In children, the symptoms cannot be attributed to imaginary playmates or other fantasy play.

Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness.  Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name.  Usually there is a primary identity that carries the individual's given name and is passive, dependent, guilty, and depressed.  The alternate identities frequently have different names and characteristics that contrast with the primary identity (e.g., are hostile, controlling, and self-destructive).  Particular identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect.  Alternate identities are experienced as taking control in sequence, ore at the expense of the other, and may deny knowledge of one another, be critical of one another, or appear to be in open conflict.  Occasionally, one or more powerful identities allocate time to the others.  Aggressive or hostile identities may at times interrupt activities or place the others in uncomfortable situations.

Individuals with this disorder experience frequent gaps in memory for personal history, both remote and recent.  The amnesia is frequently asymmetrical.  The more passive identities tend to have more constricted memories, whereas the more hostile, controlling, or "protector" identities have more complete memories.  An identity that is not in control may nonetheless gain access to consciousness by producing auditory or visual hallucinations (e.g., a voice giving instructions).  Evidence of amnesia may be uncovered by reports from others who have witnessed behavior that is disavowed by the individual or by the individual's own discoveries (e.g., finding items of clothing at home that the individual cannot remember having bought).  There may be loss of memory not only for recurrent periods of time, but also an overall loss of biographical memory for some extended period of childhood, adolescence, or even adulthood.  Transitions among identities are often triggered by psychosocial stress.  The time required to switch from one identity to another is usually a matter of seconds, but, less frequently, may b gradual.  Behavior that may be frequently associated with identity switches include rapid blinking, facial changes, changes in voice or demeanor, or disruption in the individual's train of thoughts.  The number of identities reported ranges from 2 to more than 100.  Half of reported cases include the individuals with 10 or fewer identities."

Diagnostic and Statistical Manual of Mental Disorders. 2000.  4th ed. Washington, D.C.: American Psychiatric Association.

PTSD, DID, and EMDR

Posttraumatic Stress Disorder

"The essential feature of Posttraumatic Stress Disorder us the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criteria A1).  The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2).  The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F).

Traumatic events that are experienced directly include, but are not limited to, military combat, violent personal assault (sexual assault, physical attack, robbery, mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness.  For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury.  Witnessed events include, but are not limited to, observing the serious injury or unnatural death of another person due to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts.  Events experienced by others that are learned about include, but are not limited to, violent personal assault, serious accident, or serious injury experienced y a family member or a close friend; learning about the sudden, unexpected death of a family member or a close friend; or learning that one's child has a life threatening disease.  The disorder may be especially sever or long lasting when the stressor is of human design (e.g., torture, rape). the likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase.

The traumatic event can be reexperienced in various ways.  Commonly the person has recurrent and intrusive recollections of the event (Criterion B1) or recurrent distressing dreams during which the event can be replayed or otherwise represented (Criterion B2). In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment (Criterion B3).  These episodes, often referred to as "flashbacks," are typically brief but can be associated with prolonged distress and heightened arousal.  Intense psychological distress (Criterion B4) or physiological reactivity (Criterion B5) often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event (e.g., anniversaries of the traumatic event; cold, snowy weather or uniformed guards for survivors of death camps in cold climates; hot, humid weather for combat veterans of the South Pacific; entering any elevator for an woman who was reaped in an elevator).

Stimuli associated with the trauma are persistently avoided.  The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who around recollections of it (Criterion C2).  This avoidance of reminders may include amnesia for an important aspect of the traumatic event (Criterion C3).  Diminished responsiveness to the external work, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event.  The individual may complain of having markedly diminished interest or participation in previously enjoyed activities (Criterion C4), of feeling detached or estranged from other people (Criterion C5), or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality) (Criterion C6).  The individual may have a sense of a foreshortened future (e.g., not expecting to have a career, marriage, children, or a normal life span) (Criterion C7).

The individual has persistent symptoms of anxiety or increased arousal that were not present before the trauma.  these symptoms may include difficulty falling or staying asleep that may be to recurrent nightmares during which the traumatic event is relived (Criterion D1), hypervigilance (Criterion D4), and exaggerated startle response (Criterion D5).  Some individuals report irritability or outburst of anger (Criterion D2) or difficulty concentrating or completing tasks (Criterion D3)."

 

EMDR

Eye Movement Desensitization and Reprocessing

"Eye Movement Desensitization and Reprocessing (EMDR)1 integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2. EMDR is an information processing therapy and uses an eight phase approach.

During EMDR1 the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of dual attention. This sequence of dual attention and personal association is repeated many times in the session.

Eight Phases of Treatment

The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations.

During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete.

In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions.

After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Athough eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced.

In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two.

The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system.

After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures." www.emdr.com

 1Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures (2nd ed.). New York: Guilford Press.

2Shapiro, F. (2002). EMDR as an Integrative Psychotherapy Approach: Experts of Diverse Orientations Explore the Paradigm Prism. Washington, DC: American Psychological Association Books.

 

 

 

 

NeuroBiology of Trauma

 

Cortisol and Trauma

  

Record: 1
       
Title:  PTSD symptoms predict waking salivary cortisol levels in police
officers.      
Author(s):      Neylan, Thomas C., Department of Psychiatry, University
of California, San Francisco, CA, US, neylan@itsa.ucsf.edu

Brunet, Alain, Department of Psychiatry, McGill University, Montréal,
PQ, Canada

Pole, Nnamdi, Department of Psychology, University of Michigan, Ann
Arbor, MI, US

Best, Suzanne R., Northern California Institute for Research and
Education, San Francisco, CA, US

Metzler, Thomas J., San Francisco Veterans Administration Medical
Center, San Francisco, CA, US

Yehuda, Rachel, Department of Psychiatry, Mount Sinai School of
Medicine, New York, NY, US

Marmar, Charles R., Department of Psychiatry, University of California,
San Francisco, CA, US
Address:        Neylan, Thomas C., PTSD Program, Psychiatry Service, VA
Medical Center, 116P, 4150 Clement Street, San Francisco, CA, US,
 neylan@itsa.ucsf.edu   
Source: Psychoneuroendocrinology, Vol 30(4), May 2005. pp. 373-381.

Journal URL: http://www.elsevier.com/inca/publications/store/4/7/3/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0306-4530 (Print)
Digital Object Identifier:      10.1016/j.psyneuen.2004.10.005 
Language:       English
Keywords:       post-traumatic stress disorder; dexamethasone salivary
cortisol levels; police officers; peritraumatic emotional distress     
Abstract:       This study examines whether pre- or post-dexamethasone
salivary cortisol is related to cumulative critical incident exposure,
peritraumatic responses, or post-traumatic stress disorder (PTSD)
symptom severity. Thirty active duty police officers completed the study
protocol, which included measures of peritraumatic emotional distress,
peritraumatic dissociation, duty-related trauma exposure, and PTSD
symptoms. Salivary cortisol was consolidated into three outcome
variables: (1) pre-dexamethasone free cortisol levels at 1, 30, 45, and
60 min after awakening, (2) post-dexamethasone cortisol levels at the
identical wake times, and (3) percentage of cortisol suppression.
Control variables included age, gender, average daily alcohol use, night
shift work, routine work environment stressors, and salivary
dexamethasone levels. Zero order correlations showed that greater levels
of PTSD symptoms, peritraumatic distress, and peritraumatic dissociation
were associated with lower levels of pre-dexamethasone cortisol levels
on awakening, but were not associated with the other two cortisol
variables. A trend was also noted for older subjects to have lower
pre-dexamethasone cortisol on awakening. When these four predictors were
entered simultaneously in a regression analysis, only age and PTSD
symptom severity significantly predicted pre-dexamethasone awakening
cortisol levels. These results replicate previous research indicating a
relationship between greater PTSD symptoms and lower levels of basal
cortisol on awakening, and extend this finding to a previously unstudied
non-treatment seeking population, urban police. (PsycINFO Database
Record (c) 2005 APA, all rights reserved)(journal abstract)
Subjects:       *Distress; *Hydrocortisone; *Police Personnel;
*Posttraumatic Stress Disorder; *Saliva
Classification: Neuroses & Anxiety Disorders (3215)

Police & Legal Personnel (4290)
Population:     Human (10)

Male (30)

Female (40)
Location:       US     
Age Group:      Adulthood (18 yrs & older) (300)
Tests & Measures:       Critical Incident History Questionnaire

Peritraumatic Distress Inventory

Peritraumatic Dissociative Experiences Questionnaire
Form/Content Type:      Empirical Study (0800)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20050307       
Accession Number:       2005-02023-008 
Number of Citations in Source:  41     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2005-02023-008

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2005-020
23-008">PTSD symptoms predict waking salivary cortisol levels in police
officers.</A>  
       
Database:       PsycINFO       
  _____ 

Record: 2
       
Title:  The Psychobiology of Children Exposed to Marital Violence.     
Author(s):      Saltzman, Kasey M., Stanford University School of
Medicine, Stanford, CA, US, kasey.saltzman@Stanford.edu

Holden, George W., Department of Psychology, University of Texas,
Austin, TX, US

Holahan, Charles J., Department of Psychology, University of Texas,
Austin, TX, US
Address:        Saltzman, Kasey M., 701 Welch Road, Suite 209, Palo
Alto, CA, US, kasey.saltzman@Stanford.edu      
Source: Journal of Clinical Child & Adolescent Psychology, Vol 34(1),
Feb 2005. pp. 129-139.

Journal URL:
 https://www.erlbaum.com/shop/tek9.asp?pg=products&specific=1537-4416
Publisher:      US: Lawrence Erlbaum

Publisher URL: http://www.erlbaum.com/
ISSN:   1537-4416 (Print)

1532-7639 (Electronic)
Digital Object Identifier:      10.1207/s15374424jccp3401_12   
Language:       English
Keywords:       psychobiological functioning; physiological functioning;
marital violence exposure; children    
Abstract:       We examined the psychological and physiological
functioning of a community sample of children exposed to marital
violence, comparing them to a clinical comparison group without marital
violence exposure. Results replicated past findings of elevated levels
of trauma symptomatology in this population. Further, children exposed
to marital violence differed significantly from comparison children with
respect to sympathetic nervous system functioning and
hypothalamic-pituitary-adrenal (HPA) axis functioning. Specifically,
elevations were seen in heart rate and salivary cortisol levels, but not
in orthostatic challenge response or blood pressure. These results
indicate that children exposed to marital violence have a different
physiological presentation than controls and may be physiologically
"traumatized" by virtue of marital violence exposure. (PsycINFO Database
Record (c) 2005 APA, all rights reserved)(journal abstract)
Subjects:       *Family Violence; *Marital Conflict; *Physiology;
*Psychobiology 
Classification: Behavior Disorders & Antisocial Behavior (3230)
Population:     Human (10)

Male (30)

Female (40)
Location:       US     
Age Group:      Childhood (birth-12 yrs) (100)

Preschool Age (2-5 yrs) (160)

School Age (6-12 yrs) (180)

Adolescence (13-17 yrs) (200)
Tests & Measures:       Conflict Tactics Scale

Parent-Child Conflict Tactics Scale

Trauma Symptom Inventory
Form/Content Type:      Empirical Study (0800)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Electronic

Format(s) Available: Print; Electronic
Release Date:   20050228       
Accession Number:       2005-01144-012 
Number of Citations in Source:  68     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2005-01144-012

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2005-011
44-012">The Psychobiology of Children Exposed to Marital Violence.</A> 
       
Database:       PsycINFO       
  _____ 

Record: 3
       
Title:  Initial urinary epinephrine and cortisol levels predict acute
PTSD symptoms in child trauma victims. 
Author(s):      Delahanty, Douglas L., Department of Psychology, Kent
State University, Kent, OH, US, ddelahan@kent.edu

Nugent, Nicole R.., Department of Psychology in Psychiatry, Northeastern
Ohio Universities College of Medicine (NEOUCOM), Rootstowm, OH, US

Christopher, Norman C., Akron Children's Hospital, Emergency/Trauma
Services, Akron, OH, US

Walsh, Michele, Department of Emergency Medicine and Pediatrics,
Northeastern Ohio Universities College of Medicine (NEOUCOM), Rootstown,
OH, US
Address:        Delahanty, Douglas L., Department of Psychology, Kent
State University, 118 Kent Hall, Kent, OH, US, ddelahan@kent.edu       
Source: Psychoneuroendocrinology, Vol 30(2), Feb 2005. pp. 121-128.

Journal URL: http://www.elsevier.com/inca/publications/store/4/7/3/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0306-4530 (Print)
Digital Object Identifier:      10.1016/j.psyneuen.2004.06.004 
Language:       English
Keywords:       cortisol; PTSD symptoms; child trauma victims;
catecholamines; urinary hormone levels; post traumatic stress disorder;
urinary epinephrine    
Abstract:       Previous research examining biological correlates of
posttraumatic stress disorder (PTSD) in children has suggested that
children with chronic PTSD have altered levels of catecholamines and
cortisol compared to similarly traumatized children who do not meet
diagnostic criteria. The present study extended these findings by
examining whether urinary hormone levels collected soon after a trauma
were related to subsequent acute PTSD symptoms in child trauma victims.
Initial 12-h urine samples were collected from 82 children aged 8-18
admitted to a Level 1 trauma center. Collection was begun immediately
upon admission, and samples were assayed for levels of catecholamines
and cortisol. PTSD and depressive symptomatology were assessed 6 weeks
following the accident. Results showed that the initial urinary cortisol
levels were significantly correlated with subsequent acute PTSD symptoms
(r=0.31). After removing the variance associated with demographic
variables and depressive symptoms, urinary cortisol and epinephrine
levels continued to predict a significant percentage (7-10%) of the
variance in 6-week PTSD symptoms. Examination of boys and girls
separately suggested that significance was primarily driven by the
strength of the relationships between hormone levels and acute PTSD
symptoms in boys. (PsycINFO Database Record (c) 2004 APA, all rights
reserved)
Subjects:       *Catecholamines; *Emotional Trauma; *Epinephrine;
*Hydrocortisone; *Posttraumatic Stress Disorder; Hormones; Stress      
Classification: Neuroses & Anxiety Disorders (3215)

Psychosocial & Personality Development (2840)
Population:     Human (10)

Male (30)

Female (40)
Location:       US     
Age Group:      Childhood (birth-12 yrs) (100)

School Age (6-12 yrs) (180)

Adolescence (13-17 yrs) (200)

Adulthood (18 yrs & older) (300)
Tests & Measures:       Injury severity scale

Reynolds Adolescent Depression Scale

Reynolds Child Depression Scale

Clinician-Administered PTSD Scale
Form/Content Type:      Empirical Study (0800)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20041115       
Accession Number:       2004-20302-001 
Number of Citations in Source:  37     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-20302-001

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-203
02-001">Initial urinary epinephrine and cortisol levels predict acute
PTSD symptoms in child trauma victims.</A>     
       
Database:       PsycINFO       
  _____ 

Record: 4
       
Title:  Association Between Childhood Trauma and Catecholamine Response
to Psychological Stress in Police Academy Recruits.    
Author(s):      Otte, Christian, Department of Psychiatry, University of
California, San Francisco, CA, US, otte@uke.uni-hamburg.de

Neylan, Thomas C., Department of Psychiatry, University of California,
San Francisco, CA, US

Pole, Nnamdi, Department of Psychology, University of Michigan, Ann
Arbor, MI, US

Metzler, Thomas, Department of Psychiatry, University of California, San
Francisco, CA, US

Best, Suzanne, Department of Psychiatry, University of California, San
Francisco, CA, US

Henn-Haase, Clare, Veterans Affairs Medical Center, San Francisco, CA,
US

Yehuda, Rachel, Department of Psychiatry, Mount Sinai School of
Medicine, New York, NY, US

Marmar, Charles R., Veterans Affairs Medical Center, San Francisco, CA,
US
Address:        Otte, Christian, University Hospital Hamburg-Eppendorf,
Department of Psychiatry and Psychotherapy, Martinistrasse 52, Hamburg,
Germany, 20246, otte@uke.uni-hamburg.de
Source: Biological Psychiatry, Vol 57(1), Jan 2005. pp. 27-32.

Journal URL:
 http://www.elsevier.com/inca/publications/store/5/0/5/7/5/0/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0006-3223 (Print)
Digital Object Identifier:      10.1016/j.biopsych.2004.10.009 
Language:       English
Keywords:       childhood trauma; catecholamine response; psychological
stress; police academy recruits; anxiety disorders; risk factors;
neuroendocrine response
Abstract:       Background: Childhood trauma is a risk factor for
anxiety disorders in adulthood. One possible mechanism for this
association is an increased neuroendocrine response to stress in adults
with a history of childhood trauma. Methods: In a cross-sectional study,
76 police academy recruits (mean[± SD] age 28 ± 5 years, 10 female) were
exposed to a video depicting real-life officers exposed to highly
stressful incidents. Salivary cortisol and
3-methoxy-4-hydroxy-phenylglycol (MHPG, the major metabolite of
norepinephrine) were collected at baseline, immediately after the video,
and 20 min after the video. Childhood trauma before age 14 was assessed
with an interview (Life Stressor Checklist-Revised), Results: Exposure
to the video elicited significant MHPG and cortisol responses in both
groups. Recruits with childhood trauma histories (n=16) had a
significantly greater MHPG response, as evidenced by a group effect (F =
8.0, p < .01), and a group × time interaction (F = 4.1, p < .05). The
cortisol response did not differ between groups. Conclusions: Police
academy recruits with childhood trauma histories have an increased
catecholamine response to psychological stress. This might serve as a
risk factor for anxiety disorders in recruits, and these findings might
generalize to other groups with a history of childhood trauma. (PsycINFO
Database Record (c) 2005 APA, all rights reserved)(journal abstract)
Subjects:       *Anxiety Disorders; *Catecholamines; *Early Experience;
*Emotional Trauma; *Psychological Stress; Police Personnel; Risk Factors

Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Male (30)

Female (40)
Location:       US     
Age Group:      Adulthood (18 yrs & older) (300)
Tests & Measures:       Structured Clinical Interview for DSM-IV

Pittsburgh Sleep Quality Index

Peritraumatic Dissociative Experiences Questionnaire

Life Stressor Checklist- Revised

Dissociative Experiences Scale

Michigan Alcoholism Screening Test

Symptom Checklist-90-Revised
Form/Content Type:      Empirical Study (0800)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20050207       
Accession Number:       2005-00403-005 
Number of Citations in Source:  45     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2005-00403-005

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2005-004
03-005">Association Between Childhood Trauma and Catecholamine Response
to Psychological Stress in Police Academy Recruits.</A>
       
Database:       PsycINFO       
  _____ 

Record: 5
       
Title:  Increased adrenocorticotropin suppression following
dexamethasone administration in sexually abused adolescents with
posttraumatic stress disorder. 
Author(s):      Duval, Fabrice, Centre Hospitalier, Rauffach, France,
 fabrice.duval@forenap.asso.fr

Crocq, Marc-Antoine, Centre Hospitalier, Rauffach, France

Guillon, Marie-Sabine, Institute for Research in Neurosciences and
Psychiatry, Rouffach, France

Mokrani, Marie-Claude, Institute for Research in Neurosciences and
Psychiatry, Rouffach, France

Monreal, José, Centre Hospitalier, Rauffach, France

Bailey, Paul, Centre Hospitalier, Rauffach, France

Macher, Jean-Paul, Centre Hospitalier, Rauffach, France
Address:        Duval, Fabrice, Centre Hospitalier, secteur VIII, 27 rue
de 4eme Spahis Marocain, 68250, Rouffach, France,
 fabrice.duval@forenap.asso.fr  
Source: Psychoneuroendocrinology, Vol 29(10), Nov 2004. pp. 1281-1289.

Journal URL: http://www.elsevier.com/inca/publications/store/4/7/3/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0306-4530 (Print)
Digital Object Identifier:      10.1016/j.psyneuen.2004.03.006 
Language:       English
Keywords:       adrenocorticotropin suppression; dexamethasone; sexually
abused adolescents; posttraumatic stress disorder; cortisol;
glucocorticoid receptor sensitivity;
hypothalamic-pituitary-adrenocortical axis     
Abstract:       Evidence suggests that individuals with posttraumatic
stress disorder (PTSD) have an enhanced sensitization of the
hypothalamic-pituitary-adrenocortical (HPA) axis. However, few studies
in adolescents have been performed. Fourteen sexually abused adolescent
inpatients with DSM-IV PTSD (12 female, two male; mean±SD age, 16.2 ±
1.9 years) were compared with 14 adolescent hospitalized controls (11
female, three male; mean age, 15.7 ± 2.0 years). All subjects underwent
a standard dexamethasone suppression test (DST, 1 mg given orally at
2300 h) five days after admission. Baseline blood samples were obtained
at 0800 h, and the following day, adrenocorticotropin (ACTH) and
cortisol levels were measured at 0800, 1600, and 2300 h. Clinical
assessment included the Impact of Event Scale, Stanford Acute Stress
Reaction Questionnaire, Beck Depression Inventory, and Coping Inventory
for Stressful Situations. Post-DST ACTH levels were significantly lower
in PTSD than in control adolescents (at 0800 h: P< 0.005; at 1600 h: P<
0.001; at 2300 h: P< 0.05). In patients, post-DST cortisol levels were
reduced but not significantly. No correlations were found between ACTH
and cortisol levels and time elapsed since trauma. These results
demonstrate that sexually abused adolescents with PTSD show ACTH
hypersuppression to DST suggesting enhanced glucocorticoid receptor
sensitivity in the pituitary. (PsycINFO Database Record (c) 2004 APA,
all rights reserved)(journal abstract)
Subjects:       *Corticotropin; *Hydrocortisone; *Hypothalamo Pituitary
Adrenal System; *Posttraumatic Stress Disorder; *Sexual Abuse;
Dexamethasone Suppression Test; Glucocorticoids
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Male (30)

Female (40)

Inpatient (50)
Location:       France 
Age Group:      Adolescence (13-17 yrs) (200)

Adulthood (18 yrs & older) (300)

Young Adulthood (18-29 yrs) (320)
Tests & Measures:       Impact of Event Scale; Structured Clinical
Interview for DSM-IV Axis I Disorders; Hamilton Rating Scale for
Anxiety; Coping Inventory for Stressful Situations; Stanford Acute
Stress Reaction Questionnaire

Beck Depression Inventory

Hamilton Rating Scale for Depression
Form/Content Type:      Conference Proceedings/Symposia (0600)

Empirical Study (0800)

Quantitative Study (0890)

Journal Article (2400)
Conference:     Annual ISPNE Conference, 34th, Sep, 2003, New York, NY,
US     
Conference Notes:       This conference was presented at the
aforementioned conference.     
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20040927       
Accession Number:       2004-18058-007 
Number of Citations in Source:  61     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-18058-007

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-180
58-007">Increased adrenocorticotropin suppression following
dexamethasone administration in sexually abused adolescents with
posttraumatic stress disorder.</A>     
       
Database:       PsycINFO       
  _____ 

Record: 6
       
Title:  The effect of brief exercise cessation on pain, fatigue, and
mood symptom development in healthy, fit individuals.  
Author(s):      Glass, Jennifer M., Department of Psychiatry, University
of Michigan, Ann Arbor, MI, US, jglass@umich.edu

Lyden, Angela K., Division of Rheumatology, Department of Medicine,
University of Michigan, Ann Arbor, MI, US

Petzke, Frank, Department of Anesthesiology, University of Cologne,
Cologne, Germany

Stein, Phyllis, Cardiovascular Division, Washington University, St.
Louis, MO, US

Whalen, Gail, Division of Rheumatology, Immunology, and Allergy,
Georgetown University, Washington, DC, US

Ambrose, Kirsten, Division of Rheumatology, Department of Medicine,
University of Michigan, Ann Arbor, MI, US

Chrousos, George, National Institute for Child Health & Development,
NIH, Bethesda, MD, US

Clauw, Daniel J., Division of Rheumatology, Department of Medicine,
University of Michigan, Ann Arbor, MI, US
Address:        Glass, Jennifer M., Institute for Social Research,
University of Michigan, Room 5256, 426 Thompson Street, Ann Arbor, MI,
US, jglass@umich.edu   
Source: Journal of Psychosomatic Research, Vol 57(4), Oct 2004. pp.
391-398.

