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Researchers Use New Techniques To Assess PTSD

Article Date: 09 Dec 2009 – 1:00 PST

Veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) frequently experience high rates of PTSD along with symptoms of depression and pain. However, little is known about why these symptoms occur together or the most effective treatments that can be used to alleviate them. One approach that may yield new insights is to search for biomarkers — indicators of a biological state that can be easily and reliably measured in people with an illness — to see if their presence or absence can predict symptoms that an individual will experience and identify optimal treatment strategies.

Dr. Christine Marx and her team at Duke University and the Durham VA Medical Center sought to determine if there are biomarkers associated with PTSD symptoms. They hypothesized that veterans who have PTSD (and who often experience depression and pain symptoms) show changes in neurosteroids, which are brain chemicals thought to play a key role in responsiveness to stress.

Read in Full:  http://www.medicalnewstoday.com/articles/173331.php

 

Smaller brain linked to soldiers’ PTSD risk

By Crystal Phend, Senior Staff Writer, MedPage Today

Some combat veterans’ difficulty returning to civilian life may be in part connected to smaller brain volume, researchers found.

Post-traumatic stress disorder (PTSD) after fighting in a war zone was strongly linked to smaller cortical volumes in four areas of the brain involved in identifying objects and words and putting them in context, according to a study led by Steven H. Woodward, PhD, of the National Center for PTSD at the VA Palo Alto Health Care System in California.

More…

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Children’s PTSD linked to poor hippocampus function

By Erin Digitale – Stanford School of Medicine

Psychological trauma leaves a trail of damage in a child’s brain, say scientists at the Stanford University School of Medicine and Lucile Packard Children’s Hospital. Their new study gives the first direct evidence that children with symptoms of post-traumatic stress suffer poor function of the hippocampus, a brain structure that stores and retrieves memories. The research helps explain why traumatized children behave as they do and could improve treatments for these kids.

The brain doesn’t divide between biology and psychology,” said Packard Children’s child psychiatrist Victor Carrion, MD, the primary author of the new research. “We can use the knowledge we get from understanding brain function to improve the psychology of the individual and vice versa.

Extreme stressors such as experiencing abuse or witnessing violence can make children isolate themselves from family and friends, feel disconnected from reality, experience intrusive thoughts about the trauma and struggle in school. “Post-traumatic stress is not only about the traumatic memories; it really affects daily living,” said Carrion, who is an associate professor of child and adolescent psychiatry at the School of Medicine and director of Stanford’s early life stress research program. The research was published online in the Journal of Pediatric Psychology.

The findings could be an important step toward better monitoring of PTSD treatments, which include psychotherapy techniques such as teaching relaxation exercises, helping children to construct a cohesive story about the traumatic event and helping them learn to cope with reminders of the trauma. Right now, psychologists assess such treatments by looking for improvements in symptoms, but that’s a problem because the symptoms can fluctuate from day to day. “That method has the disadvantage that we don’t know what’s happening at the neural level,” Carrion said.

To observe how kids’ brains work after trauma, Carrion’s team used functional magnetic resonance imaging to compare 16 young people who had PTSD symptoms with a control group of 11 normal youths. The scientists scanned the brains of the 10- to 17-year-old subjects during a simple test of verbal memory. Subjects read a list of words, then saw a similar list with new words added, and were asked which terms were present on the original list.

The hippocampus worked equally well in stressed and control subjects when the word list was first introduced. However, subjects with PTSD symptoms made more errors on the recall part of the test and showed less hippocampus activity than control subjects doing the same task.

Subjects with the worst hippocampus function were also most likely to experience a specific set of PTSD symptoms: Such impairment of the hippocampus was strongly correlated with “avoidance and numbing” symptoms of PTSD, including difficulty remembering the trauma, feeling cut off from others and lack of emotion.

Parents and other caregivers may find the new discoveries useful as they tend to traumatized children, Carrion said, particularly when children respond to trauma by withdrawing from people who are trying to help. Parents may sometimes misinterpret this behavior as a child’s attempt to retaliate, when it actually represents an overload of the brain’s normal mechanism for handling fear. “When parents understand that PTSD is real, they don’t take it as personally,” he said. “They become more available to their kids. That’s good because the kids need them.

In the future, physicians and scientists may be able to use fMRI scans of the hippocampus to identify children who are at high risk of PTSD after mass catastrophes, added Carrion, who has consulted on response teams for natural disasters such as Hurricane Katrina and the February 2009 wildfires in southeastern Australia. However, larger studies of brain activity in pediatric PTSD are still needed to give a more detailed understanding of the disorder.

It’s already clear that untreated PTSD can interfere with a child’s normal brain development and increase the risk of other psychiatric conditions such as depression and substance abuse, Carrion concluded. “Early intervention is critical for children with post-traumatic stress,” he said.

The research was funded by grants from the National Institute of Mental Health; NARSAD, previously known as the National Alliance for Research on Schizophrenia and Depression; the American Foundation for Suicide Prevention; and the Aloha Foundation. 

Carrión VG, Haas BW, Garrett A, et al. Reduced Hippocampal Activity in Youth with Posttraumatic Stress Symptoms: An fMRI Study. J Pediatr Psychol. 2009 Dec;doi:10.1093/jpepsy/jsp112   [Abstract]

Military Children Face More Emotional Challenges As Parental Deployments Grow Longer, Study Finds

Article Date: 09 Dec 2009 – 0:00 PST

Children in military families may suffer from more emotional and behavioral difficulties when compared to other American youths, with older children and girls struggling the most when a parent is deployed overseas, according to a new RAND Corporation study.

Researchers found that having a parent deployed for a longer period of time and having a non-deployed parent who has struggled with emotional problems were important factors associated with whether military children would struggle themselves, according to the study published online by the journal Pediatrics. 

The findings are from a RAND survey that examined the wartime well-being of 1,500 children from military families from across the nation, surveying both the children and a non-deployed parent or other caregiver.

“Our study suggests that children of deployed service members face emotional and behavioral challenges,” said Anita Chandra, the study’s lead author and a behavioral scientist at RAND, a nonprofit research organization. “While this finding may seem intuitive, our study begins to shed more light on the nature of the problem. Much more work is needed to better understand these challenges and to improve ways to support children throughout the deployment cycle.”

The RAND study is the largest to date that explores how the children of military members are faring academically, socially and emotionally during an extended period of wartime. The project was commissioned by the National Military Family Association, an independent nonprofit group that provides support and services to military families. 

Read Article in Full:  http://www.medicalnewstoday.com/articles