Journal URL:
 http://www.elsevier.com/inca/publications/store/5/2/5/4/7/4/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0022-3999 (Print)
Digital Object Identifier:      10.1016/S0022-3999(03)00622-6  
Language:       English
Keywords:       exercise cessation; pain; fatigue; mood symptom;
biological stress response; fibromyalgia; chronic fatigue syndrome;
hypothalamic pituitary adrenal axis; autonomic nervous system  
Abstract:       Abnormalities of the biological stress response
(hypothalamic-pituitary-adrenal axis and the autonomic nervous system)
have been identified in both fibromyalgia (FM) and chronic fatigue
syndrome (CFS). Although these changes have been considered to be partly
responsible for symptom expression, we examine an alternative hypothesis
that these HPA and autonomic changes can be found in subsets of healthy
individuals in the general population who may be at risk of developing
these conditions. Exposure to "stressors" (e.g., infections, trauma,
etc.) may lead to symptom expression (pain, fatigue, and other somatic
symptoms) in part by precipitating lifestyle changes. In particular, we
focus on the effect of deprivation of routine aerobic exercise on the
development of somatic symptoms. Methods: Eighteen regularly exercising
(≥4 h/week) asymptomatic, healthy adults refrained from physical
activity for 1 week. We predicted that a subset of these individuals
would develop symptoms of FM/CFS with exercise deprivation, and this
manuscript focuses on the baseline HPA axis, immune, and autonomic
function measures that may predict the development of symptoms. Results:
Eight of the subjects reported a 10% increase in one or more symptoms
(pain, fatigue, mood) after 1 week of exercise deprivation. These
symptomatic subjects had lower HPA axis (baseline cortisol prior to
VO2max testing), immune (NK cell responsiveness to venipuncture), and
autonomic function (measured by heart rate variability) at baseline
(prior to cessation of exercise) when compared to the subjects who did
not develop symptoms. Conclusions: A subset of subjects developed
symptoms of pain, fatigue, or mood changes after exercise deprivation.
This cohort was different from the individuals who did not develop
symptoms in baseline measures of HPA axis, immune, and autonomic
function. We speculate that a subset of healthy individuals who have
hypoactive function of the biological stress response systems
unknowingly exercise regularly to augment the function of these systems
and thus suppress symptoms. These individuals may be at risk for
developing chronic multisymptom illnesses (CMIs) (e.g., FM or CFS among
others) when a "stressor" leads to lifestyle changes that disrupt
regular exercise. (PsycINFO Database Record (c) 2005 APA, all rights
reserved)(journal abstract)
Subjects:       *Emotional States; *Exercise; *Fatigue; *Pain;
*Symptoms; Autonomic Nervous System; Fibromyalgia      
Classification: Promotion & Maintenance of Health & Wellness (3365)
Population:     Human (10)

Male (30)

Female (40)
Age Group:      Adulthood (18 yrs & older) (300)
Tests & Measures:       Multidimensional Fatigue Inventory

McGill Pain Questionnaire (The)

Beck Depression Inventory

Spielberger State Trait Anxiety Inventory
Form/Content Type:      Empirical Study (0800)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20050110       
Accession Number:       2004-21136-010 
Number of Citations in Source:  62     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-21136-010

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-211
36-010">The effect of brief exercise cessation on pain, fatigue, and
mood symptom development in healthy, fit individuals.</A>      
       
Database:       PsycINFO       
  _____ 

Record: 7
       
Title:  Psychobiological dysregulation in violence-exposed mothers:
Salivary cortisol of mothers with very young children pre- and
post-separation stress.
Author(s):      Schechter, Daniel S., Department of Psychiatry, College
of Physicians & Surgeons, Columbia University, New York, NY, US,
 dss11@columbia.edu

Zeanah, Charles H. Jr., Department of Psychiatry and Neurology, Tulane
University School of Medicine, New Orleans, LA, US

Myers, Michael M., Department of Psychiatry, College of Physicians &
Surgeons, Columbia University, New York, NY, US

Brunelli, Susan A., Department of Psychiatry, College of Physicians &
Surgeons, Columbia University, New York, NY, US

Liebowitz, Michael R., Department of Psychiatry, College of Physicians &
Surgeons, Columbia University, New York, NY, US

Marshall, Randall D., Department of Psychiatry, College of Physicians &
Surgeons, Columbia University, New York, NY, US

Coates, Susan W., Department of Psychiatry, College of Physicians &
Surgeons, Columbia University, New York, NY, US

Trabka, Kimberly A., Department of Psychiatry, College of Physicians &
Surgeons, Columbia University, New York, NY, US

Baca, Patricia, Department of Psychiatry, College of Physicians &
Surgeons, Columbia University, New York, NY, US

Hofer, Myron A., Department of Psychiatry and Neurology, Tulane
University School of Medicine, New Orleans, LA, US
Address:        Schechter, Daniel S., Divisions of Developmental
Psychobiology and Trauma Studies and Services, New York State
Psychiatric Institute, Unit 40, 1051 Riverside Drive, New York, NY, US,
 dss11@columbia.edu     
Source: Bulletin of the Menninger Clinic, Vol 68(4), Fal 2004. pp.
319-336.

Journal URL:
 http://www.guilford.com/cartscript.cgi?page=periodicals/jnme.htm&cart_id
=547216.21319
Publisher:      US: Guilford Publications

Publisher URL: http://www.guilford.com
ISSN:   0025-9284 (Print)
Language:       English
Keywords:       psychobiological dysregulation; violence-exposed
mothers; salivary cortisol; maternal behavior; posttraumatic stress;
child separation stress; domestic violence     
Abstract:       To understand the determinants of frightening/frightened
and other atypical maternal behavior, the authors studied a sample of 41
inner-city mothers of very young children (ages 8-50 months), the
mothers of whom had lifetime histories of interpersonal violent trauma
(i.e., physical or sexual abuse, and domestic violence) and related
posttraumatic stress. Method: The authors measured (1) maternal salivary
cortisol levels before and 30 minutes after a videotaped play paradigm
with their children, involving two separations and reunions; and (2)
cortisol reactivity 30 minutes after separation stress. Data were
analyzed using Pearson bivariate correlations, ANOVA, and multiple
linear regressions. Results: Salivary cortisol "baseline" values were
significantly negatively correlated with childhood interpersonal violent
trauma severity (i.e., trauma severity prior to age 16). However,
cortisol reactivity was not significantly correlated with interpersonal
violent trauma severity at this level of analysis. Although baseline
salivary cortisol values were not significantly correlated with current
overall psychiatric or depressive symptoms, they were negatively
correlated with severity of current posttraumatic stress symptoms (PTSS)
and with dissociative symptoms. Neither dimensions of negativity nor
distortion of maternal attributions showed any significant association
with prestress or poststress salivary cortisol levels. Salivary cortisol
baseline was negatively correlated with atypical maternal behavior via
measurement of the level of disrupted communication, at a trend-level of
significance. Conclusions: Violent trauma-associated dysregulation of
the hypothalamic-pituitary-adrenal (HPA) axis may be a marker for
increased risk for intergenerational transmission via parenting behavior
with young children. Low salivary cortisol prior to separation stress
and blunted cortisol reactivity to separation may also be markers for
posttraumatic stress. (PsycINFO Database Record (c) 2005 APA, all rights
reserved)(journal abstract)
Subjects:       *Cortisone; *Mothers; *Saliva; *Stress; *Violence;
Posttraumatic Stress Disorder; Psychobiology   
Classification: Psychophysiology (2560)
Population:     Human (10)

Female (40)
Location:       US     
Age Group:      Childhood (birth-12 yrs) (100)

Preschool Age (2-5 yrs) (160)

Adulthood (18 yrs & older) (300)

Young Adulthood (18-29 yrs) (320)

Thirties (30-39 yrs) (340)

Middle Age (40-64 yrs) (360)
Tests & Measures:       Demographic and Treatment History Questionnaire

Life Events Checklist

Brief Physical and Sexual Abuse Questionnaire

Structured Clinical Interview for the DSM-IV

Posttraumatic Stress Symptom Checklist-Short Version

Hopkins Augmented Dissociative Symptom Inventory

Beck Depression Inventory

Brief Symptom Inventory
Form/Content Type:      Empirical Study (0800)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20050307       
Accession Number:       2005-01556-003 
Number of Citations in Source:  41     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2005-01556-003

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2005-015
56-003">Psychobiological dysregulation in violence-exposed mothers:
Salivary cortisol of mothers with very young children pre- and
post-separation stress.</A>    
       
Database:       PsycINFO       
  _____ 

Record: 8
       
Title:  Women and Anxiety Disorders: Implications for Diagnosis and
Treatment.     
Author(s):      Ginsberg, David L., (Ed)
Source: CNS Spectrums, Vol 9(9), Sep 2004. pp. 1-16.

Journal URL: http://www.cnsspectrums.com/index.php3
Publisher:      US: MBL Communications, Inc

Publisher URL: http://mblcommunications.com
ISSN:   1092-8529 (Print)
Language:       English
Keywords:       anxiety disorders; medical diagnosis; agoraphobia; panic
disorder; hormonal changes; human female       
Abstract:       Community studies indicate that 19% of men and 31% of
women will develop some type of anxiety disorder during their lifetime.
The impact of gender is profound in that it increases the likelihood of
developing an anxiety disorder by 85% in women compared to men. Sex
difference in prevalence rates are apparent as early as age 6, when
girls are twice as likely as boys to have an anxiety disorder. In the
National Comorbidity Survey, the prevalence rates for panic disorder in
women and men were 5% and 2%, respectively. Agoraphobia, which often
coexists with panic disorder, has a lifetime prevalence rate of 7% in
women and 3.5% in men. Prevalence of trauma is increased in young women
as well, and is experienced earlier in life; 62% of sexual assaults are
inflicted on females ≤18 years of age, and 29% occur in children < 11
years of age. Comorbidity of anxiety in women complicates other medical
conditions as well. For example, panic disorder is highly comorbid with
CHD, which remains the leading cause of death in women in developed
countries. Fluctuations in reproductive hormone levels during the female
life cycle is thought to be responsible for modulating anxiety. This is
often implicated in the later age of onset, the more sudden and acute
symptom emergence, and the more episodic course of OCD in women, and in
the high prevalence (47.4%) of PMDD. Pregnancy appears to be a
protective period for some anxiety disorders, including panic, while for
others, such as OCD, it may be associated with onset. Hormonal changes
during pregnancy, such as increased prolactin, oxytocin, and cortisol,
may contribute to the suppression of stress response that occurs during
this period. Despite a large and growing body of literature on anxiety
disorders in general, the available data relating to women and girls
falls short of informing aspects of diagnosis, treatment, and prevention
that may entail sex differences. Additional work is required to
understand the biological and psychosocial causes of these differences.
(PsycINFO Database Record (c) 2004 APA, all rights reserved)(journal
abstract)
Subjects:       *Agoraphobia; *Anxiety Disorders; *Diagnosis; *Panic
Disorder; Hormones     
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Female (40)
Form/Content Type:      Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print
Release Date:   20041206       
Accession Number:       2004-19369-007 
Number of Citations in Source:  33     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-19369-007

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-193
69-007">Women and Anxiety Disorders: Implications for Diagnosis and
Treatment.</A> 
       
Database:       PsycINFO       
  _____ 

Record: 9
       
Title:  Low-dose cortisol for symptoms of posttraumatic stress disorder.

Author(s):      Aerni, Amanda

Traber, Rafael

Hock, Christoph

Roozendaal, Benno

Schelling, Gustav

Papassotiropoulos, Andreas

Nitsch, Roger M.

Schnyder, Ulrich

de Quervain, Dominique J. -F., Division of Psychiatry Research,
University of Zurich, Zurich, Switzerland, quervain@bli.unizh.ch
Address:        de Quervain, Dominique J. -F., Division of Psychiatry
Research, University of Zurich, Lenggstr. 31, 8029, Zurich, Switzerland,
 quervain@bli.unizh.ch  
Source: American Journal of Psychiatry, Vol 161(8), Aug 2004. pp.
1488-1490.

Journal URL: http://ajp.psychiatryonline.org/
Publisher:      US: American Psychiatric Assn

Publisher URL: http://www.appi.org
ISSN:   0002-953X (Print)
Digital Object Identifier:      10.1176/appi.ajp.161.8.1488    
Language:       English
Keywords:       cortisol administration; posttraumatic stress disorder;
memory retrieval; traumatic memories; cortisol dosage  
Abstract:       Objective: Because elevated cortisol levels inhibit
memory retrieval in healthy human subjects, the present study
investigated whether cortisol administration might also reduce excessive
retrieval of traumatic memories and related symptoms in patients with
chronic posttraumatic stress disorder (PTSD). Method: During a 3-month
observation period, low-dose cortisol (10 mg/day) was administered
orally for 1 month to three patients with chronic PTSD in a
double-blind, placebo-controlled, crossover design. Results: In each
patient investigated, there was a significant treatment effect, with
cortisol-related reductions of at least 38% in one of the daily rated
symptoms of traumatic memories, as assessed by self-administered rating
scales. In accordance, Clinician-Administered PTSD Scale ratings
assessed after each month showed cortisol-related improvements for
reexperiencing symptoms and, additionally, in one patient for avoidance
symptoms. Conclusions: The results of this pilot study indicate that
low-dose cortisol treatment reduces the cardinal symptoms of PTSD.
(PsycINFO Database Record (c) 2004 APA, all rights reserved)(journal
abstract)
Subjects:       *Drug Dosages; *Hydrocortisone; *Memory; *Posttraumatic
Stress Disorder; *Recall (Learning); Emotional Trauma  
Classification: Clinical Psychopharmacology (3340)

Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Male (30)

Female (40)
Age Group:      Adulthood (18 yrs & older) (300)

Middle Age (40-64 yrs) (360)
Tests & Measures:       Clinician-Administered PTSD Scale
Form/Content Type:      Empirical Study (0800)

Quantitative Study (0890)

Double Blind Design (0891)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Electronic

Format(s) Available: Print; Electronic
Release Date:   20040913       
Accession Number:       2004-17170-025 
Number of Citations in Source:  7      
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-17170-025

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-171
70-025">Low-dose cortisol for symptoms of posttraumatic stress
disorder.</A>  
       
Database:       PsycINFO       
  _____ 

Record: 10
       
Title:  Saliva Cortisol in Posttraumatic Stress Disorder: A Community
Epidemiologic Study.   
Author(s):      Young, Elizabeth A., Department of Psychiatry and Mental
Health Research Institute, University of Michigan, Ann Arbor, MI, US,
 eayoung@umich.edu

Breslau, Naomi, Department of Epidemiology, Michigan State University,
East Lansing, MI, US
Address:        Young, Elizabeth A., University of Michigan, School of
Medicine, Mental Health Research Institute, 205 Zina Pitcher Place, Ann
Arbor, MI, US, eayoung@umich.edu       
Source: Biological Psychiatry, Vol 56(3), Aug 2004. pp. 205-209.

Journal URL:
 http://www.elsevier.com/inca/publications/store/5/0/5/7/5/0/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0006-3223 (Print)
Digital Object Identifier:      10.1016/j.biopsych.2004.05.011 
Language:       English
Keywords:       stress; hypothalamic pituitary adrenal axis;
posttraumatic stress disorder; cortisol; saliva; trauma; comorbidity;
major depressive disorder      
Abstract:       Background: Stress activates the
hypothalamic-pituitary-adrenal (HPA) axis, so it was expected that
posttraumatic stress disorder (PTSD) would be associated with activation
of this axis; however, studies have found both increased and decreased
cortisol in PTSD. To address this question, we collected saliva cortisol
at home in a subsample of a longitudinal epidemiologic sample. Methods:
Six hundred eighty-four persons randomly selected from the total sample
of 913 were requested to collect saliva samples upon awakening and in
the early evening. Of these, 538 responded with samples, 516 of whom met
inclusion criteria. These were 68 exposed to trauma with lifetime PTSD,
265 exposed to trauma with no PTSD, and 183 never exposed to trauma.
Results: In a comparison of these three groups, lifetime PTSD revealed
elevated evening saliva cortisol compared with exposed/no PTSD. When
lifetime comorbidity with major depressive disorder (MDD) was included
in the analysis, only persons with comorhid PTSD and MDD showed this
evening elevation in cortisol. Persons with PTSD alone (never MDD)
showed normal saliva cortisol levels, as did subjects with lifetime MDD
alone. Conclusions: Neither exposure to trauma nor PTSD alone is
associated with alterations in saliva cortisol: however, elevated
cortisol is found in PTSD comorbid with lifetime MDD. (PsycINFO Database
Record (c) 2004 APA, all rights reserved)(journal abstract)
Subjects:       *Emotional Trauma; *Hydrocortisone; *Hypothalamo
Pituitary Adrenal System; *Posttraumatic Stress Disorder; Comorbidity;
Major Depression; Saliva; Stress       
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Male (30)

Female (40)
Location:       US     
Age Group:      Adulthood (18 yrs & older) (300)

Young Adulthood (18-29 yrs) (320)

Thirties (30-39 yrs) (340)
Tests & Measures:       National Institute of Mental Health-Diagnostic
Interview Schedule for DSM-III-R
Form/Content Type:      Empirical Study (0800)

Longitudinal Study (0850)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20040816       
Accession Number:       2004-16853-011 
Number of Citations in Source:  35     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-16853-011

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-168
53-011">Saliva Cortisol in Posttraumatic Stress Disorder: A Community
Epidemiologic Study.</A>       
       
Database:       PsycINFO       
  _____ 

Record: 11
       
Title:  Editorial.     
Author(s):      Burrows, Graham D., Department of Psychiatry, University
of Melbourne, Austin Hospital, Austin Health, Heidelberg, VIC,
Australia, graham.burrows@austin.org.au
Address:        Burrows, Graham D., Department of Psychiatry, University
of Melbourne, Austin Hospital, Austin Health, Heidelberg, VIC,
Australia, 3084, graham.burrows@austin.org.au  
Source: Stress & Health: Journal of the International Society for the
Investigation of Stress, Vol 20(3), Aug 2004. pp. 103.

Journal URL: http://www.interscience.wiley.com/jpages/1532-3005/
Publisher:      US: John Wiley & Sons

Publisher URL: http://www.wiley.com/WileyCDA/
ISSN:   1532-3005 (Print)

1099-1700 (Electronic)
Digital Object Identifier:      10.1002/smi.1021       
Language:       English
Keywords:       trauma; chronic stress; posttraumatic reactions
Abstract:       In this edition of "Stress and Health," there is an
interesting paper on trauma in antiquity and Ben-Ezra is extending the
timeline for the known existence of posttraumatic reactions back to
2000-2100 BC (see record 2004-18060-004). He believes the reactions to
traumatic events have not changed dramatically over the millennia. There
has been an ongoing interest in the role of
hypothalamic-pituitary-adrenal axis in chronic stress, with some
conflicting results. Kaspers and Scholz (see record 2004-18060-005)
report on the association between cortisol values and stress-related
complaints, and as expected a high level of stress was accompanied by a
broader morning cortisol distribution. They suggest a stress-induced
variation of basal cortisol concentrations. This paper should stimulate
some worthwhile discussion. Yamaguchi and colleagues (see record
2004-18060-008) conducted a study on the effect of intensive training on
rangers in the Defence Force. These measurements were following the
serotonin, P-endorphin and catecholamine in plasma. They report
significant increases in serotonin, P-endorphin, noradrenaline and
dopamine. Also, this volume emphases the international and diverse group
of studies in stress. It is a global problem and attracting global
attention. Many questions still remain, and further research is
required. We all have more to learn. (PsycINFO Database Record (c) 2004
APA, all rights reserved)
Subjects:       *Adjustment Disorders; *Emotional Trauma; *Stress;
Emotional States       
Classification: Psychological & Physical Disorders (3200)
Population:     Human (10)
Form/Content Type:      Journal Editorial (5100)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20040927       
Accession Number:       2004-18060-001 
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-18060-001

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-180
60-001">Editorial.</A> 
       
Database:       PsycINFO       
  _____ 

Record: 12
       
Title:  Basal and Dexamethasone Suppressed Salivary Cortisol
Concentrations in a Community Sample of Patients with Posttraumatic
Stress Disorder.       
Author(s):      Lindley, Steven E., Department of Veterans Affairs,
National Center for Posttraumatic Stress Disorder, Palo Alto Veterans
Affairs Health Care System, Menlo Park, CA, US

Carlson, Eve B., Department of Veterans Affairs, National Center for
Posttraumatic Stress Disorder, Palo Alto Veterans Affairs Health Care
System, Menlo Park, CA, US

Benoit, Maryse, Department of Veterans Affairs, National Center for
Posttraumatic Stress Disorder, Palo Alto Veterans Affairs Health Care
System, Menlo Park, CA, US
Address:        Lindley, Steven E., Palo Alto VA HCS, PTSD 352/177, 795
Willow Road, Menlo Park, CA, US
Source: Biological Psychiatry, Vol 55(9), May 2004. pp. 940-945.

Journal URL:
 http://www.elsevier.com/inca/publications/store/5/0/5/7/5/0/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0006-3223 (Print)
Digital Object Identifier:      10.1016/j.biopsych.2003.12.021 
Language:       English
Keywords:       salivary cortisol concentrations; posttraumatic stress
disorder; childhood trauma; severity of symptoms       
Abstract:       Posttraumatic stress disorder (PTSD) has been associated
with lower concentrations of cortisol and enhanced suppression of
cortisol by dexamethasone, although discrepancies exist among reports.
The objective of the study was to determine the pattern of cortisol
responses in patients seeking treatment for PTSD resulting from a
variety of traumatic experiences and to test whether cortisol responses
are significantly related to childhood trauma, severity of symptoms, or
length of time since trauma. Salivary cortisol was measured at 8 AM, 4
PM, and 10 PM on 2 consecutive days before and after a 10 PM dose of .5
mg dexamethasone in 17psychotropic medication and substance-free
subjects with PTSD and 17 matched control subjects. Repeated-measures
analysis of variance (ANOVA) of the baseline salivary cortisol
concentrations demonstrated a significant effect for group with higher
concentrations in the PTSD group but no significant differences in
responses to dexamethasone. The presence of childhood abuse did not
significantly affect salivary cortisol concentrations, and there was no
correlation between predexamethasone cortisol and either the seventy of
PTSD symptoms or the time since the index trauma... (PsycINFO Database
Record (c) 2004 APA, all rights reserved)
Subjects:       *Hydrocortisone; *Posttraumatic Stress Disorder;
*Symptoms      
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Male (30)

Female (40)
Location:       US     
Age Group:      Adulthood (18 yrs & older) (300)

Young Adulthood (18-29 yrs) (320)

Thirties (30-39 yrs) (340)

Middle Age (40-64 yrs) (360)

Aged (65 yrs & older) (380)
Tests & Measures:       Mini International Neuropsychiatric Interview;
Posttraumatic Dissociation Scale; Affective Lability Scale; Impulsive
Aggression Scale

State-Trait Anger Expression Inventory [1996 Edition]

Clinician-Administered PTSD Scale
Form/Content Type:      Empirical Study (0800)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20040524       
Accession Number:       2004-13702-009 
Number of Citations in Source:  56     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-13702-009

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-137
02-009">Basal and Dexamethasone Suppressed Salivary Cortisol
Concentrations in a Community Sample of Patients with Posttraumatic
Stress Disorder.</A>   
       
Database:       PsycINFO       
  _____ 

Record: 13
       
Title:  Cortisol and catecholamines in posttraumatic stress disorder: An
epidemiologic community study. 
Author(s):      Young, Elizabeth A., University of Michigan, Department
of Psychiatry and Mental Health Research Institute, Ann Arbor, MI, US,
 eayoung@umich.cdu

Breslau, Naomi, Michigan State University, College of Human Medicine,
Department of Epidemiology, East Lansing, MI, US
Address:        Young, Elizabeth A., Mental Health Research Institute,
University of Michigan, 205 Zina Pitcher Pl, Ann Arbor, MI, US,
 eayoung@umich.cdu      
Source: Archives of General Psychiatry, Vol 61(4), Apr 2004. pp.
394-401.

Journal URL: http://archpsyc.ama-assn.org/
Publisher:      US: American Medical Assn

Publisher URL: http://www.amapublications.com
ISSN:   0003-990X (Print)
Digital Object Identifier:      10.1001/archpsyc.61.4.394      
Language:       English
Keywords:       cortisol; catecholamines; posttraumatic stress disorder;
epidemiological study  
Abstract:       Examined urinary catecholamine and cortisol levels in
individuals with PTSD in a community sample. A representative cohort of
young adult community residents, assessed periodically during a 10-year
period for exposure to trauma and PTSD, was used to select a subset for
urine collection studies conducted in a sleep laboratory across 2
consecutive nights and the intermediate day. The sample of young adults
was randomly selected from a large health maintenance organization and
is representative of the geographic area except for the extremes of the
socioeconomic status range. A subsample was selected from the 10- year
follow-up cohort. Eligibility criteria were: (1) persons exposed to
trauma during the preceding 5 years, (2) other individuals who met PTSD
criteria, and (3) a random preselected subsample. Of 439 eligible
individuals, 292 (66.5%) participated, including 69 with lifetime PTSD.
The lifetime PTSD group demonstrated significantly higher catecholamine
levels than the group exposed to trauma without PTSD and the nonexposed
group. Women with MDD plus PTSD demonstrated significantly higher
cortisol levels than women with neither disorder or with either disorder
alone. Persons with PTSD had neither an increase nor a decrease in mean
urinary cortisol levels. (PsycINFO Database Record (c) 2004 APA, all
rights reserved)
Subjects:       *Catecholamines; *Epidemiology; *Hydrocortisone;
*Posttraumatic Stress Disorder; Communities    
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Male (30)

Female (40)
Location:       US     
Age Group:      Adulthood (18 yrs & older) (300)

Young Adulthood (18-29 yrs) (320)

Thirties (30-39 yrs) (340)
Form/Content Type:      Empirical Study (0800)

Longitudinal Study (0850)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Electronic

Format(s) Available: Print; Electronic
Release Date:   20040628       
Accession Number:       2004-13149-011 
Number of Citations in Source:  44     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-13149-011

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-131
49-011">Cortisol and catecholamines in posttraumatic stress disorder: An
epidemiologic community study.</A>     
       
Database:       PsycINFO       
  _____ 

Record: 14
       
Title:  Paroxetine Treatment of Depression With Posttraumatic Stress
Disorder: Effects on Autonomic Reactivity and Cortisol Secretion.      
Author(s):      Tucker, Phebe, Department of Psychiatry, University of
Oklahoma Health Sciences Center, Oklahoma City, OK, US,
 Phebe-Tucker@ouhsc.edu

Beebe, Katherine L., Scientific Communications, GlaxoSmithKline,
Research Triangle Park, NC, US

Burgin, Christie, General Clinical Research Center, University of
Oklahoma Health Sciences Center, Oklahoma City, OK, US

Wyatt, Dorothy B., Department of Psychiatry, University of Oklahoma
Health Sciences Center, Oklahoma City, OK, US

Parker, Don E., General Clinical Research Center, University of Oklahoma
Health Sciences Center, Oklahoma City, OK, US

Masters, Barbara K., Department of Psychiatry, University of Oklahoma
Health Sciences Center, Oklahoma City, OK, US

Nawar, Ola, Department of Psychiatry, University of Oklahoma Health
Sciences Center, Oklahoma City, OK, US
Address:        Tucker, Phebe, Department of Psychiatry, University of
Oklahoma Health Sciences Center, WP 3440, PO Box 26901, Oklahoma City,
OK, US, Phebe-Tucker@ouhsc.edu 
Source: Journal of Clinical Psychopharmacology, Vol 24(2), Apr 2004. pp.
131-140.

Journal URL: http://www.psychopharmacology.com/
Publisher:      US: Lippincott Williams & Wilkins

Publisher URL: http://www.lww.com/
ISSN:   0271-0749 (Print)
Language:       English
Keywords:       posttraumatic stress disorder; paroxetine; serotonin
reuptake inhibitor treatment; comorbidity; major depression; cortisol
secretion; autonomic reactivity; neurobiology; subjective symptoms; PTSD

Abstract:       Effects of paroxetine treatment of comorbid depression
and posttraumatic stress disorder (PTSD) on subjective symptoms,
autonomic reactivity, and diurnal salivary cortisols were assessed
prospectively. Cross-sectional baseline psychophysiologic assessments of
22 patients with depression + PTSD, 21 with depression alone, and 20
asymptomatic, previously traumatized controls found that comorbid
patients had higher blood pressure and heart rate reactivity to
individualized trauma scripts than purely depressed and control groups.
After 10 weeks of open-label paroxetine, comorbid patients significantly
improved in all PTSD symptom evaluations and physiologic reactivity
measures but did not change cortisol levels or acquire a robust diurnal
cortisol pattern. Ten treated depressed patients did not change in
physiologic or cortisol measures. Results demonstrate that sampled
comorbid patients had autonomic reactivity patterns similar to PTSD that
responded to selective serotonin reuptake inhibitor treatment but had
diurnal cortisol secretion patterns different from depression or that
expected for PTSD, which did not change with treatment. Results suggest
a complexity in the neurobiology of comorbid PTSD and major depression
and its response to treatment. (PsycINFO Database Record (c) 2004 APA,
all rights reserved)
Subjects:       *Comorbidity; *Hydrocortisone; *Major Depression;
*Paroxetine; *Posttraumatic Stress Disorder; Autonomic Nervous System;
Cardiovascular Reactivity; Drug Therapy; Neurobiology; Symptoms
Classification: Clinical Psychopharmacology (3340)
Population:     Human (10)

Male (30)

Female (40)
Location:       US     
Age Group:      Adulthood (18 yrs & older) (300)

Young Adulthood (18-29 yrs) (320)

Thirties (30-39 yrs) (340)

Middle Age (40-64 yrs) (360)
Tests & Measures:       Revised Impact of Event Scale; Revised Beck
Anxiety Inventory; Treatment Outcome PTSD Scale; the Structured Clinical
Interview for DSM-IV; CAPS-I; Clinical Global Impressions

Beck Depression Inventory [1993 Revised]
Form/Content Type:      Empirical Study (0800)

Longitudinal Study (0850)

Prospective Study (0851)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20040426       
Accession Number:       2004-12400-004 
Number of Citations in Source:  41     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-12400-004

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-124
00-004">Paroxetine Treatment of Depression With Posttraumatic Stress
Disorder: Effects on Autonomic Reactivity and Cortisol Secretion.</A>  
       
Database:       PsycINFO       
  _____ 

Record: 15
       
Title:  Effects of trauma exposure on the cortisol response to
dexamethasone administration in PTSD and major depressive disorder.    
Author(s):      Yehuda, Rachel, Mount Sinai School of Medicine and Bronx
Veterans Affairs, Dept of Psychiatry, The Traumatic Stress Studies
Program, Bronx, NY, US, rachel.yehuda@med.va.gov

Halligan, Sarah L., Mount Sinai School of Medicine and Bronx Veterans
Affairs, Dept of Psychiatry, The Traumatic Stress Studies Program,
Bronx, NY, US

Golier, Julia A., Mount Sinai School of Medicine and Bronx Veterans
Affairs, Dept of Psychiatry, The Traumatic Stress Studies Program,
Bronx, NY, US

Grossman, Robert, Mount Sinai School of Medicine and Bronx Veterans
Affairs, Dept of Psychiatry, The Traumatic Stress Studies Program,
Bronx, NY, US

Bierer, Linda M., Mount Sinai School of Medicine and Bronx Veterans
Affairs, Dept of Psychiatry, The Traumatic Stress Studies Program,
Bronx, NY, US
Address:        Yehuda, Rachel, rachel.yehuda@med.va.gov       
Source: Psychoneuroendocrinology, Vol 29(3), Apr 2004. pp. 389-404.

Journal URL: http://www.elsevier.com/inca/publications/store/4/7/3/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0306-4530 (Print)
Digital Object Identifier:      10.1016/S0306-4530(03)00052-0  
Language:       English
Keywords:       cortisol suppression; trauma exposure; trauma survivors;
posttraumatic stress disorder; dexamethasone administration; major
depressive disorder; psychiatric diagnoses     
Abstract:       To evaluate cortisol suppression following 0.5 mg of
dexamethasone (DEX) in trauma survivors (N = 52) with posttraumatic
stress disorder (PTSD), major depressive disorder (MDD), both, or
neither disorder, and in subjects never exposed to trauma (N = 10), in
order to examine interactions between diagnosis and trauma history on
cortisol negative feedback inhibition. Lifetime trauma exposure and
psychiatric diagnoses were assessed and blood samples were obtained at
8:00 a.m. for the determination of baseline cortisol. Participants
ingested 0.5 mg of DEX at 11:00 p.m. and blood samples for determination
of cortisol and DEX were obtained at 8:00 a.m. the following day. PTSD
was associated with enhanced cortisol suppression in response to DEX.
Among trauma survivors, the presence of a traumatic event prior to the
focal trauma had a substantial impact on cortisol suppression in
subjects with MDD. Such subjects were more likely to show cortisol
alterations similar to those associated with PTSD, whereas subjects with
MDD with no prior trauma were more likely to show alterations in the
opposite direction, i.e. relative non-suppression. Cortisol
hypersuppression in PTSD appears not to be dependent on the presence of
traumatic events prior to the focal trauma. (PsycINFO Database Record
(c) 2004 APA, all rights reserved)
Subjects:       *Dexamethasone; *Hydrocortisone; *Major Depression;
*Posttraumatic Stress Disorder; *Survivors; Comorbidity; Emotional
Trauma 
Classification: Psychological Disorders (3210)
Population:     Human (10)

Male (30)

Female (40)
Location:       US     
Age Group:      Adulthood (18 yrs & older) (300)

Young Adulthood (18-29 yrs) (320)

Thirties (30-39 yrs) (340)

Middle Age (40-64 yrs) (360)
Tests & Measures:       Clinician-Administered PTSD Scale

Structured Clinical Interview for DSM-IV Axis I Disorders
Form/Content Type:      Empirical Study (0800)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20040209       
Accession Number:       2004-10405-006 
Number of Citations in Source:  39     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-10405-006

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-104
05-006">Effects of trauma exposure on the cortisol response to
dexamethasone administration in PTSD and major depressive disorder.</A>
       
Database:       PsycINFO       
  _____ 

Record: 16
       
Title:  Salivary Cortisol and Posttraumatic Stress Disorder in a
Low-Income Community Sample of Women.  
Author(s):      Young, Elizabeth A., Department of Psychiatry and Mental
Health Research Institute, University of Michigan, Ann Arbor, MI, US

Tolman, Richard, School of Social Work, University of Michigan, Ann
Arbor, MI, US

Witkowski, Kristine, School of Social Work, University of Michigan, Ann
Arbor, MI, US

Kaplan, George, Department of Epidemiology, University of Michigan, Ann
Arbor, MI, US
Address:        Young, Elizabeth A., 205 Zina Pitcher Place, Ann Arbor,
MI, US 
Source: Biological Psychiatry, Vol 55(6), Mar 2004. pp. 621-626.

Journal URL:
 http://www.elsevier.com/inca/publications/store/5/0/5/7/5/0/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0006-3223 (Print)
Digital Object Identifier:      10.1016/j.biopsych.2003.09.009 
Language:       English
Keywords:       salivary cortisol; posttraumatic stress disorder; adult
trauma; low income women       
Abstract:       Background: Studies of male combat veterans with
posttraumatic stress disorder have demonstrated a profile of low
cortisol. Studies with women with posttraumatic stress disorder (PTSD)
have focused on childhood sexual abuse and holocaust survivors, both of
whom experienced trauma during development, which could be different
than adult trauma exposure. Methods: Using an epidemiologic sample of
low-income women from an urban area in Michigan, we conducted structured
psychiatric interviews and saliva cortisol collection on a subsample of
women with exposure to trauma but never PTSD (n = 72), recent PTSD (n =
29), and past PTSD (n = 70). Saliva cortisol was collected at awakening,
30 minutes later, at bedtime, and during a clinic visit. Results: Recent
trauma exposure but not past trauma exposure led to an increase in
saliva cortisol. Neither recent PTSD nor past PTSD resulted in any
saliva cortisol changes compared with the trauma exposed, never PTSD
group. Recent major depression (past 12 months) demonstrated a weak
effect (p = .08) on bedtime saliva cortisol. Conclusions: While recent
trauma exposure can increase saliva cortisol, neither recent nor past
PTSD affected saliva cortisol in our community sample of women. Our data
do not support saliva cortisol changes associated ... (PsycINFO Database
Record (c) 2004 APA, all rights reserved)(journal abstract)
Subjects:       *Adult Development; *Emotional Trauma; *Hydrocortisone;
*Lower Income Level; *Posttraumatic Stress Disorder; Human Females     
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Female (40)
Location:       US     
Age Group:      Adulthood (18 yrs & older) (300)

Young Adulthood (18-29 yrs) (320)

Thirties (30-39 yrs) (340)

Middle Age (40-64 yrs) (360)
Tests & Measures:       University of Michigan-Composite International
Diagnostic Inventory; Conflict Tactics Scale; World Health
Organization-Composite International Diagnostic Inventory-Short Form
Form/Content Type:      Empirical Study (0800)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20040419       
Accession Number:       2004-12034-009 
Number of Citations in Source:  30     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-12034-009

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-120
34-009">Salivary Cortisol and Posttraumatic Stress Disorder in a
Low-Income Community Sample of Women.</A>      
       
Database:       PsycINFO       
  _____ 

Record: 17
       
Title:  Stress Doses of Hydrocortisone, Traumatic Memories, and Symptoms
of Posttraumatic Stress Disorder in Patients After Cardiac Surgery: A
Randomized Study.      
Author(s):      Schelling, Gustav, Department of Anaesthesiology,
Ludwig-Maximilians University, Munich, Germany

Kilger, Erich, Department of Anaesthesiology, Ludwig-Maximilians
University, Munich, Germany

Roozendaal, Benno, Center for the Neurobiology of Learning and Memory,
Department of Neurobiology and Behavior, University of California,
Irvine, CA, US

de Quervain, Dominique J.-F., Division of Psychiatry Research,
University of Zürich, Zürich, Switzerland

Briegel, Josef, Department of Anaesthesiology, Ludwig-Maximilians
University, Munich, Germany

Dagge, Alexander, Department of Anaesthesiology, Ludwig-Maximilians
University, Munich, Germany

Rothenhäusler, Hans-Bernd, Department of Psychiatry, Ludwig-Maximilians
University, Munich, Germany

Krauseneck, Till, Department of Psychiatry, Ludwig-Maximilians
University, Munich, Germany

Nollert, Georg, Department of Cardiac Surgery, Ludwig-Maximilians
University, Munich, Germany

Kapfhammer, Hans-Peter, Department of Psychiatry, Ludwig-Maximilians
University, Munich, Germany
Address:        Schelling, Gustav, Ludwig-Maximilians University,
Klinikum Grosshadern, Department of Anaesthesiology, 81377, Muenchen,
Germany
Source: Biological Psychiatry, Vol 55(6), Mar 2004. pp. 627-633.

Journal URL:
 http://www.elsevier.com/inca/publications/store/5/0/5/7/5/0/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0006-3223 (Print)
Digital Object Identifier:      10.1016/j.biopsych.2003.09.014 
Language:       English
Keywords:       stress doses; hydrocortisone; traumatic memories;
posttraumatic stress disorder; cardiac surgery; cortisol concentration;
chronic stress 
Abstract:       Traumatic experiences associated with cardiac surgery
(CS) can result in traumatic memories and posttraumatic stress disorder
(PTSD). Because it is known that subjects who develop PTSD often show
sustained reductions in circulating cortisol concentrations, we
performed a prospective, randomized study to examine whether exogenously
administered stress doses of hydrocortisone during the perioperative
period of CS reduces the long-term incidence of chronic stress and PTSD
symptoms. Patients were prospectively randomized to receive either
stress doses of hydrocortisone or standard treatment during the
perioperative period of CS. Of 48 available patients at 6 months after
CS, 26 had received stress doses of hydrocortisone and 22 standard
treatment. Traumatic memories and PTSD symptoms were diagnosed with
previously validated questionnaires. As compared with patients after
standard therapy, patients from the hydrocortisone group had
significantly lower chronic stress symptom scores. There was no
significant difference regarding the number or type of traumatic
memories between the hydrocortisone and the standard treatment groups.
Stress doses of hydrocortisone in patients undergoing CS are associated
with a lower intensity of chronic stress and PTSD symptoms at 6 months
after CS. (PsycINFO Database Record (c) 2004 APA, all rights reserved)
Subjects:       *Emotional Trauma; *Heart Surgery; *Hydrocortisone;
*Posttraumatic Stress Disorder; *Stress; Chronic Illness; Drug Therapy;
Memory 
Classification: Clinical Psychopharmacology (3340)
Population:     Human (10)

Male (30)

Female (40)
Age Group:      Adulthood (18 yrs & older) (300)

Middle Age (40-64 yrs) (360)

Aged (65 yrs & older) (380)
Tests & Measures:       Posttraumatic 10 Stress Symptom Inventory
Form/Content Type:      Empirical Study (0800)

Longitudinal Study (0850)

Prospective Study (0851)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20040419       
Accession Number:       2004-12034-010 
Number of Citations in Source:  44     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-12034-010

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-120
34-010">Stress Doses of Hydrocortisone, Traumatic Memories, and Symptoms
of Posttraumatic Stress Disorder in Patients After Cardiac Surgery: A
Randomized Study.</A>  
       
Database:       PsycINFO       
  _____ 

Record: 18
       
Title:  Pituitary-adrenal responses to standard and low-dose
dexamethasone suppression tests in adult survivors of child abuse.     
Author(s):      Newport, D. Jeffrey, Department of Psychiatry and
Behavioral Sciences, Emory University School of Medicine, Atlanta, GA,
US

Heim, Christine, Department of Psychiatry and Behavioral Sciences, Emory
University School of Medicine, Atlanta, GA, US

Bonsall, Robert, Department of Psychiatry and Behavioral Sciences, Emory
University School of Medicine, Atlanta, GA, US

Miller, Andrew H., Department of Psychiatry and Behavioral Sciences,
Emory University School of Medicine, Atlanta, GA, US

Nemeroff, Charles B., Department of Psychiatry and Behavioral Sciences,
Emory University School of Medicine, Atlanta, GA, US
Address:        Nemeroff, Charles B., Emory University School of
Medicine, Department of Psychiatry and Behavioral Sciences, Woodruff
Memorial Research Building, 1639 Pierce Drive, Suite 4000, Atlanta, GA,
US     
Source: Biological Psychiatry, Vol 55(1), Jan 2004. pp. 10-20.

Journal URL:
 http://www.elsevier.com/inca/publications/store/5/0/5/7/5/0/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0006-3223 (Print)
Digital Object Identifier:      10.1016/S0006-3223(03)00692-9  
Language:       English
Keywords:       pituitary-adrenal responses; childhood trauma; abuse
survivors; major depression; dexamethasone suppression tests;
posttraumatic stress disorder; glucocorticoid feedback; cortisol
suppression; women     
Abstract:       Background: Previous studies indicate that adverse
childhood events are associated with persistent changes in
corticotropin-releasing factor neuronal systems. Our aim was to
determine whether altered glucocorticoid feedback mediates the
neuroendocrine sequelae of childhood trauma. Methods: Standard and
low-dose dexamethasone suppression tests (DST) were performed in women
with a history of child abuse (n = 19), child abuse and major depression
(n = 16), major depression and no childhood trauma (n = 10), and no
history of mental illness or childhood trauma (n = 19). Secondary
analysis with posttraumatic stress disorder (PTSD) as the organizing
diagnosis was also conducted. Results: In the low-dose DST, depressed
women with a history of abuse exhibited greater cortisol suppression
than any comparator group and greater corticotropin suppression than
healthy volunteers or nondepressed abuse survivors. There were no
differences between nondepressed abuse survivors and healthy volunteers
in the low-dose DST or between any subject groups in the standard DST.
The PTSD analysis produced similar results. Conclusions: Cortisol
supersuppression is evident in psychiatrically ill trauma survivors, but
not in nondepressed abuse survivors, indicating that enhanced
glucocorticoid feedback is... (PsycINFO Database Record (c) 2004 APA,
all rights reserved)(journal abstract)
Subjects:       *Child Abuse; *Dexamethasone Suppression Test; *Early
Experience; *Hydrocortisone; *Major Depression; Emotional Trauma;
Posttraumatic Stress Disorder; Survivors       
Classification: Behavior Disorders & Antisocial Behavior (3230)
Population:     Human (10)

Female (40)
Age Group:      Adulthood (18 yrs & older) (300)
Tests & Measures:       Structured Clinical Interview for DSM-IV Axis I
Disorders: Clinician Version

Hamilton Anxiety Rating Scale

Hamilton Rating Scale for Depression
Form/Content Type:      Empirical Study (0800)

Qualitative Study (0880)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20040202       
Accession Number:       2004-10078-002 
Number of Citations in Source:  87     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-10078-002

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-100
78-002">Pituitary-adrenal responses to standard and low-dose
dexamethasone suppression tests in adult survivors of child abuse.</A> 
       
Database:       PsycINFO       
  _____ 

Record: 19
       
Title:  Physical and sexual abuse, salivary cortisol, and neurologic
correlates of violent criminal behavior in female prison inmates.      
Author(s):      Brewer-Smyth, Kathleen, School of Medicine, University
of Pennsylvania, School of Nursing, Philadelphia, PA, US

Wolbert Burgess, Ann, School of Medicine, University of Pennsylvania,
School of Nursing, Philadelphia, PA, US

Shults, Justine, School of Medicine, University of Pennsylvania, Center
for Clinical Epidemiology and Biostatistics, Philadelphia, PA, US
Address:        Brewer-Smyth, Kathleen, College of Health and Nursing
Science, University of Delaware, 313 McDowell Hall, Newark, DE, US     
Source: Biological Psychiatry, Vol 55(1), Jan 2004. pp. 21-31.

Journal URL:
 http://www.elsevier.com/inca/publications/store/5/0/5/7/5/0/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0006-3223 (Print)
Digital Object Identifier:      10.1016/S0006-3223(03)00705-4  
Language:       English
Keywords:       physical abuse; sexual abuse; salivary cortisol;
traumatic brain injuries; neurologic correlates; neuroendocrine
abnormalities; nonviolent crimes; violent criminal behavior; female
prison inmates 
Abstract:       Background: Both physical and emotional traumas have
been related to neurologic and neuroendocrine abnormalities that may be
associated with violent behavior. Methods: A modified case-control
design was used for blinded comparison of 113 female inmates convicted
of violent and nonviolent crimes. History of having been physically or
sexually abused, neurologic history and physical examination, basal
salivary cortisol levels, and associated variables were investigated to
identify possible risk factors for violent compared to nonviolent
criminal convictions. Results: Of all inmates studied, 95% had
neurologic histories predating the current crime and/or neurologic
examination abnormalities. Logistic regression revealed morning cortisol
levels, number of years since last abuse, number of prior suicide
attempts, and traumatic brain injuries with loss of consciousness to be
significantly associated with current violent convictions, with a mean
of two brain injuries with loss of consciousness per subject in the
violent group. Conclusions: A greater number of traumatic brain injuries
with loss of consciousness and suicide attempts, more recent abuse, and
low morning basal salivary cortisol levels could be associated with
dangerous violent criminal behavior, including murder, in female...
(PsycINFO Database Record (c) 2004 APA, all rights reserved)(journal
abstract)
Subjects:       *Child Abuse; *Female Criminals; *Physiological
Correlates; *Risk Factors; *Violent Crime; Criminal Behavior; Early
Experience; Emotional Trauma; Hydrocortisone; Neuroendocrinology;
Physical Abuse; Sexual Abuse; Traumatic Brain Injury   
Classification: Psychological & Physical Disorders (3200)
Population:     Human (10)

Female (40)
Age Group:      Adulthood (18 yrs & older) (300)
Tests & Measures:       Beck Depression Inventory--II
Form/Content Type:      Conference Proceedings/Symposia (0600)

Empirical Study (0800)

Quantitative Study (0890)

Single Blind Design (0892)

Journal Article (2400)
Conference:     Annual Meeting of the American Society of
Neurorehabilitation, May, 2001, Philadelphia, PA, US   
Conference Notes:       An earlier version of this article was presented
at the aforementioned conference, and a different portion of another
draft was presented at the State of the Science Congress, Washington, DC
(2002).
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20040202       
Accession Number:       2004-10078-003 
Number of Citations in Source:  75     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-10078-003

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-100
78-003">Physical and sexual abuse, salivary cortisol, and neurologic
correlates of violent criminal behavior in female prison inmates.</A>  
       
Database:       PsycINFO       
  _____ 

Record: 20
       
Title:  HPA-axis reactivity to interpersonal stress in young adults who
self-injure.   
Author(s):      Mcardle, Eliza T., U Massachusetts Amherst, US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 64(10-B), 2004. pp. 5226.
Publisher:      US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN:   0419-4217 (Print)
Order Number:   AAI3110531     
Language:       English
Keywords:       interpersonal stress; young adults; self-injuries      
Abstract:       The purpose of this study was to examine HPA-axis
functioning in a non-patient sample of self-injurious adolescents in
response to an interpersonal stressor. Salivary cortisol levels were
measured two times prior to and five times following an interpersonal
stressor as markers of HPA-axis reactivity. Women exclusively show a
positive relation between self-injurious behavior and the rate at which
they reach peak cortisol levels. Both trauma symptoms and depressive
symptoms are shown to moderate the relations between self-injurious
behavior and cortisol levels in women. Men show no association between
these factors, perhaps indicating different processes behind and reasons
for self-injurious behavior. These results have implications for
theories of etiology, development, maintenance, and treatment of
self-injurious behavior in patient populations and in the general
public. (PsycINFO Database Record (c) 2004 APA, all rights reserved)
Subjects:       *Interpersonal Communication; *Self Destructive
Behavior; *Stress      
Classification: Health & Mental Health Treatment & Prevention (3300)
Population:     Human (10)
Form/Content Type:      Journal Article (2400)
Publication Type:       Dissertation Abstract (350); Print

Format(s) Available: Print
Release Date:   20041213       
Accession Number:       2004-99008-360 
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-99008-360

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-990
08-360">HPA-axis reactivity to interpersonal stress in young adults who
self-injure.</A>       
       
Database:       PsycINFO       
  _____ 

Record: 21
       
Title:  Posttraumatic stress disorder in children: Relationship between
parental stress, chronic stress exposure, and HPA-axis dysregulation.  
Author(s):      Cerbone, Arleen Beth, Tulane U., US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 64(12-B), 2004. pp. 6370.
Publisher:      US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN:   0419-4217 (Print)
Order Number:   AAI3116918     
Language:       English
Keywords:       posttraumatic stress disorder; parental stress; chronic
stress exposure; children      
Abstract:       This study examines the relation between trauma,
HPA-Axis dysregulation and PTSD symptoms as moderated by exposure to
chronic life stress and parental stress. Sixty-three children and their
parents participated in the study. Participants ranged in age from 7 to
14 years and were predominantly African-American. It was hypothesized
(1) that there would be a significant positive relation between the
number of traumatic events experienced and PTSD symptoms, and that this
relationship would be moderated by both chronic stress and parental
stress, such that as stress increased so would PTSD symptoms; and (2)
that there would be a significant relation between exposure to trauma
and HPA-Axis dysregulation, as measured by cortisol level, such that
cortisol levels would show greater dysregulation under conditions of
high trauma exposure than under conditions of low trauma exposure, and
that this relationship would be moderated by both chronic stress and
parental stress. Results revealed that children in the present sample
endorsed high exposure to trauma and generally low cortisol levels,
although trauma was not directly related to cortisol levels. Chronic
stress moderated the relation between trauma and PTSD symptoms, such
that as chronic stress increased, so did PTSD symptoms. Parental stress
moderated the relation between trauma and PM cortisol, such that as
parental stress increased, PM cortisol decreased. Additionally, chronic
stress by parental stress moderated the relation between trauma and PTSD
symptoms, as well as the relation between trauma and PM cortisol.
Findings are interpreted within a psychobiological framework and suggest
distinct biological processes for traumatic stress versus stress.
(PsycINFO Database Record (c) 2004 APA, all rights reserved)
Subjects:       *Child Care; *Chronic Stress; *Parental Attitudes;
*Posttraumatic Stress Disorder 
Classification: Physiological Psychology & Neuroscience (2500)

Health & Mental Health Treatment & Prevention (3300)
Population:     Human (10)
Age Group:      Childhood (birth-12 yrs) (100)

School Age (6-12 yrs) (180)

Adolescence (13-17 yrs) (200)
Form/Content Type:      Empirical Study (0800)

Journal Article (2400)
Publication Type:       Dissertation Abstract (350); Print

Format(s) Available: Print
Release Date:   20041115       
Accession Number:       2004-99012-257 
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-99012-257

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-990
12-257">Posttraumatic stress disorder in children: Relationship between
parental stress, chronic stress exposure, and HPA-axis
dysregulation.</A>     
       
Database:       PsycINFO       
  _____ 

Record: 22
       
Title:  Trauma as allostatic load: Evidence of long term changes in the
stress response in a nonclinical sample.       
Author(s):      Ganzel, Barbara Lynn, Cornell U., US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 64(12-B), 2004. pp. 6370.
Publisher:      US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN:   0419-4217 (Print)
Order Number:   AAI3114540     
Language:       English
Keywords:       allostatic load; salivary cortisol; biological stress;
substance abuse; social support; locus of control; trauma exposure     
Abstract:       Traditionally in social stress theory, the stress
response has been modeled as static. However, there is substantial
evidence that the biological stress response itself adjusts over time in
response to individual experience, ecological context, and the nature of
the stressor. Establishing ongoing development within the stress
response itself compels a reevaluation of the invariance of biology
within social stress models and focuses a new lens on the mechanisms of
acquired vulnerability and resistance to stress. Integration of previous
conceptualizations of allostasis and allostatic load with recent
findings in the neurobiology of emotion provides a theoretical platform
for incorporating biology into the social psychological study of stress,
resulting in a full model of the pyschosocial stress process. Trauma
exposure may be a key example of an experience that produces long-term
changes in the stress response in normal adults. This possibility was
investigated in a prospective study of women who were exposed to a
uniform single-event stressor (the medical college admissions test).
Subjects ( N = 44) were assessed for social support, locus of control,
and lifetime incidence of substance abuse and affective mental disorders
at baseline. Subjects self-sampled morning and afternoon salivary
cortisol and kept daily diaries of positive and negative mood over a
period of 25 days (for three weeks before the examination, and four days
after). Long-term effects of prior trauma on women's endocrine responses
manifested as a consistent reduction in the afternoon measures of
salivary cortisol across all time points. This finding was unaffected by
control for social support, size of social network, and number of
pre-trauma affective disorders, and was significant only for the group
of women ( n = 19) with a history of exposure to one or more severe
traumas. There were also significant increases in negative mood during
the pre-examination period in the group of women with histories of more
severe trauma exposure, relative to the other women in the study.
Notably, the association between prior trauma and afternoon cortisol
levels appears to be focused in the group experiencing exclusively
social loss traumas, rather than traumas involving personal threat or
harm. (PsycINFO Database Record (c) 2004 APA, all rights reserved)
Subjects:       *Hydrocortisone; *Social Networks; *Social Stress; Drug
Abuse; Internal External Locus of Control; Stress Reactions    
Classification: Physiological Psychology & Neuroscience (2500)
Population:     Human (10)

Female (40)
Form/Content Type:      Empirical Study (0800)

Longitudinal Study (0850)

Prospective Study (0851)

Journal Article (2400)
Publication Type:       Dissertation Abstract (350); Print

Format(s) Available: Print
Release Date:   20041115       
Accession Number:       2004-99012-040 
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-99012-040

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-990
12-040">Trauma as allostatic load: Evidence of long term changes in the
stress response in a nonclinical sample.</A>   
       
Database:       PsycINFO       
  _____ 

Record: 23
       
Title:  Risk and resilience in posttraumatic stress disorder.  
Author(s):      Yehuda, Rachel, Bronx VA Medical Center, Mt. Sinai
School of Medicine, Bronx, NY, US, rachel.yehuda@med.va.gov
Address:        Yehuda, Rachel, Bronx VA Medical Center, 130 West
Kingsbridge Rd., Building 107, Psychiatry 116A OOMH, Room 125A, Bronx,
NY, US, rachel.yehuda@med.va.gov       
Source: Journal of Clinical Psychiatry, Vol 65(Suppl1), 2004. Special
issue: Update on posttraumatic stress disorder. pp. 29-36.
Publisher:      US: Physicians Postgraduate Press

Publisher URL: http://www.psychiatrist.com/
ISSN:   0160-6689 (Print)
Language:       English
Keywords:       posttraumatic stress disorder; life threatening trauma;
cortisol levels; terrorist activity; traumatic memories; PTSD patients;
symptoms; at risk populations; neuroendocrine changes  
Abstract:       Posttraumatic stress disorder (PTSD) is a common
psychiatric disorder. In light of recent war and terrorist activity
worldwide, it is likely that increased numbers of individuals will be
exposed to severe or life-threatening trauma, and the incidence of PTSD
may be even higher. PTSD may develop after exposure to a traumatic event
where the individual experienced, witnessed, or was confronted by either
actual or threatened loss of life or serious injury. Patients may
reexperience intrusive recollections of the event in ways that are
highly distressing and may be described as reliving the memory. Symptoms
of avoidance are noted because patients wish to escape recollections
(thoughts, feelings, conversations, places) related to the trauma. They
also experience symptoms of hyperarousal and difficulty concentrating or
exaggerated startle response. PTSD patients represent only a subset of
those exposed to trauma. It is of interest why certain individuals are
at risk for development of PTSD. Studies suggest that previous exposure
to trauma and intensity of the response to acute trauma may affect the
development of PTSD. Neuroendocrine changes, such as lower cortisol
levels, also may influence formation and processing of traumatic
memories and may be associated with PTSD. (PsycINFO Database Record (c)
2004 APA, all rights reserved)
Subjects:       *Emotional Trauma; *Epidemiology; *Etiology;
*Posttraumatic Stress Disorder; *Stress; At Risk Populations;
Neuroendocrinology; Symptoms   
Classification: Affective Disorders (3211)
Population:     Human (10)
Form/Content Type:      Conference Proceedings/Symposia (0600)

Literature Review (1300)

Journal Article (2400)
Conference:     The International Consensus Group on Depression and
Anxiety, 8th, Jul, 2002, Limerick, Ireland     
Conference Notes:       This article is derived from the aforementioned
proceedings.   
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20040217       
Accession Number:       2004-10639-004 
Number of Citations in Source:  52     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-10639-004

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-106
39-004">Risk and resilience in posttraumatic stress disorder.</A>      
       
Database:       PsycINFO       
  _____ 

Record: 24
       
Title:  Resting Regional Cerebral Perfusion in Recent Posttraumatic
Stress Disorder.       
Author(s):      Bonne, Omer, Department of Psychiatry, Hadassah
University Hospital, Jerusalem, Israel

Gilboa, Asaf, Department of Psychiatry, Hadassah University Hospital,
Jerusalem, Israel

Louzoun, Yoram, Department of Nuclear Medicine, Hadassah University
Hospital, Jerusalem, Israel

Brandes, Dalia, Department of Psychiatry, Hadassah University Hospital,
Jerusalem, Israel

Yona, Ilan, Department of Psychiatry, Hadassah University Hospital,
Jerusalem, Israel

Lester, Hava, Department of Nuclear Medicine, Hadassah University
Hospital, Jerusalem, Israel

Barkai, Gavriel, Department of Psychiatry, Hadassah University Hospital,
Jerusalem, Israel

Freedman, Nanette, Department of Nuclear Medicine, Hadassah University
Hospital, Jerusalem, Israel

Chisin, Roland, Department of Nuclear Medicine, Hadassah University
Hospital, Jerusalem, Israel

Shalev, Arieh Y., Department of Psychiatry, Hadassah University
Hospital, Jerusalem, Israel
Address:        Bonne, Omer, Mood and Anxiety Disorders Program,
National Institute of Mental Health, 15K North Drive, Room 200,
Bethesda, MD, US       
Source: Biological Psychiatry, Vol 54(10), Nov 2003. pp. 1077-1086.

Journal URL:
 http://www.elsevier.com/inca/publications/store/5/0/5/7/5/0/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0006-3223 (Print)
Digital Object Identifier:      10.1016/S0006-3223(03)00525-0  
Language:       English
Keywords:       posttraumatic stress disorder; temporal lobe;
cerebellum; cortisol; cerebral blood flow      
Abstract:       Brain imaging research in posttraumatic stress disorder
has been largely performed on patients with chronic disease, often
heavily medicated, with current or past alcohol and substance abuse.
Additionally, virtually only activation brain imaging paradigms have
been done in posttraumatic stress disorder, whereas in other mental
disorders both resting and activation studies have been performed.
Twenty-eight (11 posttraumatic stress disorder) trauma survivors
underwent resting state hexamethylpropyleneamineoxime single photon
emission computed tomography and magnetic resonance imaging 6 months
after trauma. Eleven nontraumatized subjects served as healthy controls.
Regional cerebral blood flow in the cerebellum was higher in
posttraumatic stress disorder than in both control groups. Regional
cerebral blood flow in right precentral, superior temporal, and fusiform
gyri in posttraumatic stress disorder was higher than in healthy
controls. Cerebellar and extrastriate regional cerebral blood flow were
positively correlated with continuous measures of depression and
posttraumatic stress disorder. Cortisol level in posttraumatic stress
disorder was negatively correlated with medial temporal lobe perfusion.
Anterior cingulate perfusion and cortisol level were positively
correlated in... (PsycINFO Database Record (c) 2004 APA, all rights
reserved)(journal abstract)
Subjects:       *Brain; *Cerebellum; *Cerebral Blood Flow;
*Posttraumatic Stress Disorder; *Temporal Lobe; Hydrocortisone 
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Male (30)

Female (40)
Location:       Israel 
Tests & Measures:       Beck Depression Inventory

Clinician-Administered PTSD Scale
Form/Content Type:      Empirical Study (0800)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20031201       
Accession Number:       2003-09950-014 
Number of Citations in Source:  70     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-09950-014

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-099
50-014">Resting Regional Cerebral Perfusion in Recent Posttraumatic
Stress Disorder.</A>   
       
Database:       PsycINFO       
  _____ 

Record: 25
       
Title:  Salivary cortisol responses to dexamethasone in adolescents with
posttraumatic stress disorder. 
Author(s):      Lipschitz, Deborah S., Yale University School of
Medicine, New Haven, CT, US, deborah.lipschitz@yale.edu

Rasmusson, Ann M., Yale University School of Medicine, New Haven, CT, US

Yehuda, Rachel, Mount Sinai School of Medicine, New York, NY, US

Wang, Shelia, Yale University School of Medicine, New Haven, CT, US

Anyan, Walter, Yale University School of Medicine, New Haven, CT, US

Gueoguieva, Ralitza, Yale University School of Medicine, New Haven, CT,
US

Grilo, Carlos M., Yale University School of Medicine, New Haven, CT, US

Fehon, Dwain C., Yale University School of Medicine, New Haven, CT, US

Southwick, Steven M., Yale University School of Medicine, New Haven, CT,
US
Address:        Lipschitz, Deborah S., University Towers, Suite 2H, 100
York Street, New Haven, CT, US, deborah.lipschitz@yale.edu     
Source: Journal of the American Academy of Child & Adolescent
Psychiatry, Vol 42(11), Nov 2003. pp. 1301-1317.

Journal URL: http://www.jaacap.com/
Publisher:      US: Lippincott Williams & Wilkins

Publisher URL: http://www.lww.com/
ISSN:   0890-8567 (Print)
Language:       English
Keywords:       posttraumatic stress disorder; Dexamethasone; salivary
cortisol responses     
Abstract:       Objective: Previous studies of adults with posttraumatic
stress disorder (PTSD) have found various abnormalities in the
regulation of the hypothalamic-pituitary-adrenal axis, including
enhanced suppression of cortisol following low-dose dexamethasone. The
purpose of the present study was to investigate salivary cortisol
responses to low-dose dexamethasone in adolescents with PTSD. Method:
Forty-eight adolescents (20 with current PTSD, 9 trauma controls without
PTSD, and 19 healthy nontraumatized controls) were enrolled in the
study. On day 1, baseline saliva samples were obtained at 8 A.M. and 0.5
mg of dexamethasone was administered at 11 P.M. Cortisol and
dexamethasone levels were assessed at 8 A.M. the following day. Results:
Adolescents with current PTSD showed no difference in the suppression of
salivary cortisol in response to low-dose (0.5 mg) dexamethasone
compared to trauma controls without PTSD and nontraumatized controls.
More severely affected PTSD subjects with co-occurring major depression
showed higher pre- and post-dexamethasone salivary cortisol levels
compared to controls. Conclusions: The present study did not find
evidence for enhanced suppression of salivary cortisol at 8 A.M.
following low-dose dexamethasone in multiply traumatized adolescents
with PTSD... (PsycINFO Database Record (c) 2004 APA, all rights
reserved)(journal abstract)
Subjects:       *Dexamethasone; *Posttraumatic Stress Disorder;
*Salivation    
Classification: Clinical Psychopharmacology (3340)
Population:     Human (10)
Age Group:      Adolescence (13-17 yrs) (200)
Tests & Measures:       Childhood Trauma Questionnaire

Beck Depression Inventory
Form/Content Type:      Empirical Study (0800)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20031201       
Accession Number:       2003-09226-009 
Number of Citations in Source:  35     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-09226-009

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-092
26-009">Salivary cortisol responses to dexamethasone in adolescents with
posttraumatic stress disorder.</A>     
       
Database:       PsycINFO       
  _____ 

Record: 26
       
Title:  Enhanced Cellular Immune Response in Women With PTSD Related to
Childhood Abuse.       
Author(s):      Altemus, Margaret, Cornell U, Dept of Psychiatry, Weill
Medical Coll, New York, NY, US, maltemus@med.cornell.edu

Cloitre, Marylene

Dhabhar, Firdaus S.
Address:        Altemus, Margaret, Dept of Psychiatry, Weill Medical
Coll, 1300 York Ave., Box 244, New York, NY, US,
 maltemus@med.cornell.edu       
Source: American Journal of Psychiatry, Vol 160(9), Sep 2003. pp.
1705-1707.

Journal URL: http://ajp.psychiatryonline.org/
Publisher:      US: American Psychiatric Assn

Publisher URL: http://www.appi.org
ISSN:   0002-953X (Print)
Digital Object Identifier:      10.1176/appi.ajp.160.9.1705    
Language:       English
Keywords:       delayed-type hypersensitivity; posttraumatic stress
disorder; cellular immune response; women; child abuse; trauma;
psychiatric disorders; salivary cortisol; plasma cortisol; inflammatory
reactions      
Abstract:       Disturbed regulation of both the
hypothalamic-pituitary-adrenal (HPA) axis and the
sympathoadrenomedullary system in posttraumatic stress disorder (PTSD)
suggests that immune function, which is modulated by these systems, also
may be dysregulated in individuals with PTSD. Delayed-type
hypersensitivity skin test responses were measured in 16 women with PTSD
due to childhood sexual or physical abuse and 15 women who did not have
a history of abuse, other trauma, or psychiatric disorders. HPA axis
activity was assessed by examination of circadian salivary cortisol
levels and a single time point measurement of plasma cortisol. Results
show that delayed-type hypersensitivity was enhanced in women with PTSD.
Cortisol measures did not differ between PTSD and healthy comparison
subjects. The authors conclude that these results suggest that
cell-mediated inflammatory reactions are greater in individuals with
PTSD. (PsycINFO Database Record (c) 2004 APA, all rights reserved)
Subjects:       *Emotional Trauma; *Human Females; *Hydrocortisone;
*Immunoreactivity; *Posttraumatic Stress Disorder; Blood Plasma; Child
Abuse; Mental Disorders; Saliva
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Female (40)
Age Group:      Adulthood (18 yrs & older) (300)
Tests & Measures:       Clinician-Administered PTSD Scale

Structured Clinical Interview for DSM-IV Axis I Disorders
Form/Content Type:      Empirical Study (0800)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Electronic

Format(s) Available: Print; Electronic
Release Date:   20031027       
Accession Number:       2003-07539-027 
Number of Citations in Source:  12     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-07539-027

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-075
39-027">Enhanced Cellular Immune Response in Women With PTSD Related to
Childhood Abuse.</A>   
       
Database:       PsycINFO       
  _____ 

Record: 27
       
Title:  Endocrine, cognitive and hippocampal/cortical 5HT-sub(1A/2A)
receptor changes evoked by a time-dependent sensitisation (TDS) stress
model in rats. 
Author(s):      Harvey, Brian H., Division of Pharmacology, School of
Pharmacy, Potchefstroom University for Christian Higher Education,
Potchefstroom, South Africa, fklbhh@puknet.puk.ac.za

Naciti, Carla, Division of Pharmacology, School of Pharmacy,
Potchefstroom University for Christian Higher Education, Potchefstroom,
South Africa

Brand, Linda, Division of Pharmacology, School of Pharmacy,
Potchefstroom University for Christian Higher Education, Potchefstroom,
South Africa

Stein, Dan J., MRC Unit on Anxiety and Stress Disorders, Department of
Psychiatry, University of Stellenbosch, Tygerberg, South Africa
Address:        Harvey, Brian H., Division of Pharmacology, School of
Pharmacy, Potchefstroom University for Christian Higher Education,
Potchefstroom, South Africa, 2520, fklbhh@puknet.puk.ac.za     
Source: Brain Research, Vol 983(1-2), Sep 2003. pp. 97-107.

Journal URL: http://www.elsevier.com/locate/brainres
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0006-8993 (Print)
Digital Object Identifier:      10.1016/S0006-8993(03)03033-6  
Language:       English
Keywords:       hippocampus; serotonin; Posttraumatic stress disorder;
prefrontal cortex; spatial memory; time-dependent sensitization
Abstract:       Post traumatic stress disorder (PTSD) is characterised
by hyperarousal, anxiety and amnesic symptoms. Deficits in explicit
memory recall have been causally related to volume reductions of the
hippocampus and prefrontal cortex. While stress-related glucocorticoid
secretion appears involved in this apparent atrophy, there is also
evidence for low plasma cortisol in PTSD. Prior exposure to trauma is an
important risk factor for PTSD, suggesting a role for sensitisation.
Using Sprague-Dawley rats, we studied the effects of a time-dependent
sensitisation (TDS) model of stress on spatial memory deficits, 1 week
post-stress, using the Morris water maze. Basal and 7-day post-stress
plasma corticosterone levels were also determined. Due to the putative
role of serotonin in anxiety and stress, and in the treatment of PTSD,
hippocampal 5HT-sub(1A) and prefrontal cortex 5HT-sub(2A) radioligand
binding studies were performed. TDS stress evoked a marked deficit in
spatial memory on day 7 post TDS stress, coupled with significantly
depressed plasma corticosterone levels. Moreover, TDS stress induces
diverse adaptive 5HT receptor changes in critical brain areas involved
in emotion and memory that may underlie the effect of stress on
cognitive function. (PsycINFO Database Record (c) 2004 APA, all rights
reserved)
Subjects:       *Hippocampus; *Posttraumatic Stress Disorder;
*Prefrontal Cortex; *Serotonin; *Spatial Memory; Anxiety; Rats; Stress 
Classification: Neuropsychology & Neurology (2520)
Population:     Animal (20)

Male (30)
Form/Content Type:      Empirical Study (0800)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20040830       
Accession Number:       2003-07998-006 
Number of Citations in Source:  58     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-07998-006

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-079
98-006">Endocrine, cognitive and hippocampal/cortical 5HT-sub(1A/2A)
receptor changes evoked by a time-dependent sensitisation (TDS) stress
model in rats.</A>     
       
Database:       PsycINFO       
  _____ 

Record: 28
       
Title:  Higher Cortisol Levels Following Exposure to Traumatic Reminders
in Abuse-Related PTSD. 
Author(s):      Elzinga, Bernet M., Section of Clinical & Health
Psychology, Leiden U, Leiden, Netherlands, elzinga@fsw.leidenuniv.nl

Schmahl, Christian G., Dept of Psychiatry & Psychotherapy, U Freiburg
Medical School, Freiburg, Germany

Vermetten, Eric, Dept of Psychiatry, University Medical Ctr, Central
Military Hosp, Netherlands

van Dyck, Richard, Dept of Psychiatry, Vrije U, Amsterdam, Netherlands

Bremner, J. Douglas, Depts of Psychiatry & Behavioral Sciences &
Radiology, Ctr for Positron Emission Tomography, Emory U School of
Medicine, Atlanta, GA, US
Address:        Elzinga, Bernet M., Section of Clinical & Health
Psychology, Leiden U, PO Box 9555, 2300 RB, Leiden, Netherlands,
 elzinga@fsw.leidenuniv.nl      
Source: Neuropsychopharmacology, Vol 28(9), Sep 2003. pp. 1656-1665.

Journal URL: http://www.nature.com/npp/
Publisher:      United Kingdom: Nature Publishing

Publisher URL: http://www.nature.com/
ISSN:   0893-133X (Print)
Digital Object Identifier:      10.1038/sj.npp.1300226 
Language:       English
Keywords:       memory; PTSD; post-traumatic stress disorder; salivary
cortisol; stress-induced cortisol; childhood abuse     
Abstract:       The first purpose of this study was to assess cortisol
responsivity to traumatic reminders in women with posttraumatic stress
disorder (PTSD) related to childhood abuse. The second aim was to assess
the relationship between stress-induced cortisol levels and neutral and
emotional memory. Salivary cortisol levels were measured before, during
and after exposure to personalized trauma scripts in abused women with
(N=12) and without current PTSD (N=12). Memory for neutral and emotional
material was assessed immediately after trauma scripts exposure and 3
days later. PTSD patients had 122% higher cortisol levels during script
exposure, 69% higher cortisol levels during recovery, and 60% higher
levels in the period leading up to the script exposure compared to
controls. PTSD symptoms were highly predictive of cortisol levels during
trauma script exposure, but not during periods of rest. Both in PTSD
patients and controls, memory consolidation after the trauma scripts was
impaired relative to baseline, with no differences between the two
groups on memory performance. There was no association between memory
performance and cortisol levels. These results are consistent with
higher cortisol levels following exposure to traumatic stressors in
PTSD. (PsycINFO Database Record (c) 2004 APA, all rights reserved)
Subjects:       *Hydrocortisone; *Posttraumatic Stress Disorder;
*Stress; Child Abuse; Memory   
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Female (40)
Age Group:      Adulthood (18 yrs & older) (300)

Thirties (30-39 yrs) (340)
Tests & Measures:       Dissociative Experiences Scale

Clinician-Administered PTSD Scale

Hamilton Rating Scale for Depression

Structured Clinical Interview for DSM-IV Axis I Disorders
Form/Content Type:      Empirical Study (0800)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20030929       
Accession Number:       2003-07716-012 
Number of Citations in Source:  68     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-07716-012

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-077
16-012">Higher Cortisol Levels Following Exposure to Traumatic Reminders
in Abuse-Related PTSD.</A>     
       
Database:       PsycINFO       
  _____ 

Record: 29
       
Title:  Dexamethasone Suppression Test Findings in Subjects With
Personality Disorders: Associations With Posttraumatic Stress Disorder
and Major Depression.  
Author(s):      Grossman, Robert, Mount Sinai School of Medicine, Dept
of Psychiatry, New York, NY, US, robert.a.grossman@mssm.edu

Yehuda, Rachel

New, Antonia

Schmeidler, James

Silverman, Jeremy

Mitropoulou, Vivian

Maria, Nelly Sta.

Golier, Jiulia

Siever, Larry
Address:        Grossman, Robert, Dept of Psychiatry, Mount Sinai School
of Medicine, Box 1230, New York, NY, US, robert.a.grossman@mssm.edu    
Source: American Journal of Psychiatry, Vol 160(7), Jul 2003. pp.
1291-1297.

Journal URL: http://ajp.psychiatryonline.org/
Publisher:      US: American Psychiatric Assn

Publisher URL: http://www.appi.org
ISSN:   0002-953X (Print)
Digital Object Identifier:      10.1176/appi.ajp.160.7.1291    
Language:       English
Keywords:       dexamethasone suppression; cortisol suppression; major
depression; comorbid posttraumatic stress disoder; PTSD; personality
disorders; gender differences; age differences 
Abstract:       Objective: Previous studies using the 1.0-mg
dexamethasone suppression test (DST) in subjects with personality
disorders have produced mixed results. However, these studies focused on
major depression and did not consider the possible effects of the
comorbidity of posttraumatic stress disorder (PTSD). PTSD has been shown
to be associated with increased cortisol suppression. To investigate the
effect of PTSD, the authors conducted a 0.5-mg DST, which is more
sensitive than the 1.0-mg DST for detection of increased cortisol
suppression, in a group of subjects with personality disorders. Method:
Subjects with personality disorders (N=52) ingested 0.5 mg of
dexamethasone. Pre- and postfasting blood samples were drawn for
measurement of cortisol levels. A three-way analysis of covariance was
used to test for the main effects of major depression, PTSD, and gender
on percent cortisol suppression, with plasma dexamethasone concentration
as a covariate. Secondary analyses assessed for main and interaction
effects of age at which trauma(s) occurred and a diagnosis of borderline
personality disorder. Results: Neither major depression nor gender had a
significant effect on percent cortisol suppression. Subjects with PTSD
had significantly higher percent cortisol suppression than subjects...
(PsycINFO Database Record (c) 2004 APA, all rights reserved)(journal
abstract)
Subjects:       *Dexamethasone Suppression Test; *Hydrocortisone; *Major
Depression; *Personality Disorders; *Posttraumatic Stress Disorder; Age
Differences; Comorbidity; Human Sex Differences
Classification: Personality Disorders (3217)
Population:     Human (10)

Male (30)

Female (40)
Location:       US     
Age Group:      Adulthood (18 yrs & older) (300)

Young Adulthood (18-29 yrs) (320)

Thirties (30-39 yrs) (340)

Middle Age (40-64 yrs) (360)
Tests & Measures:       Childhood Trauma Questionnaire
Form/Content Type:      Empirical Study (0800)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Electronic

Format(s) Available: Print; Electronic
Release Date:   20030721       
Accession Number:       2003-05744-015 
Number of Citations in Source:  44     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-05744-015

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-057
44-015">Dexamethasone Suppression Test Findings in Subjects With
Personality Disorders: Associations With Posttraumatic Stress Disorder
and Major Depression.</A>      
       
Database:       PsycINFO       
  _____ 

Record: 30
       
Title:  Prospective evaluation of plasma cortisol in recent trauma
survivors with posttraumatic stress disorder.  
Author(s):      Bonne, Omer, The Center for Traumatic Stress, Hadassah
University Hospital, Jerusalem, Israel, bonneo@intra.nimh.nih.gov

Brandes, Dalia, The Center for Traumatic Stress, Hadassah University
Hospital, Jerusalem, Israel

Segman, Ronen, The Center for Traumatic Stress, Hadassah University
Hospital, Jerusalem, Israel

Pitman, Roger K., Massachusetts General Hospital, Harvard Medical
School, Boston, MA, US

Yehuda, Rachel, Department of Psychiatry, Mount Sinai School of
Medicine, New York, NY, US

Shalev, Arieh Y., The Center for Traumatic Stress, Hadassah University
Hospital, Jerusalem, Israel
Address:        Bonne, Omer, Mood and Anxiety Disorders Program,
National Institute of Mental Health, 15K North Drive, Room 200,
Bethesda, MD, US, bonneo@intra.nimh.nih.gov    
Source: Psychiatry Research, Vol 119(1-2), Jul 2003. pp. 171-175.

Journal URL:
 http://www.elsevier.com/wps/find/journaldescription.cws_home/522773/desc
ription#description
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0165-1781 (Print)
Digital Object Identifier:      10.1016/S0165-1781(03)00098-2  
Language:       English
Keywords:       plasma cortisol; PTSD symptoms; hypothalamic pituitary
adrenal axis abnormalities; clinician administered PTSD scale;
posttraumatic stress disorder  
Abstract:       Hypothalamic pituitary adrenal axis abnormalities have
been described in posttraumatic stress disorder (PTSD), and among the
recently traumatized. Plasma cortisol and continuous measures of PTSD
symptoms were obtained from 21 survivors, at 1 week and 6 months after
traumatic events. Eight survivors met Clinician Administered PTSD Scale
criteria for PTSD at 6 months. Cortisol levels at 1 week did not predict
subsequent PTSD. Survivors with and without PTSD had similar mean levels
of cortisol at both time points. Cortisol levels at 6 months negatively
correlated with self-reported PTSD symptoms within PTSD subjects.
(PsycINFO Database Record (c) 2004 APA, all rights reserved)(journal
abstract)
Subjects:       *Hydrocortisone; *Hypothalamo Pituitary Adrenal System;
*Physiological Correlates; *Posttraumatic Stress Disorder; *Survivors;
Evaluation     
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Male (30)

Female (40)
Location:       Israel 
Age Group:      Adulthood (18 yrs & older) (300)
Form/Content Type:      Empirical Study (0800)

Longitudinal Study (0850)

Prospective Study (0851)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20030818       
Accession Number:       2003-05963-021 
Number of Citations in Source:  24     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-05963-021

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-059
63-021">Prospective evaluation of plasma cortisol in recent trauma
survivors with posttraumatic stress disorder.</A>      
       
Database:       PsycINFO       
  _____ 

Record: 31
       
Title:  Hipersupresión de cortisol con dexametasona en el trastorno
límite de la personalidad. Un estudio piloto.  
Translated Title:       Enhanced suppression of cortisol after
dexamethasone in borderline personality disorder. A pilot study.       
Author(s):      Carrasco, J. L., Hospital Clínico San Carlos, Madrid,
Spain, jcarrasco.hcsc@salud.madrid.org

Díaz-Marsá, M., Fundación Jiménez Díaz, Madrid, Spain

Pastrana, J. Ignacio, Fundación Jiménez Díaz, Madrid, Spain

Molina, R., Fundación Jiménez Díaz, Madrid, Spain

Brotons, L., Fundación Jiménez Díaz, Madrid, Spain

Horcajadas, C., Fundación Jiménez Díaz, Madrid, Spain
Address:        Carrasco, J. L., Servicio de Psiquiatria, Hospital
Clinico San Carlos, Martin Lagos, s/n, 28040, Madrid, Spain,
 jcarrasco.hcsc@salud.madrid.org
Source: Actas Españolas de Psiquiatría, Vol 31(3), May-Jun 2003. pp.
138-141.

Journal URL:
 http://db.doyma.es/cgi-bin/wdbcgi.exe/doyma/mrevista_info.sobre?pident_r
evista=104
Publisher:      Spain: Grupo Ars XXI de Comunicacion, S.A.

Publisher URL: http://www.ArsXXI.com
ISSN:   1139-9287 (Print)
Language:       Spanish
Keywords:       borderline personality disorder; post-traumatic stress
disorder; dexamethasone suppression; childhood trauma events;
hypothalamic pituitary adrenal; hypersensitive response
Abstract:       Some studies have suggested the etiological role of
childhood traumatic events in borderline personality disorder involving the stress response mechanisms and the activity of
hypothalamic-pituitary adrenal axis. Recent preliminary results show
that BPD, similar to that found in post-traumatic stress disorder might
have a hypersensitive response to the dexamethasone test. Fourteen BPD
patients, diagnosed according to DSM-IV criteria, without a major
depressive episode or history of bipolar or psychotic disorder, were
compared with 10 patients with other personality disorders. Plasma
cortisol was measured at baseline and following an oral test with 0.25
mg of dexamethasone. Nine out of 14 BPD patients were cortisol
suppressors in the test versus only 2 out of 10 patients with other
personality disorders. The degree of cortisol suppression was
significantly greater for BPD patients (73%) than for patients with
other personality disorder (34%). Baseline cortisol concentrations,
although lower in BPD patients, were not significantly different among
groups. BPD could be associated with hypersensitivity of feedback
mechanisms of the HPA axis similar to PSD, which suggests a possible
role for traumatic experiences in the pathogenesis of the disorder.
(PsycINFO Database Record (c) 2004 APA, all rights reserved)
Subjects:       *Borderline Personality Disorder; *Hypothalamo Pituitary
Adrenal System; *Immunoreactivity; *Major Depression; *Posttraumatic
Stress Disorder; Comorbidity; Dexamethasone; Hydrocortisone; Stress    
Classification: Personality Disorders (3217)
Population:     Human (10)
Form/Content Type:      Empirical Study (0800)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20040628       
Accession Number:       2003-99986-005 
Number of Citations in Source:  16     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-99986-005

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-999
86-005">Hipersupresión de cortisol con dexametasona en el trastorno
límite de la personalidad. Un estudio piloto.</A>      
       
Database:       PsycINFO       
  _____ 

Record: 32
       
Title:  Biological Factors in Patients with Post-traumatic Stress
Disorder and Alcoholism.       
Author(s):      Thaller, Vlatko, University Department of Psychiatry KB
"Sestre Milosrdnice", Referal Centre for Alcoholism Ministry of Health,
Zagreb, Croatia, vlatko.thaller@zg.tel.hr

Marušic, Srdan, University Department of Psychiatry KB "Sestre
Milosrdnice", Referal Centre for Alcoholism Ministry of Health, Zagreb,
Croatia

Katinic, Krizo, University Department of Psychiatry KB "Sestre
Milosrdnice", Referal Centre for Alcoholism Ministry of Health, Zagreb,
Croatia

Buljan, Danijel, University Department of Psychiatry KB "Sestre
Milosrdnice", Referal Centre for Alcoholism Ministry of Health, Zagreb,
Croatia

Golik-Gruber, Vesna, University Department of Psychiatry KB "Sestre
Milosrdnice", Referal Centre for Alcoholism Ministry of Health, Zagreb,
Croatia

Potkonjak, Jelena, University Department of Psychiatry KB "Sestre
Milosrdnice", Referal Centre for Alcoholism Ministry of Health, Zagreb,
Croatia
Address:        Thaller, Vlatko, University Department of Psychiatry KB
"Sestre Milosrdnice", Referal Centre for Alcoholism, Ministry of Health,
Vinogradska, HR-10000, Zagreb, Croatia, vlatko.thaller@zg.tel.hr       
Source: European Journal of Psychiatry, Vol 17(2), Apr-Jun 2003. pp.
87-98.
Publisher:      Spain: European Journal of Psychiatry
ISSN:   0213-6163 (Print)
Language:       English
Keywords:       neuroendocrine system damage; post-traumatic stress
disorder; alcoholism; biological factors; defence mechanism; traumatic
events; stress reactions; hormone production; mental functions 
Abstract:       Exposure to numerous stressful events cause the
development of body defence mechanisms, as a result of numerous factors,
where mostly the CNS, but also the adrenal and cardiorespiratory system
play the major roles. When the inner homeostasis is endangered, the
neuroendocrine system is activated, and its response to danger depends
upon the intensity of the stressor, duration of exposure and capability
of the system to compensate stress. The exposure to stress and the
direct effect of the stressor initiates yet another defence mechanism,
that is the increased consumption of alcohol, as a manner of
self-medication under the direct influence of the stressor. Both PTSD
and alcoholism can gradually lead to damage to the neuroendocrine
system. In our study of the function of the neuroendocrine system, we
included patients suffering from PTSD and alcoholism and a group of
patients suffering only from alcoholism. We measured the levels of
cortisol in serum and 24 hr urine, dexamethasone suppression test and
serum levels of ACTH, TSH, T3, T4, testosterone, prolactine and growth
hormone. The presence of alterations of the neuroendocrine axes in both
groups of subjects tested is more pronounced in the group of subjects
with comorbidity of PTSD and alcoholism. (PsycINFO Database Record (c)
2004 APA, all rights reserved)
Subjects:       *Alcoholism; *Neuroendocrinology; *Posttraumatic Stress
Disorder; *Stress Reactions; Comorbidity; Emotional Trauma; Hormones   
Classification: Psychological & Physical Disorders (3200)
Population:     Human (10)

Male (30)

Female (40)
Age Group:      Adulthood (18 yrs & older) (300)
Form/Content Type:      Empirical Study (0800)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print
Release Date:   20030908       
Accession Number:       2003-07318-003 
Number of Citations in Source:  26     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-07318-003

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-073
18-003">Biological Factors in Patients with Post-traumatic Stress
Disorder and Alcoholism.</A>   
       
Database:       PsycINFO       
  _____ 

Record: 33
       
Title:  Proactive sensitizing effects of acute stress on acoustic
startle responses and experimentally induced colitis in rats:
Relationship to corticosterone.
Author(s):      Milde, Anne Marita, Department of Biological and Medical
Psychology, University of Bergen, Bergen, Norway,
 anne.milde@psybp.uib.no

Sundberg, HÃ¥kan, Department of Biological and Medical Psychology,
University of Bergen, Bergen, Norway

Roseth, Arne G., Department of Medicine, Aker University Hospital, Oslo,
Norway

Murison, Robert, Department of Biological and Medical Psychology,
University of Bergen, Bergen, Norway
Address:        Milde, Anne Marita, Department of Biological and Medical
Psychology, University of Bergen, Arstadveien 21, 5009, Bergen, Norway,
 anne.milde@psybp.uib.no
Source: Stress: The International Journal on the Biology of Stress, Vol
6(1), Feb 2003. pp. 49-57.
Publisher:      United Kingdom: Taylor & Francis

Publisher URL: http://www.taylorandfrancis.com/
ISSN:   1025-3890 (Print)
Digital Object Identifier:      10.1080/1025389031000075808    
Language:       English
Keywords:       sensitizing effects; acute stress; acoustic startle
responses; colitis; rats; corticosterone; dextran sulphate sodium      
Abstract:       In humans, some individuals develop a syndrome after
trauma (post-traumatic stress disorder, PTSD) characterized by increased
startle responses and lower than normal cortisol secretion. We explored
a rat model using the acoustic startle response (ASR) as a behavioral
indicator of the effect of a short series of shocks. Because
gastrointestinal disorders have been associated with prior stress, we
also studied the rats' vulnerability to a chemically-induced colitis.
After initial blood sampling, 12 rats were exposed to ten 1 mA 5 s
foot-shocks while 12 rats served as controls. Nineteen days later the
rats were tested for ASR. Thirty trials (10 trials at each of 95, 105,
and 115dB, pseudo-randomized) were given. After exposure for 6 days to
dextran sulphate sodium in their drinking water, the rats were killed
and the colons examined for erosions. Shocked rats showed greater
startle responses and more colonic erosion than unshocked rats, but the
shock effects were significant only for animals with low initial plasma
corticosterone levels. Shocked rats also showed higher levels of
granulocyte marker protein (GMP) in their feces. These results suggest
that low Corticosterone secretion may represent a marker for
vulnerability to long term effects of shocks as indicated by increased
startle responses and colonic pathology. (PsycINFO Database Record (c)
2004 APA, all rights reserved)(journal abstract)
Subjects:       *Acoustic Reflex; *Colitis; *Corticosterone; *Startle
Reflex; *Stress; Rats  
Classification: Psychophysiology (2560)
Population:     Animal (20)

Male (30)
Form/Content Type:      Empirical Study (0800)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Electronic

Format(s) Available: Print; Electronic
Release Date:   20040913       
Accession Number:       2004-17016-007 
Number of Citations in Source:  56     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-17016-007

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2004-170
16-007">Proactive sensitizing effects of acute stress on acoustic
startle responses and experimentally induced colitis in rats:
Relationship to corticosterone.</A>    
       
Database:       PsycINFO       
  _____ 

Record: 34
       
Title:  The relationship among hormone levels, amnesia, and
post-traumatic stress in motor vehicle accident victims.       
Author(s):      Flesher, Mitchell Roy, Kent State U., US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 64(1-B), 2003. pp. 417.
Publisher:      US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN:   0419-4217 (Print)
Order Number:   AAI3077605     
Language:       English
Keywords:       hormone levels; amnesia; post-traumatic stress; motor
vehicle accident; trauma victims; amnesic patients; susceptibility     
Abstract:       The literature regarding amnesia and post-traumatic
stress reveals disagreement as to whether a trauma victim can
subsequently develop post-traumatic stress from an event for which
he/she is amnesic. Conflicting results may be attributable to
inconsistencies in defining amnesic status. Previous research has
suggested that amnesic patients who Nave no memory of the precipitating
trauma display different hormone profiles in the immediate aftermath of
the event and are less likely to develop subsequent PTSD. The present
study examines hormone levels and subsequent ASD and PTSD among amnesic
and nonamnesic victims of motor vehicle accidents (MVAs). Initial
urinary catecholamines and cortisol and subsequent salivary cortisol
levels were assessed in hospitalized MVA victims. Participants were
evaluated for ASD symptoms two weeks following the accident and PTSD
symptoms six weeks post-accident. Amnesic patients displayed lower
initial cortisol levels, and higher morning salivary cortisol levels and
greater difference between morning and evening levels compared to
nonamnesics two weeks following the accident. Furthermore, amnesics
demonstrated lower incidence of PTSD at the six-week follow-up and fewer
intrusive symptoms at both time points. Nonsigificant differences that
were found in diagnostic incidence of ASD may Nave been due to small
number of patients meeting ASD criteria. Patients with partial memories
were found to be similar to nonamnesics in hormone profile and
symptomatology. These results suggest that amnesics may be less likely
to meet diagnostic criteria for posttraumatic stress syndromes due to
lesser incidence of intrusive symptoms, and that the lack of
re-experiencing phenomenon may contribute to differences in subsequent
neuroendocrine functioning. (PsycINFO Database Record (c) 2004 APA, all
rights reserved)
Subjects:       *Amnesia; *Hormones; *Motor Traffic Accidents; *Motor
Vehicles; *Posttraumatic Stress Disorder; Susceptibility (Disorders)   
Classification: Health & Mental Health Treatment & Prevention (3300)

Physiological Psychology & Neuroscience (2500)
Population:     Human (10)

Inpatient (50)
Form/Content Type:      Empirical Study (0800)
Publication Type:       Dissertation Abstract (350); Print

Format(s) Available: Print
Release Date:   20040105       
Accession Number:       2003-95014-025 
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-95014-025

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-950
14-025">The relationship among hormone levels, amnesia, and
post-traumatic stress in motor vehicle accident victims.</A>   
       
Database:       PsycINFO       
  _____ 

Record: 35
       
Title:  Neuroendocrine patterns across the longitudinal clinical course
of posttraumatic stress disorder.      
Author(s):      Inslicht, Sabra Shelly, U Pittsburgh, US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 64(1-B), 2003. pp. 422.
Publisher:      US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN:   0419-4217 (Print)
Order Number:   AAI3078848     
Language:       English
Keywords:       neuroendocrine dysregulation; posttraumatic stress
disorder; vulnerability mechanism; domestic violence victims   
Abstract:       While neuroendocrine dysregulation has been proposed as
a vulnerability mechanism for posttraumatic stress disorder (PTSD), the
persistence of these alterations across the clinical course has not been
established. We examined neuroendocrine dysregulation in domestic
violence victims with PTSD that has remitted (n = 14) compared to women
with current PTSD (n = 14), and abuse-exposed (n = 20), and nonexposed
controls (n = 12). Additive and interactive effects of person- and
trauma-related characteristics and psychiatric comorbidities were also
explored. Marginal effects were found for aggregated measures of
cortisol, with heightened cortisol levels in PTSD-remitted and
current-PTSD groups compared to controls. For cortisol, an interaction
between PTSD grouping and depression suggested a moderating influence of
depression. Results did not support hypotheses regarding dysregulated
catecholamines in PTSD. Persistent cortisol dysregulation in
subsyndromal remitted PTSD supports the possibility of neuroendocrine
differences that persist across the clinical course of PTSD and may be
involved in risk for posttraumatic stress responding. (PsycINFO Database
Record (c) 2004 APA, all rights reserved)
Subjects:       *Neuroendocrinology; *Posttraumatic Stress Disorder;
Family Violence
Classification: Health & Mental Health Treatment & Prevention (3300)

Physiological Psychology & Neuroscience (2500)
Population:     Human (10)
Form/Content Type:      Empirical Study (0800)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Dissertation Abstract (350); Print

Format(s) Available: Print
Release Date:   20040105       
Accession Number:       2003-95014-293 
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-95014-293

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-950
14-293">Neuroendocrine patterns across the longitudinal clinical course
of posttraumatic stress disorder.</A>  
       
Database:       PsycINFO       
  _____ 

Record: 36
       
Title:  Injury severity, prior trauma history, urinary cortisol levels
and acute PTSD in motor vehicle accident victims.      
Author(s):      Delahanty, Douglas L., Kent State U, Dept of Psychology,
Kent, OH, US, ddelahan@kent.edu

Raimonde, A. Jay, Summa Health System, Akron, OH, US

Spoonster, Eileen, Summa Health System, Akron, OH, US

Cullado, Michael, Summa Health System, Akron, OH, US
Address:        Delahanty, Douglas L., Dept of Psychology, Kent State U,
118 Kent Hall, Kent, OH, US, ddelahan@kent.edu 
Source: Journal of Anxiety Disorders, Vol 17(2), 2003. pp. 149-164.

Journal URL: http://www.elsevier.com/inca/publications/store/8/0/1/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0887-6185 (Print)
Digital Object Identifier:      10.1016/S0887-6185(02)00185-8  
Language:       English
Keywords:       trauma history; ptsd symptoms; urinary cortisol levels;
motor vehicle accident; traumatic experiences  
Abstract:       This study examined the relationship between prior
history of traumatic events, life threat, and injury severity
experienced during a motor vehicle accident (MVA), and posttraurnatic
stress disorder (PTSD) assessed 1 month after the accident. In addition,
initial urinary cortisol levels after the accident were examined as a
possible mediator of this relationship. Fifteen hour urinary cortisol
samples were collected from 117 MVA victims (mean age 37.3 yrs) upon
admission to the trauma unit. In the hospital, subjective life threat
was measured and objective Injury Severity Scores (ISSs) were computed.
One month after the accident, participants were assessed for prior
history of traumatic experiences, presence of acute PTSD, and levels of
intrusive and avoidant thoughts and behaviors. Victims, who met PTSD
diagnostic criteria, reported more prior traumatic events, and
significantly greater life threat despite receiving significantly lower
ISSs than victims who did not develop PTSD. The relationships between
ISSs and PTSD symptoms and prior trauma history and PTSD symptoms were
mediated by cortisol levels. Results suggest that cortisol levels in the
acute aftermath of a traumatic event may serve as a mechanism through
which various factors may increase risk for PTSD. (PsycINFO Database
Record (c) 2004 APA, all rights reserved)
Subjects:       *Hydrocortisone; *Injuries; *Motor Traffic Accidents;
*Posttraumatic Stress Disorder; Threat 
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Male (30)

Female (40)
Age Group:      Adulthood (18 yrs & older) (300)
Form/Content Type:      Empirical Study (0800)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20030421       
Accession Number:       2003-02984-004 
Number of Citations in Source:  56     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-02984-004

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-029
84-004">Injury severity, prior trauma history, urinary cortisol levels
and acute PTSD in motor vehicle accident victims.</A>  
       
Database:       PsycINFO       
  _____ 

Record: 37
       
Title:  Dissociative Symptoms and Cortisol Responses to Recounting
Traumatic Experiences Among Childhood Sexual Abuse Survivors with PTSD.
Author(s):      Koopman, Cheryl, Stanford University, Stanford, CA, US,
 koopman@stanford.edu

Sephton, Sandra, University of Louisville, Louisville, KY, US

Abercrombie, Heather C., Stanford University, Stanford, CA, US

Classen, Catherine, Stanford University, Stanford, CA, US

Butler, Lisa D., Stanford University, Stanford, CA, US

Gore-Felton, Cheryl, Medical College of Wisconsin, Milwaukee, WI, US

Borggrefe, Anne, Stanford University, Stanford, CA, US

Spiegel, David, Stanford University, Stanford, CA, US
Address:        Koopman, Cheryl, Department of Psychiatry and
Behavioural Sciences, Stanford University, Stanford, CA, US,
 koopman@stanford.edu   
Source: Journal of Trauma & Dissociation, Vol 4(4), 2003. pp. 29-44.

Journal URL: http://www.haworthpressinc.com/store/product.asp?sku=J229
Publisher:      US: Haworth Press

Publisher URL: http://www.haworthpress.com
ISSN:   1529-9732 (Print)
Digital Object Identifier:      10.1300/J229v04n04_03  
Language:       English
Keywords:       dissociative symptoms; cortisol responses; recounting
traumatic experiences; childhood sexual abuse survivors; women with PTSD

Abstract:       This study examined dissociative symptoms in relation to
changes in evening salivary cortisol levels after recounting traumatic
experiences among 49 women with PTSD for child sexual abuse (CSA). Each
woman was interviewed to describe her sexual abuse and was assessed on
acute dissociative symptoms in response to a recent stressful event in
the previous month. Salivary cortisol was assessed during the interview
using saliva samples taken immediately before and after the interview.
Changes in cortisol levels were measured at one hour, 24 hours, and 48
hours after the interview. Acute dissociative symptoms were related to
salivary cortisol levels 24 hours after the interview, with high
dissociators showing elevated levels compared to low dissociators. These
results suggest that dissociative symptoms in response to recent life
stress are associated with cortisol dysregulation among women with PTSD
for CSA. (PsycINFO Database Record (c) 2004 APA, all rights
reserved)(journal abstract)
Subjects:       *Dissociative Disorders; *Emotional Trauma;
*Posttraumatic Stress Disorder; *Sexual Abuse; *Survivors; Child Abuse;
Early Experience; Human Females; Hydrocortisone; Symptoms      
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Female (40)
Age Group:      Adulthood (18 yrs & older) (300)

Young Adulthood (18-29 yrs) (320)

Thirties (30-39 yrs) (340)

Middle Age (40-64 yrs) (360)

Aged (65 yrs & older) (380)
Form/Content Type:      Empirical Study (0800)

Quantitative Study (0890)

Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20040726       
Accession Number:       2003-11050-002 
Number of Citations in Source:  35     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-11050-002

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-110
50-002">Dissociative Symptoms and Cortisol Responses to Recounting
Traumatic Experiences Among Childhood Sexual Abuse Survivors with
PTSD.</A>      
       
Database:       PsycINFO       
  _____ 

Record: 38
       
Title:  Peritraumatic dissociation is inversely related to catecholamine
levels in initial urine samples of motor vehicle accident victims.     
Author(s):      Delahanty, Douglas L., Kent State U, Dept of Psychology,
Kent, OH, US, ddelahan@kent.edu

Royer, Doreen K., Kent State U, Dept of Psychology, Kent, OH, US

Raimonde, A. Jay, Summa Health System, Akron, OH, US

Spoonster, Eileen, Summa Health System, Akron, OH, US
Address:        Delahanty, Douglas L., Kent State U, Dept of Psychology,
118 Kent Hall, Kent, OH, US, ddelahan@kent.edu 
Source: Journal of Trauma & Dissociation, Vol 4(1), 2003. pp. 65-80.

Journal URL: http://www.haworthpressinc.com/store/product.asp?sku=J229
Publisher:      US: Haworth Press

Publisher URL: http://www.haworthpress.com
ISSN:   1529-9732 (Print)
Language:       English
Keywords:       peritraumatic dissociation; posttraumatic stress
disorder; physiological arousal; catecholamines; cortisol; motor vehicle
accident victims       
Abstract:       Investigated the relationship between self-reports of
peritraumatic dissociation during a motor vehicle accident (MVA) and
measures of physiological arousal in the immediate aftermath of the
accident. Upon admittance to the hospital, 15-hr urine samples were
collected from 99 MVA victims (aged 18-84 yrs) to measure levels of
urinary catecholamines and cortisol. Within 2 days of the accident,
participants reported symptoms of peritraumatic dissociation, and 1 mo
after the accident, 59 participants completed an interview designed to
assess symptoms of posttraumatic stress disorder (PTSD). Results reveal
that patients who subsequently developed PTSD reported significantly
higher levels of peritraumatic dissociation than victims who did not
develop PTSD, and that dissociation was negatively associated with
levels of urinary norepinephrine and epinephrine. Dissociation was not
related to urinary cortisol or cardiovascular levels upon admission.
These findings are consistent with previous research that has suggested
that high dissociators may constitute a subgroup of trauma victims who
are physiologically less reactive to trauma. (PsycINFO Database Record
(c) 2004 APA, all rights reserved)
Subjects:       *Dissociation; *Motor Traffic Accidents; *Physiological
Arousal; *Posttraumatic Stress Disorder; Catecholamines; Hydrocortisone
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Male (30)

Female (40)
Age Group:      Adulthood (18 yrs & older) (300)

Young Adulthood (18-29 yrs) (320)

Thirties (30-39 yrs) (340)

Middle Age (40-64 yrs) (360)

Aged (65 yrs & older) (380)
Form/Content Type:      Empirical Study (0800)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20030210       
Accession Number:       2003-01346-004 
Number of Citations in Source:  33     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-01346-004

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-013
46-004">Peritraumatic dissociation is inversely related to catecholamine
levels in initial urine samples of motor vehicle accident victims.</A> 
       
Database:       PsycINFO       
  _____ 

Record: 39
       
Title:  Salivary cortisol levels and the cortisol response to
dexamethasone before and after EMDR: A case report.    
Author(s):      Heber, Ruth, Mount Sinai School of Medicine, New York,
NY, US, rthbr@bellatlantic.net

Kellner, Michael, U Hospital Eppendorf, Hamburg, Germany

Yehuda, Rachel, Mount Sinai School of Medicine, New York, NY, US
Address:        Heber, Ruth, 200 East 33rd Street, Apt. 4-i, New York,
NY, US, rthbr@bellatlantic.net 
Source: Journal of Clinical Psychology, Vol 58(12), Dec 2002. pp.
1521-1530.

Journal URL: http://www.interscience.wiley.com/jpages/0021-9762/
Publisher:      US: John Wiley & Sons

Publisher URL: http://www.wiley.com/WileyCDA/
ISSN:   0021-9762 (Print)

1097-4679 (Electronic)
Digital Object Identifier:      10.1002/jclp.10102     
Language:       English
Keywords:       eye movement desensitization & reprocessing; salivary
cortisol levels; symptom improvement; chronic posttraumatic stress
disorder; dexamethasone administration & suppression; female 41 yr old 
Abstract:       Reports a case study in which pre and post-Eye Movement
Desensitization and Reprocessing (EMDR) treatment salivary cortisol
levels and salivary cortisol response to 0.50 mg of dexamethasone were
measured in a 41-yr-old female with chronic posttraumatic stress
disorder (PTSD) symptoms. The author's goal was to determine whether
symptom improvement following trauma-focused treatment (EMDR) is
associated with changes in basal salivary cortisol or in the cortisol
response to dexamethasone administration. Findings show moderate symptom
improvement, an increase in basal cortisol levels, and a more attenuated
cortisol hypersuppression in response to the dexamethasone suppression
test following EMDR treatment. Results suggest the potential utility of
including neuroendocrine measures in the assessment of treatment outcome
in PTSD. (PsycINFO Database Record (c) 2004 APA, all rights reserved)
Subjects:       *Dexamethasone; *Eye Movement Desensitization Therapy;
*Hydrocortisone; *Posttraumatic Stress Disorder; *Stress; Symptoms     
Classification: Psychotherapy & Psychotherapeutic Counseling (3310)
Population:     Human (10)

Female (40)
Age Group:      Adulthood (18 yrs & older) (300)

Middle Age (40-64 yrs) (360)
Form/Content Type:      Empirical Study (0800)

Clinical Case Report (0820)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20021226       
Accession Number:       2002-11286-008 
Number of Citations in Source:  27     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-11286-008

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-112
86-008">Salivary cortisol levels and the cortisol response to
dexamethasone before and after EMDR: A case report.</A>
       
Database:       PsycINFO       
  _____ 

Record: 40
       
Title:  Effects of stress hormones on traumatic memory formation and the
development of posttraumatic stress disorder in critically ill patients.

Author(s):      Schelling, Gustav, Ludwig-Maximilians-U, Dept of
Anesthesiology, Munich, Germany,
 gustav.schelling@ana.med.uni-muenchen.de
Address:        Schelling, Gustav, Dept of Anesthesiology, Klinikum
Grosshadern, 81377, Munich, Germany,
 gustav.schelling@ana.med.uni-muenchen.de       
Source: Neurobiology of Learning & Memory, Vol 78(3), Nov 2002. pp.
596-609.

Journal URL: http://www.academicpress.com/nlm
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   1074-7427 (Print)
Digital Object Identifier:      10.1006/nlme.2002.4083 
Language:       English
Keywords:       stress hormones; trauma; memory formation; posttraumatic
stress disorder; intensive care unit; critical illness; survivors      
Abstract:       Studied the relationship between stress hormones,
traumatic memories, and the development of post-traumatic stress
disorder (PTSD) in long-term survivors of intensive care unit (ICU)
treatment. Results demonstrate a clear and vivid recall of different
categories of traumatic memory such as nightmares, anxiety, respiratory
distress, or pain with little or no recall of factual events. The number
of categories of traumatic memory recalled increased with the total
administered dosages of stress hormones and the evaluation of these
categories at different time points after discharge from the ICU showed
better memory consolidation with higher dosages of stress hormones
administered. However, the administration of stress doses of cortisol to
critically ill patients resulted in more complex findings as it caused a
significant reduction in PTSD symptoms measured after recovery. This
effect can possibly be explained by a differential influence of cortisol
on memory. Findings indicate that stress hormones influence the
development of PTSD through complex and simultaneous interactions on
memory formation and retrieval. The author's studies also demonstrate
that animal models of aversive learning are useful in analyzing and
predicting clinical findings in critically ill humans. (PsycINFO
Database Record (c) 2004 APA, all rights reserved)
Subjects:       *Drug Therapy; *Hormones; *Intensive Care; *Memory;
*Posttraumatic Stress Disorder 
Classification: Inpatient & Hospital Services (3379)
Population:     Human (10)

Inpatient (50)
Form/Content Type:      Conference Proceedings/Symposia (0600)

Empirical Study (0800)
Conference:     Conference on the Neurobiology of Learning &
Memory--Making Memories in the Brain: Orchestration of Cells & Systems,
7th, Nov, 2001, Irvine, CA, US 
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20030102       
Accession Number:       2002-11177-013 
Number of Citations in Source:  47     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-11177-013

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-111
77-013">Effects of stress hormones on traumatic memory formation and the
development of posttraumatic stress disorder in critically ill
patients.</A>  
       
Database:       PsycINFO       
  _____ 

Record: 41
       
Title:  The effects of experience on the development of emotional
expression and signature formation in rhesus macaque (macaca mulatta)
vocal communication.   
Author(s):      Jovanovic, Tanja, Emory U., US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 63(4-B), Oct 2002. pp. 2103.
Publisher:      US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN:   0419-4217 (Print)
Order Number:   AAI3050110     
Language:       English
Keywords:       emotional expression; signature formation; experience;
rhesus macaque; vocal communication    
Abstract:       The present study employed cross-fostering to
investigate the effects of experience on emotional expression and
signature formation in rhesus macaque (Macaca mulatta) vocal
communication. The subjects of the study were twelve rhesus macaques:
six were foster-reared by abusive mothers and six were foster-reared by
control mothers. Vocalizations were recorded from the subjects in their
social groups for two years and blood samples were assayed for cortisol
and adrenocorticotropin hormone (ACTH) levels. Emotional components of
calls were affected by early trauma (maternal abuse). The acoustic
variables measuring emotional expression in affiliative calls, as well
as ACTH levels, were lower in abused than control subjects. On the other
hand, abused subjects expressed exaggerated levels of fear during mild
contact aggression. An unexpected result of the cross-fostering
procedure was hyper-emotionality in the cross-fostered subjects compared
to unmanipulated controls. The second part of the study used
discriminant function analysis to classify the screams of cross-fostered
subjects to either their biological or foster family. In the present
study, matrilineal signatures were clearly discriminated among different
families of rhesus macaques. Furthermore, the screams of the majority of
cross-fostered subjects classified to the foster matriline, suggesting
that these signatures were learned rather than inherited. Agonistic
screams that demonstrated foster family signatures were associated with
maternal aid during attack. Furthermore, the similarity of the subjects'
screams to the foster prototypes was related to social rank and history
of abuse. The screams of higher-ranking animals were more similar to the
foster prototype than were the screams of lower-ranking subjects. In
contrast, the screams of abused animals were not as similar to the
foster prototype as were the screams of nonabused subjects, indicating
that abuse (or the abnormal mother-infant bond) disturbed emotionality
and learning. Thus, the present study found significant effects of
experience on rhesus macaque vocal communication. (PsycINFO Database
Record (c) 2004 APA, all rights reserved)
Subjects:       *Animal Communication; *Animal Emotionality; *Animal
Vocalizations; *Primates (Nonhuman)    
Classification: Physiological Psychology & Neuroscience (2500)
Population:     Animal (20)
Form/Content Type:      Empirical Study (0800)
Publication Type:       Dissertation Abstract (350); Print

Format(s) Available: Print
Release Date:   20030303       
Accession Number:       2002-95020-182 
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-95020-182

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-950
20-182">The effects of experience on the development of emotional
expression and signature formation in rhesus macaque (macaca mulatta)
vocal communication.</A>       
       
Database:       PsycINFO       
  _____ 

Record: 42
       
Title:  Urinary cortisol and catecholamines in mothers of child cancer
survivors with and without PTSD.       
Author(s):      Glover, Dorie A., U California, Neuropsychiatric Inst,
Div of Child & Adolescent Psychiatry, Los Angeles, CA, US,
 dglover@mednet.ucla.edu

Poland, Russell E., Cedars-Sinai Medical Ctr, Dept of Psychiatry &
Mental Health, Los Angeles, CA, US
Address:        Glover, Dorie A., dglover@mednet.ucla.edu      
Source: Psychoneuroendocrinology, Vol 27(7), Oct 2002. pp. 805-819.

Journal URL: http://www.elsevier.com/inca/publications/store/4/7/3/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0306-4530 (Print)
Digital Object Identifier:      10.1016/S0306-4530(01)00081-6  
Language:       English
Keywords:       posttraumatic stress disorder; mothers of child cancer
survivors; urinary cortisol & catecholamines; epinephrine;
norepinephrine; physiological correlates; caregiver burden;
neuroendocrine correlates      
Abstract:       Reduced cortisol coupled with elevated catecholamines
has been reported for patients with post-traumatic stress disorder
(PTSD) precipitated by war and other traumas considered to be "outside
the range of usual experiences". It is unclear whether these
neuroendocrine abnormalities also occur in PTSD precipitated by more
commonly experienced traumas associated with life-threatening illness.
Overnight urinary cortisol, norepinephrine (NE) and epinephrine (E) were
measured in 21 US mothers of pediatric cancer survivors with (n=14; mean
age 42 yrs) and without PTSD symptoms (n=7; mean age 42.25 yrs) and in
control mothers of healthy children (n=8). Mothers meeting subthreshold
and full PTSD criteria were combined to form the PTSD symptoms group.
The PTSD group showed lower total urinary cortisol and a trend for
higher total urinary NE than the non-PTSD group, who in turn were no
different from controls. There were no significant group effects for E.
Cortisol (but not NE) effects remained after controlling for symptoms of
co-morbid depression. The finding of reduced cortisol in illness-related
PTSD demonstrates neuroendocrine dysregulation similar to that found
previously in other types of trauma. (PsycINFO Database Record (c) 2004
APA, all rights reserved)
Subjects:       *Caregiver Burden; *Catecholamines; *Hydrocortisone;
*Mothers; *Posttraumatic Stress Disorder; Biological Markers;
Epinephrine; Neoplasms; Neuroendocrinology; Norepinephrine;
Physiological Correlates       
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Female (40)
Location:       US     
Form/Content Type:      Empirical Study (0800)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20021030       
Accession Number:       2002-06008-004 
Number of Citations in Source:  36     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-06008-004

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-060
08-004">Urinary cortisol and catecholamines in mothers of child cancer
survivors with and without PTSD.</A>   
       
Database:       PsycINFO       
  _____ 

Record: 43
       
Title:  The cortisol and glucocorticoid receptor response to low dose
dexamethasone administration in aging combat veterans and Holocaust
survivors with and without posttraumatic stress disorder.      
Author(s):      Yehuda, Rachel, Mount Sinai School of Medicine, Dept of
Psychiatry, Traumatic Stress Program, New York, NY, US

Halligan, Sarah L., Mount Sinai School of Medicine, Dept of Psychiatry,
Traumatic Stress Program, New York, NY, US

Grossman, Robert

Golier, Julia A., Mount Sinai School of Medicine, Dept of Psychiatry,
Traumatic Stress Program, New York, NY, US

Wong, Cheryl, Mount Sinai School of Medicine, Dept of Psychiatry,
Traumatic Stress Program, New York, NY, US
Address:        Yehuda, Rachel, Bronx Veterans Affairs Medical Ctr,
OOMH-116A, 130 West Kingsbridge Rd, Bronx, NY, US      
Source: Biological Psychiatry, Vol 52(5), Sep 2002. pp. 393-403.

Journal URL:
 http://www.elsevier.com/inca/publications/store/5/0/5/7/5/0/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0006-3223 (Print)
Digital Object Identifier:      10.1016/S0006-3223(02)01357-4  
Language:       English
Keywords:       cortisol; glucocorticoid receptor; low dose
dexamethasone; posttraumatic stress disorder; PTSD symptom severity;
aging; trauma survivors; Holocaust survivors; male combat veterans     
Abstract:       Because alterations in cortisol negative feedback
inhibition associated with aging are generally opposite of those
observed in posttraumatic stress disorder (PTSD), we examined the
cortisol and glucocorticoid receptor (GR) response to dexamethasone
(DEX) in older trauma survivors. 23 Holocaust survivors, 27 male combat
veterans, and 10 comparison subjects (Ss) provided samples for plasma or
salivary cortisol and glucocorticoid receptor determination in
mononuclear leukocytes at 8:00 AM on the day of and following, 0.5 mg of
DEX at 11:00 PM. Greater percent suppression of cortisol and lymphocyte
GR was observed in older trauma survivors with PTSD compared to
survivors without PTSD and comparison Ss. There was a significant main
effect of depression in the direction of reduced suppression following
DEX consistent with the effects of DEX in major depressive disorder
patients. Responses to DEX were uncorrelated with PTSD symptom severity,
but cortisol suppression was associated with years elapsed since the
most recent, but not focal, traumatic event. The response to DEX is
generally similar in older and younger trauma survivors, but the
findings suggest that age, symptom severity, and lifetime trauma
exposure characteristics may influence this response. (PsycINFO Database
Record (c) 2004 APA, all rights reserved)
Subjects:       *Aging; *Dexamethasone; *Glucocorticoids;
*Hydrocortisone; *Posttraumatic Stress Disorder; Combat Experience;
Holocaust Survivors; Military Veterans 
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Male (30)

Female (40)
Location:       US     
Age Group:      Adulthood (18 yrs & older) (300)

Middle Age (40-64 yrs) (360)

Aged (65 yrs & older) (380)
Form/Content Type:      Empirical Study (0800)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20021009       
Accession Number:       2002-18551-003 
Number of Citations in Source:  48     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-18551-003

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-185
51-003">The cortisol and glucocorticoid receptor response to low dose
dexamethasone administration in aging combat veterans and Holocaust
survivors with and without posttraumatic stress disorder.</A>  
       
Database:       PsycINFO       
  _____ 

Record: 44
       
Title:  Psychobiology of the acute stress response and its relationship
to the psychobiology of post-traumatic stress disorder.
Author(s):      Marshall, Randall D., New York State Psychiatric Inst,
Anxiety Disorders Clinic, New York, NY, US

Garakani, Amir, Mount Sinai School of Medicine, New York, NY, US
Address:        Marshall, Randall D., New York State Psychiatric Inst,
Anxiety Disorders Clinic, 1051 Riverside Drive, New York, NY, US       
Source: Psychiatric Clinics of North America, Vol 25(2), Jun 2002.
Special issue: Recent advances in the study of biological alterations in
post-traumatic stress disorder. pp. 385-395.

Journal URL:
 http://www.harcourthealth.com/scripts/om.dll/serve?action=searchDB&searc
hDBfor=home&id=cpsy
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0193-953X (Print)
Language:       English
Keywords:       PTSD; posttraumatic stress disorder; acute stress
response; biological predictors; traumatic experiences; baseline
cortisol; psychobiology
Abstract:       Reviews literature on the psychobiology of the acute
stress response and its relationship to the psychobiology of
posttraumatic stress disorder (PTSD). There are no longitudinal studies
that examine biological preexisting traits/vulnerabilities in relation
to the subsequent development of PTSD. This would require assessment of
relevant variables prior to the experience of trauma. In the interim, a
few studies of the acute response to trauma provide the best data about
biological predictors of chronic illness. Relatively lower baseline
cortisol after acute trauma is associated with the development of PTSD.
The determinants of this finding are entirely unclear, but may be
associated with traumatic experiences during critical periods of
development, genetic factors, pre-existing conditions, and
cortical/subcortical networks that reflect life experience and its
influence on meaningful appraisal of the trauma. (PsycINFO Database
Record (c) 2004 APA, all rights reserved)
Subjects:       *Emotional Trauma; *Hydrocortisone; *Posttraumatic
Stress Disorder; *Psychobiology; *Stress Reactions     
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)
Form/Content Type:      Literature Review (1300)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print
Release Date:   20020807       
Accession Number:       2002-17407-008 
Number of Citations in Source:  29     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-17407-008

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-174
07-008">Psychobiology of the acute stress response and its relationship
to the psychobiology of post-traumatic stress disorder.</A>    
       
Database:       PsycINFO       
  _____ 

Record: 45
       
Title:  Chronic stress, cortisol regulation, interpersonal relatedness,
cognitive burden, and depressive symptoms among community-dwelling
survivors of brain injury.     
Author(s):      Bay, Esther Helen, U Michigan, US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 62(10-B), May 2002. pp. 4461.
Publisher:      US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN:   0419-4217 (Print)
Order Number:   AAI3029291     
Language:       English
Keywords:       cognitive burden; chronic stress; cortisol regulation;
interpersonal relatedness; depressive symptoms; brain injury   
Abstract:       Depression after traumatic brain injury is one of the
most common and problematic mood disorders, affecting more than a third
of those in the recovery process. Efforts to empirically examine this
topic have failed to elucidate theoretical explanations and mechanisms.
As part of the theory building process this study, using regression
analysis, provided a cross-sectional examination of how major concepts,
chronic stress, cortisol regulation, interpersonal relatedness and
cognitive burden, which were derived from nursing and other disciplines
could be related to post-brain injury depression. These concepts were
empirically rooted in studies of depression. Thus, hypotheses were
stated which posited explanatory relationships between depressive
symptoms and these concepts. Seventy-five participants and their
significant others were recruited from outpatient rehabilitation
clinics. All had sustained a mild-to-moderate brain injury and were
within two years of the trauma. Participants with TBI were asked to
complete a computerized battery of cognitive tests on short-term memory
and directed attention, provide a 12-hour profile of salivary cortisol
and complete self-report questionnaires. Relative versions of the
depression instruments were also completed. Overall, it was determined
that when time-since-injury was included in regression models, pre- and
post-injury stress explained a significant amount of the variability in
depressive symptoms. Furthermore, a lowered sense-of-belonging, not
social support, was a strong correlate of depressive symptoms. As in
other studies, cognitive test results failed to provide clarity about
the relationship between depressed mood and cognition. Post-injury
stress and belonging account for nearly 75% of the variability of
depressive symptoms. Cortisol regulation, determined by a 12-hour
salivary cortisol profile of 50 of these participants, displayed
circadian rhythm variation but demonstrated a lack of association with
measures of cognition, head injury indices, depressive symptoms and
post-injury stress. This study provides a foundation for further study
of TBI and depression. Longitudinal studies, including pre-injury
variables such as childhood adversities and the frequency of major
stressful life events require further examination to develop knowledge
regarding TBI and eventual nursing interventions. (PsycINFO Database
Record (c) 2004 APA, all rights reserved)
Subjects:       *Head Injuries; *Hydrocortisone; *Interpersonal
Interaction; *Major Depression; *Psychological Stress; Chronic Stress;
Cognitive Processes    
Classification: Physiological Psychology & Neuroscience (2500)
Population:     Human (10)
Age Group:      Adulthood (18 yrs & older) (300)
Form/Content Type:      Empirical Study (0800)
Publication Type:       Dissertation Abstract (350); Print

Format(s) Available: Print
Release Date:   20020821       
Accession Number:       2002-95008-039 
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-95008-039

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-950
08-039">Chronic stress, cortisol regulation, interpersonal relatedness,
cognitive burden, and depressive symptoms among community-dwelling
survivors of brain injury.</A> 
       
Database:       PsycINFO       
  _____ 

Record: 46
       
Title:  Urinary free cortisol and childhood trauma in cocaine dependent
adults.
Author(s):      Roy, Alec, New Jersey Healthcare System, Dept of
Veterans Affairs, East Orange, NJ, US, alec.roy@med.va.gov
Address:        Roy, Alec, New Jersey Healthcare System, Psychiatry
Service 116A, Dept of Veterans Affairs, 385 Tremont Ave, East Orange,
NJ, US, alec.roy@med.va.gov    
Source: Journal of Psychiatric Research, Vol 36(3), May-Jun 2002. pp.
173-177.

Journal URL: http://www.elsevier.com/inca/publications/store/2/4/1/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0022-3956 (Print)
Digital Object Identifier:      10.1016/S0022-3956(02)00002-X  
Language:       English
Keywords:       childhood trauma; hypothalamic-pituitary-adrenal axis
function; cocaine dependence; cocaine withdrawal; urinary-free cortisol
Abstract:       Examined whether childhood trauma may have a
relationship to hypothalamic-pituitary-adrenal (HPA) axis function as an
adult. 46 withdrawn cocaine-dependent patients participated in 24-hr
urine collections for determinations of urinary-free cortisol (UFC) and
completed the Childhood Trauma Questionnaire (CTQ). Patients with a mean
UFC output below the median had significantly higher CTQ scores for
childhood sexual abuse than patients with UFC outputs above the median.
Multiple regression analysis showed that both childhood emotional
neglect and sexual abuse were independently associated with UFC outputs.
These cross-sectional data, in a sample of middle-aged cocaine dependent
patients, suggest the possibility that childhood trauma may have an
effect on HPA axis function and thus predispose to psychiatric
disorders. (PsycINFO Database Record (c) 2004 APA, all rights reserved)
Subjects:       *Drug Dependency; *Early Experience; *Emotional Trauma;
*Hydrocortisone; *Hypothalamo Pituitary Adrenal System; Child Abuse;
Child Neglect; Cocaine; Emotional Abuse; Sexual Abuse  
Classification: Substance Abuse & Addiction (3233)

Drug & Alcohol Rehabilitation (3383)
Population:     Human (10)

Male (30)

Female (40)
Location:       US     
Age Group:      Adulthood (18 yrs & older) (300)
Form/Content Type:      Empirical Study (0800)

Longitudinal Study (0850)

Prospective Study (0851)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20020619       
Accession Number:       2002-13583-008 
Number of Citations in Source:  25     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-13583-008

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-135
83-008">Urinary free cortisol and childhood trauma in cocaine dependent
adults.</A>    
       
Database:       PsycINFO       
  _____ 

Record: 47
       
Title:  Diurnal salivary cortisol in pediatric posttraumatic stress
disorder.      
Author(s):      Carrion, Victor G., Stanford U School of Medicine, Dept
of Psychiatry Behavioral Sciences, Div of Child & Adolescent Psychiatry
& Child Development, Stanford, CA, US

Weems, Carl F., Stanford U School of Medicine, Dept of Psychiatry
Behavioral Sciences, Div of Child & Adolescent Psychiatry & Child
Development, Stanford, CA, US

Ray, Rebecca D., Stanford U School of Medicine, Dept of Psychiatry
Behavioral Sciences, Div of Child & Adolescent Psychiatry & Child
Development, Stanford, CA, US

Glaser, Bronwyn, Stanford U School of Medicine, Dept of Psychiatry
Behavioral Sciences, Div of Child & Adolescent Psychiatry & Child
Development, Stanford, CA, US

Hessl, David, Stanford U School of Medicine, Dept of Psychiatry
Behavioral Sciences, Div of Child & Adolescent Psychiatry & Child
Development, Stanford, CA, US

Reiss, Allan L., Stanford U School of Medicine, Dept of Psychiatry
Behavioral Sciences, Div of Child & Adolescent Psychiatry & Child
Development, Stanford, CA, US
Address:        Carrion, Victor G., Stanford U, Div of Child &
Adolescent Psychiatry & Child Development, Stanford, CA, US    
Source: Biological Psychiatry, Vol 51(7), Apr 2002. pp. 575-582.

Journal URL:
 http://www.elsevier.com/inca/publications/store/5/0/5/7/5/0/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0006-3223 (Print)
Digital Object Identifier:      10.1016/S0006-3223(01)01310-5  
Language:       English
Keywords:       diurnal salivary cortisol; PTSD symptoms; trauma
exposure; HPA axis     
Abstract:       The hypothalamic-pituitary-adrenal (HPA) axis has been
implicated in the pathophysiology of posttraumatic stress disorder
(PTSD). Additional information on basal cortisol levels in children
exposed to trauma and experiencing PTSD symptoms may contribute to the
understanding of the role of this axis in PTSD. 51 children (30 boys and
21 girls, aged 7-14 yrs) with a history of exposure to trauma and PTSD
symptoms were compared with 31 age- and gender-matched healthy controls.
Salivary cortisol was obtained from Ss during home measurements and was
collected 4 times a day (prebreakfast, prelunch, predinner, and prebed)
for up to 3 consecutive days. The clinical group demonstrated
significantly elevated cortisol levels when compared with the controls.
In addition, exploratory analyses revealed that girls with PTSD symptoms
had significantly elevated cortisol levels when compared with boys with
PTSD symptoms. The physiologic response of children with history of
trauma and with PTSD symptoms may be characterized by heightened adrenal
activity. (PsycINFO Database Record (c) 2004 APA, all rights reserved)
Subjects:       *Human Biological Rhythms; *Hydrocortisone; *Hypothalamo
Pituitary Adrenal System; *Posttraumatic Stress Disorder; *Stress
Reactions      
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Male (30)

Female (40)
Location:       US     
Age Group:      Childhood (birth-12 yrs) (100)

School Age (6-12 yrs) (180)

Adolescence (13-17 yrs) (200)
Form/Content Type:      Empirical Study (0800)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20020522       
Accession Number:       2002-02992-006 
Number of Citations in Source:  37     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-02992-006

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-029
92-006">Diurnal salivary cortisol in pediatric posttraumatic stress
disorder.</A>  
       
Database:       PsycINFO       
  _____ 

Record: 48
       
Title:  Autoimmunity, dehydroepiandrosterone (DHEA), and stress.       
Author(s):      Schwartz, Kenneth E., Genelabs Technologies, Inc.,
Redwood City, CA, US, kschwartz@genelabs.com
Address:        Schwartz, Kenneth E., Genelabs Technologies, Inc., 505
Penobscot Drive, Redwood City, CA, US, kschwartz@genelabs.com  
Source: Journal of Adolescent Health, Vol 30(4, Suppl), Apr 2002. pp.
37-43.

Journal URL:
 http://www.elsevier.com/inca/publications/store/5/0/5/7/6/5/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   1054-139X (Print)
Digital Object Identifier:      10.1016/S1054-139X(01)00385-8  
Language:       English
Keywords:       dehydroepiandrosterone; adrenal androgenic steroids;
stress; autoimmune diseases; systemic lupus erythematosus      
Abstract:       Discusses recent advances regarding interactions between
adrenal androgenic steroids, stress, and the immune system. The primary
androgenic steroid discussed is dehyroepiandrosterone (DHEA). The
secretion of DHEA throughout the developmental cycle is described.
Dissociation of DHEA from cortisol release is present during acute
stress, such as may occur following burns or acute trauma, and
psychological stress as encountered prior to surgery. Abnormalities of
the hypothalamic-pituitary-adrenal axis, steroid metabolism, and
autoimmune disease are addressed. The observation that some autoimmune
diseases, including systemic lupus erythematosus (SLE), are more common
in females raises the question of the role of sex hormones in
autoimmunity. The topics of blood androgen levels in rheumatoid
arthritis and interactions between cytokines and adrenal androgens are
also discussed. The use of DHEA in the treatment of SLE is explored.
(PsycINFO Database Record (c) 2004 APA, all rights reserved)
Subjects:       *Androgens; *Immunologic Disorders; *Steroids; *Stress;
Lupus  
Classification: Immunological Disorders (3291)
Population:     Human (10)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20020703       
Accession Number:       2002-12873-005 
Number of Citations in Source:  72     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-12873-005

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-128
73-005">Autoimmunity, dehydroepiandrosterone (DHEA), and stress.</A>   
       
Database:       PsycINFO       
  _____ 

Record: 49
       
Title:  Longitudinal course of salivary cortisol in post-traumatic
stress disorder.       
Author(s):      Kellner, Michael, University Hosp Hamburg-Eppendorf,
Dept of Psychiatry & Psychotherapy, Hamburg, Germany

Yehuda, Rachel, Mount Sinai Medical Ctr, Dept of Psychiatry, New York,
NY, US

Arlt, Josef, University Hosp Hamburg-Eppendorf, Dept of Psychiatry &
Psychotherapy, Hamburg, Germany

Wiedemann, Klaus, University Hosp Hamburg-Eppendorf, Dept of Psychiatry
& Psychotherapy, Hamburg, Germany
Source: Acta Psychiatrica Scandinavica, Vol 105(2), Feb 2002. pp.
153-155.

Journal URL: http://www.blackwellmunksgaard.com/actapsych
Publisher:      United Kingdom: Blackwell Publishing

Publisher URL: http://www.blackwellpublishing.com
ISSN:   0001-690X (Print)

1600-0447 (Electronic)
Digital Object Identifier:      10.1034/j.1600-0447.2002.01012.x       
Language:       English
Keywords:       chronic posttraumatic stress disorder; PTSD; cortisol
secretion; dexamethasone suppression; longitudinal course      
Abstract:       In chronic posttraumatic stress disorder (PTSD), an
alteration of hypothalamic-pituitary-adrenocortical axis function with
lowered cortisol secretion and hypersuppression to dexamethasone has
been described repeatedly. However, so far no longitudinal data on the
natural course or on the effect of therapy are available. The authors
measured basal and post-dexamethasone morning salivary cortisol in a
drug-free female 28 yr old patient with chronic PTSD monthly for nearly
2 years and assessed PTSD and depressive symptoms. Salivary cortisol
decreased dramatically 3 months after the traumatic event and in the
further course showed an inverse relation to fluctuating but gradually
improving PTSD symptoms. Post-dexamethasone cortisol was suppressed
below the detection limit early after trauma and rose again more than 1
year post-trauma. Both the potential renormalization of low cortisol
levels in improving chronic PTSD and the putative vulnerability to
develop PTSD in subjects with increased dexamethasone suppression need
further research. (PsycINFO Database Record (c) 2004 APA, all rights
reserved)
Subjects:       *Dexamethasone; *Hydrocortisone; *Posttraumatic Stress
Disorder; Hypothalamo Pituitary Adrenal System 
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Female (40)
Age Group:      Adulthood (18 yrs & older) (300)

Young Adulthood (18-29 yrs) (320)
Form/Content Type:      Empirical Study (0800)

Clinical Case Report (0820)

Longitudinal Study (0850)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20021113       
Accession Number:       2002-15883-011 
Number of Citations in Source:  11     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-15883-011

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-158
83-011">Longitudinal course of salivary cortisol in post-traumatic
stress disorder.</A>   
       
Database:       PsycINFO       
  _____ 

Record: 50
       
Title:  "Longitudinal course of salivary cortisol in post-traumatic
stress disorder": Comment.     
Author(s):      Agargün, Mehmed Yücel, Yuzuncu Yil U, School of
Medicine, Dept of Psychiatry, Van, Turkey
Source: Acta Psychiatrica Scandinavica, Vol 105(2), Feb 2002. pp.
155-156.

Journal URL: http://www.blackwellmunksgaard.com/actapsych
Publisher:      United Kingdom: Blackwell Publishing

Publisher URL: http://www.blackwellpublishing.com
ISSN:   0001-690X (Print)

1600-0447 (Electronic)
Language:       English
Keywords:       chronic posttraumatic stress disorder; PTSD; cortisol
secretion; dexamethasone suppression; longitudinal course      
Abstract:       Comments on the longitudinal case report by M. Kellner
et al (see record 2002-15883-011) describing the course of salivary
cortisol in chronic posttraumatic stress disorder (PTSD). Kellner et al
reported an inverse relationship of PTSD symptoms and morning salivary
cortisol levels. The current author discusses the neurobiology of both
acute and chronic PTSD and differentiate it from the neurobiology of
acute stress and major depression. It is suggested that the development
of PTSD occurs in subjects predisposed to biological hyperresponsiveness
or a progressive sensitization in the
hypothalamic-pituitary-adrenocoritcal axis. This may explain why the
fear response precipitates PTSD in some trauma survivors, whereas others
develop depression or are not affected. (PsycINFO Database Record (c)
2004 APA, all rights reserved)
Subjects:       *Dexamethasone; *Hydrocortisone; *Posttraumatic Stress
Disorder; Hypothalamo Pituitary Adrenal System 
Classification: Neuroses & Anxiety Disorders (3215)
Form/Content Type:      Comment (0500)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20021113       
Accession Number:       2002-15883-012 
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-15883-012

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-158
83-012">"Longitudinal course of salivary cortisol in post-traumatic
stress disorder": Comment.</A> 
       
Database:       PsycINFO       
  Record: 1
       
Title:  The role of early adverse experience and adulthood stress in the
prediction of neuroendocrine stress reactivity in women: A multiple
regression analysis.   
Author(s):      Heim, Christine, Emory U School of Medicine, Dept of
Psychiatry & Behavioral Sciences, Atlanta, GA, US

Newport, D. Jeffrey, Emory U School of Medicine, Dept of Psychiatry &
Behavioral Sciences, Atlanta, GA, US

Wagner, Dieter, U Trier, Ctr for Psychobiological & Psychosomatic
Research, Trier, Germany

Wilcox, Molly M., Emory U School of Medicine, Dept of Psychiatry &
Behavioral Sciences, Atlanta, GA, US

Miller, Andrew H., Emory U School of Medicine, Dept of Psychiatry &
Behavioral Sciences, Atlanta, GA, US

Nemeroff, Charles B., Emory U School of Medicine, Dept of Psychiatry &
Behavioral Sciences, Atlanta, GA, US, cnemero@emory.edu
Address:        Nemeroff, Charles B., Emory U School of Medicine, Dept
of Psychiatry & Behavioral Sciences, 1639 Pierce Drive, WMRB, Suite
4000, Atlanta, GA, US, cnemero@emory.edu       
Source: Depression & Anxiety, Vol 15(3), 2002. pp. 117-125.
Publisher:      US: John Wiley & Sons

Publisher URL: http://www.wiley.com/WileyCDA/
ISSN:   1091-4269 (Print)
Digital Object Identifier:      10.1002/da.10015.abs   
Language:       English
Keywords:       early adverse experience; adulthood stress; prediction;
neuroendocrine stress reactivity; women; depression; early abuse;
trauma; severity; adrenocorticotropin; ACTH; corticotropin releasing
factor 
Abstract:       Sought to evaluate the relative role of early adverse
experience vs. stress experiences in adulthood in the prediction of
neuroendocrine stress reactivity in women. A total of 49 women (aged
18-45 yrs; normal volunteers, depressed patients, and women with a
history of early abuse) underwent a battery of interviews and completed
dimensional rating scales on stress experiences and psychopathology, and
were subsequently exposed to a standardized psychosocial laboratory
stressor. Outcome measures were plasma adrenocorticotropin (ACTH) and
cortisol responses to the stress test. Peak ACTH responses to
psychosocial stress were predicted by a history of childhood abuse, the
number of separate abuse events, the number of adulthood traumas, and
the severity of depression. Similar predictors were identified for peak
cortisol responses. Although abused women reported more severe negative
life events in adulthood than controls, life events did not affect
neuroendocrine reactivity. The interaction of childhood abuse and
adulthood trauma was the most powerful predictor of ACTH responsiveness.
Findings suggest that a history of childhood abuse is related to
increased neuroendocrine stress reactivity, which is further enhanced
when additional trauma is experienced in adulthood. (PsycINFO Database
Record (c) 2004 APA, all rights reserved)
Subjects:       *Child Abuse; *Corticotropin; *Emotional Trauma;
*Hydrocortisone; *Stress Reactions; Adult Development; Corticotropin
Releasing Factor; Early Experience; Human Females; Major Depression;
Neuroendocrinology; Prediction; Severity (Disorders); Stress   
Classification: Psychophysiology (2560)
Population:     Human (10)

Female (40)
Age Group:      Adulthood (18 yrs & older) (300)

Young Adulthood (18-29 yrs) (320)

Thirties (30-39 yrs) (340)

Middle Age (40-64 yrs) (360)
Form/Content Type:      Empirical Study (0800)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20020605       
Accession Number:       2002-13493-004 
Number of Citations in Source:  46     
       
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Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-134
93-004">The role of early adverse experience and adulthood stress in the
prediction of neuroendocrine stress reactivity in women: A multiple
regression analysis.</A>       
       
Database:       PsycINFO       
  _____ 

Record: 2
       
Title:  Zur Rolle von Sprache und Körper bel der Integration
traumatischer Erfahrungen.     
Translated Title:       Neurobiological correlates of traumatic
experiences.   
Author(s):      Hüther, Gerald, ghuether@gwde.de
Address:        Hüther, Gerald, Klinik und Poliklinik fur Psychiatrie
und Psychotherapie, Von-Siebold-Str. 5, 37075, Gottingen, Germany,
 ghuether@gwde.de       
Source: Experimentelle und Klinische Hypnose, Vol 18(1-2), 2002. pp.
8-22.
Publisher:      Germany: dgvt-Verlag

Publisher URL: http://www.dgvt.de/verlag/
ISSN:   0933-1093 (Print)
Language:       German 
Keywords:       neurobiological correlates; traumatic experiences;
behavioral emergency; synaptic connections; glutamatergic input;
neuronal circuitry; stress-sensitive cortico-limbic neuronal networks  
Abstract:       Traumatic experiences elicit an uncontrollable
activation of stress-sensitive cortico-limbic neuronal networks and
neuroendocrine circuits. The overshooting excitation in conjunction with
strong and long-lasting activation of the HPA-System and cortisol
secretion causes a destabilization of established neuronal circuitry
(dendritic degeneration, synaptic regression) in brain regions with high
cortisol receptor density and glutamatergic input (e.g. the
hippocampus). Under these conditions,most victims of a trauma switch
back into a pattern of "behavioral emergency reactions" (freezing,
panic, stereotypes) and a (variety of self-protective, defensive
response-patterns (dissociation, depersonalization, derealization). The
more the neuronal and synaptic connections involved in the generation of
these defense responses become facilitated and stabilized, the more
automatized the response. It is difficult under these conditions to
acquire novel, more complex (frontocortical) patterns of coping,
especially for children. More detrimental to the internal organization
of the brain than the actually experienced trauma is the subjectively
felt loss or destruction of security-providing resources (psychosocial
support, self-image, competence, faith and belief). (PsycINFO Database
Record (c) 2004 APA, all rights reserved)
Subjects:       *Emotional Trauma; *Life Experiences; *Neural Pathways;
*Neurobiology; *Synapses; Brain; Corticotropin 
Classification: Neuropsychology & Neurology (2520)
Population:     Human (10)
Form/Content Type:      Journal Article (2400)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print
Release Date:   20040112       
Accession Number:       2003-99334-001 
Number of Citations in Source:  46     
       
Persistent link to this record:
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Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-993
34-001">Zur Rolle von Sprache und Körper bel der Integration
traumatischer Erfahrungen.</A> 
       
Database:       PsycINFO       
  _____ 

Record: 3
       
Title:  Neurobiological disturbances in youth with childhood trauma and
in youth with conduct disorder.
Author(s):      Lipschitz, Deborah S., Yale U School of Medicine, New
Haven, CT, US, lipschitz.deborah@west-haven.va.gov

Morgan, Charles A. III, Yale U School of Medicine, New Haven, CT, US

Southwick, Steven M., Yale U School of Medicine, New Haven, CT, US
Address:        Lipschitz, Deborah S., Connecticut VAMC, Psychiatry
Service (116a), 950 Campbell Avenue, West Haven, CT, US,
 lipschitz.deborah@west-haven.va.gov    
Source: Journal of Aggression, Maltreatment & Trauma, Vol 6(1), 2002.
pp. 149-174.

Journal URL: http://www.haworthpressinc.com/store/product.asp?sku=J146
Publisher:      US: Haworth Press

Publisher URL: http://www.haworthpress.com
ISSN:   1092-6771 (Print)
Digital Object Identifier:      10.1300/J146v06n01_08  
Language:       English
Keywords:       neurobiological disturbances; childhood trauma; conduct
disorder; disordered arousal; posttraumatic stress disorder; attention
deficit hyperactivity disorder; oppositional defiant disorder  
Abstract:       Focuses on findings from studies that characterize
neurobiological functioning related to dysregulation of arousal systems
in individuals suffering from traumatic stress or a disruptive behavior
disorder (defined here as attention deficit hyperactivity disorder,
oppositional defiant disorder, or conduct disorder). The authors review
and contrast some of the neurobiological mechanisms associated with
disordered arousal, which include basal cortisol and cortisol reactivity
to stress, psychophysiological parameters, and catecholamine studies.
The reviews are confined to studies of traumatized and/or aggressive
youth that have focused on traditional measures of arousal. (PsycINFO
Database Record (c) 2004 APA, all rights reserved)
Subjects:       *Behavior Disorders; *Emotional Trauma; *Neurobiology;
*Physiological Arousal; *Posttraumatic Stress Disorder; Attention
Deficit Disorder; Conduct Disorder; Oppositional Defiant Disorder      
Classification: Behavior Disorders & Antisocial Behavior (3230)
Population:     Human (10)
Age Group:      Childhood (birth-12 yrs) (100)

Adolescence (13-17 yrs) (200)
Form/Content Type:      Literature Review (1300)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20021030       
Accession Number:       2002-17962-009 
Number of Citations in Source:  89     
       
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Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2002-179
62-009">Neurobiological disturbances in youth with childhood trauma and
in youth with conduct disorder.</A>    
       
Database:       PsycINFO       
  _____ 

Record: 4
       
Title:  Neurobiological disturbances in youth with childhood trauma and
in youth with conduct disorder.
Author(s):      Lipschitz, Deborah S., Yale U, School of Medicine, New
Haven, CT, US, lipschitz.deborah@west-haven.va.gov

Morgan, Charles A. III, Yale U, School of Medicine, New Haven, CT, US

Southwick, Steven M., Yale U, School of Medicine, New Haven, CT, US
Address:        Lipschitz, Deborah S., Psychiatric Service (116a),
Connecticut VAMC, 950 Campbell Avenue, West Haven, CT, US,
 lipschitz.deborah@west-haven.va.gov    
Source: Trauma and juvenile delinquency: Theory, research, and
interventions. Greenwald, Ricky (Ed); pp. 149-174. Binghamton, NY, US:
Haworth Maltreatment and Trauma Press/The Haworth Press, Inc, 2002. xxv,
276 pp.        
ISBN:   0-7890-1974-4 (hardcover)

0-7890-1975-2 (paperback)
Language:       English
Keywords:       neurobiological disturbances; childhood trauma; conduct
disorder; disordered arousal; posttraumatic stress disorder; attention
deficit hyperactivity disorder; oppositional defiant disorder  
Abstract:       (from the chapter) Focuses on findings from studies that
characterize neurobiological functioning related to dysregulation of
arousal systems in individuals suffering from traumatic stress or a
disruptive behavior disorder (defined here as attention deficit
hyperactivity disorder, oppositional defiant disorder, or conduct
disorder). The authors review and contrast some of the neurobiological
mechanisms associated with disordered arousal, which include basal
cortisol and cortisol reactivity to stress, psychophysiological
parameters, and catecholamine studies. The reviews are confined to
studies of traumatized and/or aggressive youth that have focused on
traditional measures of arousal. (PsycINFO Database Record (c) 2004 APA,
all rights reserved)
Subjects:       *Behavior Disorders; *Emotional Trauma; *Neurobiology;
*Physiological Arousal; *Posttraumatic Stress Disorder; Attention;
Attention Deficit Disorder; Behavior Problems; Conduct Disorder;
Oppositional Defiant Disorder  
Classification: Behavior Disorders & Antisocial Behavior (3230)
Population:     Human (10)
Age Group:      Childhood (birth-12 yrs) (100)

Adolescence (13-17 yrs) (200)
Form/Content Type:      Literature Review (1300)
Intended Audience:      Psychology: Professional & Research (PS)
Publication Type:       Chapter (160); Print
Release Date:   20030526       
Accession Number:       2003-00408-007 
Number of Citations in Source:  89     
       
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href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2003-004
08-007">Neurobiological disturbances in youth with childhood trauma and
in youth with conduct disorder.</A>    
       
Database:       PsycINFO       
  _____ 

Record: 5
       
Title:  Association of serotonin and cortisol indices with childhood
abuse in bulimia nervosa.      
Author(s):      Steiger, Howard, Douglas Hosp, Eating Disorders Program,
Verdun, PQ, Canada

Gauvin, Lise

Israël, Mimi

Koerner, Naomi

Ng Ying Kin, N. M. K.

Paris, Joel

Young, Simon N.
Source: Archives of General Psychiatry, Vol 58(9), Sep 2001. pp.
837-843.

Journal URL: http://archpsyc.ama-assn.org/
Publisher:      US: American Medical Assn

Publisher URL: http://www.amapublications.com
ISSN:   0003-990X (Print)
Digital Object Identifier:      10.1001/archpsyc.58.9.837      
Language:       English
Keywords:       serotonin; cortisol levels; childhood abuse; bulimia
nervosa; human females; psychological symptoms; eating disorder
symptoms; physical abuse; sexual abuse 
Abstract:       Examined the association of serotonin and cortisol
indices with childhood abuse (CHA) in bulimia nervosa. The authors
compared 45 bulimic women reporting CHA, bulimic women without CHA,
normal eaters with a history of abuse, and normal eaters with no abuse
history on symptom, 5-hydroxytryptamine (5-HT), and cortisol indices.
All Ss were aged 18-40 yrs. It was hypothesized that abuse would
coincide with increased eating and psychological symptoms and decreased
5-HT and cortisol activity. To assess eating disorder (ED) symptoms, the
Eating Disorder Examination interview and the Eating Attitudes Test were
used. Body mass index was computed from self-reported height and weight.
CHA was assessed with the Childhood Trauma Interview, quantifying the
nature, frequency, and duration of childhood physical and sexual abuse.
Results revealed that abuse was reported by 76% of bulimic Ss and 52% of
nonbulimic Ss. Significant bulimic and nonbulimic differences were
indicated for physical abuse, but not for sexual abuse. Bulimic Ss
reporting child abuse showed decreased plasma cortisol levels relative
to nonabused Ss who were normal eaters. Results suggest that bulimia
nervosa and CHA are both generally associated with reduced 5-HT, but CHA
may be more specifically linked to reduced cortisol levels activity.
(PsycINFO Database Record (c) 2004 APA, all rights reserved)
Subjects:       *Bulimia; *Child Abuse; *Hydrocortisone;
*Psychodynamics; *Serotonin; Eating Disorders; Emotional Abuse; Physical
Abuse; Sexual Abuse; Symptoms  
Classification: Eating Disorders (3260)
Population:     Human (10)

Female (40)
Age Group:      Adulthood (18 yrs & older) (300)

Young Adulthood (18-29 yrs) (320)

Thirties (30-39 yrs) (340)

Middle Age (40-64 yrs) (360)
Form/Content Type:      Empirical Study (0800)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20010926       
Accession Number:       2001-18667-005 
Number of Citations in Source:  31     
       
Persistent link to this record:
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Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2001-186
67-005">Association of serotonin and cortisol indices with childhood
abuse in bulimia nervosa.</A>  
       
Database:       PsycINFO       
  _____ 

Record: 6
       
Title:  Glucocorticoid feedback sensitivity and adrenocrotical
responsiveness in posttraumatic stress disorder.       
Author(s):      Kanter, Evan D., VA Pugent Sound Health Care System,
Mental Illness Research, Education, & Clinical Ctr, Seattle, WA, US

Wilkinson, Charles W.

Radant, Allen D.

Petrie, Eric C.

Dobie, Dorcas J.

McFall, Miles E.

Peskind, Elaine R.

Raskind, Murray A.
Source: Biological Psychiatry, Vol 50(4), Aug 2001. pp. 238-245.

Journal URL:
 http://www.elsevier.com/inca/publications/store/5/0/5/7/5/0/
Publisher:      Netherlands: Elsevier Science

Publisher URL: http://elsevier.com
ISSN:   0006-3223 (Print)
Digital Object Identifier:      10.1016/S0006-3223(01)01158-1  
Language:       English
Keywords:       PTSD; adrenal cortex; ACTH; cortisol; metyrapone;
glucocorticoid feedback; Vietnam veterans;
hypothalamic-pituitary-adrenal axis; combat exposure   
Abstract:       There is evidence for enhanced negative feedback
sensitivity of the hypothalamic-pituitary-adrenal (HPA) axis in
posttraumatic stress disorder (PTSD). The authors examined the HPA axis
employing a metyrapone-cortisol infusion protocol designed to study
negative feedback sensitivity. Vietnam combat trauma-exposed Ss (mean
age 50 yrs) met Diagnostic and Statistical Manual of Mental Disorders-IV
(DSM-IV) criteria for PTSD. Exclusion criteria included substance abuse
and most medications. Endogenous feedback inhibition was removed by
blocking cortisol synthesis with oral metyrapone and reintroduced by
intravenous infusion of cortisol. In a placebo condition, Ss received
oral placebo and normal saline infusion. Serial blood samples drawn over
4 hrs were assayed for adrenocorticotrophic hormone (ACTH), cortisol,
and 11-deoxycortisol. Selected samples were assayed for cortisol binding
globulin (CBG) and dehydroepiandrosterone (DHEA). Basal plasma cortisol
was significantly decreased in 13 PTSD Ss compared with 16 controls. No
significant difference in the ACTH response to cortisol infusion
following metyrapone was observed; however 11-deoxycortisol was
significantly decreased in PTSD Ss. In addition, CBG was significantly
increased in PTSD Ss, and DHEA was significantly decreased in both PTSD
and combat-exposed controls. (PsycINFO Database Record (c) 2004 APA, all
rights reserved)
Subjects:       *Adrenal Cortex Hormones; *Corticotropin;
*Hydrocortisone; *Hypothalamo Pituitary Adrenal System; *Posttraumatic
Stress Disorder; Military Veterans     
Classification: Neuroses & Anxiety Disorders (3215)

Military Psychology (3800)
Population:     Human (10)

Male (30)
Location:       US     
Age Group:      Adulthood (18 yrs & older) (300)
Form/Content Type:      Empirical Study (0800)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20010919       
Accession Number:       2001-18433-002 
Number of Citations in Source:  42     
       
Persistent link to this record:
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Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2001-184
33-002">Glucocorticoid feedback sensitivity and adrenocrotical
responsiveness in posttraumatic stress disorder.</A>   
       
Database:       PsycINFO       
  _____ 

Record: 7
       
Title:  Low cortisol and a flattening of expected daytime rhythm:
Potential indices of risk in human development.
Author(s):      Gunnar, Megan R., U Minnesota, Inst of Child
Development, Minneapolis, MN, US

Vazquez, Delia M.
Source: Development & Psychopathology, Vol 13(3), Sum 2001. Special
issue: Stress and development: Biological and psychological
consequences. pp. 515-538.

Journal URL: http://uk.cambridge.org/journals/dpp/
Publisher:      US: Cambridge Univ Press

Publisher URL: http://www.cup.org
ISSN:   0954-5794 (Print)
Digital Object Identifier:      10.1017/S0954579401003066      
Language:       English
Keywords:       stress; limbic-hypothalamic-pituitary-adrenocortical
axis suppression; adverse early life conditions; hypocortisolism       
Abstract:       Since the work of H. Selye, stress has been associated
with increased activity of the
limbic-hypothalamic-pituitary-adrenocortical (LHPA) axis. Recently, a
number of studies in adults have shown that this neuroendocrine axis may
be hyporesponsive in a number of stress-related states. Termed
hypocortisolism (HPT), the paradoxical suppression of the LHPA axis
under conditions of trauma and prolonged stress presently challenges
basic concepts in stress research. Adverse conditions that produce
elevated cortisol levels early in life are hypothesized to contribute to
the development of HPT in adulthood. However, as reviewed in this paper,
HPT also may be a common phenomenon early in human childhood. The
authors argue that developmental studies are needed that help explicate
the origins of low cortisol and to determine whether the development of
HPT is preceded by periods of frequent or chronic activation of the LHPA
axis. They also argue that developmental researchers who incorporate
measures of salivary cortisol into their studies of at-risk populations
need to be aware of the HPT phenomenon. Lastly, they note that evidence
of low cortisol under adverse early life conditions in humans adds to
the importance of understanding the implications of HPT for health and
development. (PsycINFO Database Record (c) 2004 APA, all rights
reserved)
Subjects:       *Early Experience; *Hydrocortisone; *Hypothalamo
Pituitary Adrenal System; *Limbic System; *Stress; Human Development;
Risk Factors   
Classification: Psychological Disorders (3210)

Developmental Psychology (2800)
Population:     Human (10)
Age Group:      Childhood (birth-12 yrs) (100)

Adolescence (13-17 yrs) (200)

Adulthood (18 yrs & older) (300)
Form/Content Type:      Literature Review (1300)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20010912       
Accession Number:       2001-18325-005 
Number of Citations in Source:  112    
       
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href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2001-183
25-005">Low cortisol and a flattening of expected daytime rhythm:
Potential indices of risk in human development.</A>    
       
Database:       PsycINFO       
  _____ 

Record: 8
       
Title:  Childhood trauma and risk for PTSD: Relationship to
intergenerational effects of trauma, parental PTSD, and cortisol
excretion.     
Author(s):      Yehuda, Rachel, Bronx Veterans Affairs, Bronx, NY, US,
 Rachel.yehuda@med.va.gov

Halligan, Sarah L.

Grossman, Robert
Source: Development & Psychopathology, Vol 13(3), Sum 2001. Special
issue: Stress and development: Biological and psychological
consequences. pp. 733-753.

Journal URL: http://uk.cambridge.org/journals/dpp/
Publisher:      US: Cambridge Univ Press

Publisher URL: http://www.cup.org
ISSN:   0954-5794 (Print)
Digital Object Identifier:      10.1017/S0954579401003170      
Language:       English
Keywords:       childhood trauma; PTSD risk; intergenerational effects
of trauma; parental PTSD; transgenerational patterns; cortisol
excretion; adult offspring of Holocaust survivors      
Abstract:       Among the adverse mental health consequences of
childhood trauma is the risk related to the development of posttraumatic
stress disorder (PTSD) in adulthood. Other risk factors for PTSD,
including parental trauma exposure and parental PTSD, can also
contribute to the experience of child trauma. The authors examined
associations between childhood trauma and PTSD in 51 adult children of
Holocaust survivors and 41 comparison Ss, in consideration of parental
trauma exposure and parental PTSD. They also examined these variables in
relation to 24-hr urinary cortisol levels. Adult offspring of Holocaust
survivors showed significantly higher levels of self-reported childhood
trauma, particularly emotional abuse and neglect, relative to comparison
Ss. The difference was largely attributable to parental PTSD.
Self-reported childhood trauma was also related to severity of PTSD in
Ss, and emotional abuse was significantly associated with 24-hr mean
urinary cortisol secretion. It is concluded that the experience of
childhood trauma may be an important factor in the transmission of PTSD
from parent to child. (PsycINFO Database Record (c) 2004 APA, all rights
reserved)
Subjects:       *Adult Offspring; *Early Experience; *Emotional Trauma;
*Holocaust Survivors; *Hydrocortisone; At Risk Populations;
Intergenerational Relations; Parent Child Relations; Posttraumatic
Stress Disorder; Risk Factors; Transgenerational Patterns      
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Male (30)

Female (40)
Age Group:      Adulthood (18 yrs & older) (300)
Form/Content Type:      Empirical Study (0800)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20010912       
Accession Number:       2001-18325-016 
Number of Citations in Source:  76     
       
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Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2001-183
25-016">Childhood trauma and risk for PTSD: Relationship to
intergenerational effects of trauma, parental PTSD, and cortisol
excretion.</A> 
       
Database:       PsycINFO       
  _____ 

Record: 9
       
Title:  The psychobiology of children exposed to marital violence.     
Author(s):      Saltzman, Kristina Muffler, U Texas At Austin, US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 61(11-B), Jun 2001. pp. 6147.
Publisher:      US: Univ Microfilms International

Publisher URL: http://www.il.proquest.com/umi/
ISSN:   0419-4217 (Print)
Order Number:   AAI9992905     
Language:       English
Keywords:       psychobiology; children; marital violence      
Abstract:       Holden (1997) writes that "children who live in
maritally violent homes are at risk for a wide variety of problems,"
including anxiety, depression, attachment difficulties, behavioral
acting out, hyperactivity and impulsivity, post-traumatic stress
disorder, and diffuse functional difficulties in social, familial, and
academic realms. However, there has been no examination to date on the
specific physiological impact of exposure to marital violence upon
children. The present study was an attempt to both replicate previous
behavioral and psychological findings in children exposed to marital
violence and to broaden the body of knowledge by also examining the
physiology of this population. Participants were recruited from the
community via collaboration with a large Southwestern police department
(N = 21) and a clinical control group was used for comparison (N = 27).
Degree and severity of exposure to marital violence were assessed, as
were trauma symptoms, behavior disturbance, dissociation, sleep
dysregulation, baseline and "triggered" cortisol levels, baseline and
"triggered" heart rate, baseline and "triggered" blood pressure, and
orthostatic challenge response. Children exposed to marital violence had
higher baseline and "triggered" levels of cortisol, higher baseline and
"triggered" heart rate, higher "triggered" diastolic blood pressure,
more trauma symptoms, higher levels of internalizing behaviors, higher
levels of dissociation, and higher levels of sleep dysregulation. No
erects were found for resting blood pressure, orthostatic challenge
response, or externalizing behaviors. These results suggest that
children exposed to marital violence have a different physiological
profile than controls, and that, in essence, these children may be
'physically abused' by virtue of exposure to marital violence. (PsycINFO
Database Record (c) 2004 APA, all rights reserved)
Subjects:       *Family Violence; *Marital Conflict; *Psychobiology    
Classification: Health & Mental Health Treatment & Prevention (3300)
Population:     Human (10)
Age Group:      Adolescence (13-17 yrs) (200)
Form/Content Type:      Empirical Study (0800)

Experimental Replication (0830)
Publication Type:       Dissertation Abstract (350); Print

Format(s) Available: Print
Release Date:   20011114       
Accession Number:       2001-95010-174 
       
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10-174">The psychobiology of children exposed to marital violence.</A> 
       
Database:       PsycINFO       
  _____ 

Record: 10
       
Title:  Psychogenic lowering of urinary cortisol levels linked to
increased emotional numbing and a shame-depressive syndrome in
combat-related posttraumatic stress disorder.  
Author(s):      Mason, John W.

Wang, Sheila

Yehuda, Rachel

Riney, Sherry

Charney, Dennis S.

Southwick, Steven M.
Source: Psychosomatic Medicine, Vol 63(3), May-Jun 2001. pp. 387-401.

Journal URL: http://www.psychosomaticmedicine.org/
Publisher:      US: Lippincott Williams & Wilkins

Publisher URL: http://www.lww.com/
ISSN:   0033-3174 (Print)
Language:       English
Keywords:       urinary cortisol levels; individual differences;
posttraumatic stress disorder; Vietnam veterans; disengagement;
shameladen depression; guilt   
Abstract:       Searched for the intrapsychic correlates of individual
differences in cortisol levels in male Vietnam combat veterans with
posttraumatic stress disorder. A measurement of urinary cortisol levels
and clinical assessment with a broad profile of psychometric tests
during a single 48-hour period in 30 inpatients took place. The main
finding by both correlation and t test analyses was a significant
inverse relationship between urinary cortisol levels and a symptom
complex composed of 2 closely interrelated clinical subgroupings,
"disengagement" and "shame-laden depression." The findings support the
concept that cortisol levels reflect the ongoing balance between the
undifferentiated emotional arousal state of engagement (associated with
higher cortisol levels) and opposing antiarousal disengagement defense
mechanisms (associated with lower cortisol levels). It appears that the
low cortisol levels often seen in patients with posttraumatic stress
disorder are psychogenic and reflect a dominating effect of
disengagement coping strategies, which represent secondary compensatory
adaptations during the chronic course of this disorder to counteract
primary arousal symptoms, especially those related to an intractable
shame-laden depressive syndrome. (PsycINFO Database Record (c) 2004 APA,
all rights reserved)
Subjects:       *Emotional Trauma; *Hydrocortisone; *Military Veterans;
*Posttraumatic Stress Disorder; *Urine; Guilt; Individual Differences;
Major Depression; Physiological Correlates; Shame      
Classification: Neuroses & Anxiety Disorders (3215)
Population:     Human (10)

Male (30)

Inpatient (50)
Form/Content Type:      Empirical Study (0800)
Publication Type:       Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date:   20010606       
Accession Number:       2001-17855-007 
Number of Citations in Source:  51     
       
Persistent link to this record:
 http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2001-17855-007

       
Cut and Paste:  <A
href="http://search.epnet.com/login.aspx?direct=true&db=psyh&an=2001-178
55-007">Psychogenic lowering of urinary cortisol levels linked to
increased emotional numbing and a shame-depressive syndrome in
combat-related posttraumatic stress disorder.</A>      
       
Database:       PsycINFO       
  _____ 

Record: 11
       
Title:  Relationship among plasma cortisol, catecholamines, neuropeptide
Y, and human performance during exposure to uncontrollable stress.     
Author(s):      Morgan, Charles A. III, Yale U, School of Medicine, New
Haven, CT, US

Wang, Sheila

Rasmusson, Ann

Hazlett, Gary

Anderson, George

Charney, Dennis S.
Source: Psychosomatic Medicine, Vol 63(3), May-Jun 2001. pp. 412-422.

Journal URL: http://www.psychosomaticmedicine.org/
Publisher:      US: Lippincott Williams & Wilkins

Publisher URL: http://www.lww.com/
ISSN:   0033-3174 (Print)
Language:       English
Keywords:       neurobiological responses; threat; individual
differences; uncontrollable stress; cortisol; neuropeptide Y;
norepinephrine; US Army; performance   
Abstract:       Explored the idea that differences in the
neurobiological responses of individuals that are exposed to threat are
significantly related to psychological and behavioral indices.
Individual differences in neurohormonal, psychological, and performance
indices among 44 healthy, male Ss (mean age 27.8 yrs) enrolled in US
Army survival school were investigated. Ss were examined before, during,
and after exposure to uncontrollable stres. Stress-induced release of
cortisol, neuropeptide Y, and norepinephrine were positively correlated;
cortisol release during stress accounted for 42% of the variance in
neuropeptide Y release during stress. Cortisol also accounted for 22% of
the variance in psychological symptoms of dissociation and 31% of the
variance in militar performance during stress. Data suggest that some
biological differences may exist before index trauma exposure and before
the development of stress-related illness. The data also imply a
relationship among specific neurobiological factors and psychological
dissociation. In addition, the data provide clues about the way in which
individuals' psychobiological responses to threat differ from one
another. (PsycINFO Database Record (c) 2004 APA, all rights reserved)
Subjects:       *Catecholamines; *Hydrocortisone; *Individual
Differences; *Peptides; *Stress; Dissociation; Human Males; Military
Personnel; Neuropeptide Y      
Classification: Neuropsychology & Neurology (2520)

Military Psychology (3800)
Population:     Human (10)

Male (30)
Location:       US     
Age Group:      Adulthood (18 yrs & older) (300)
Form/Content Type:      Empirical Study (0800)
Publication Type:       Peer Reviewed Journal (270); Print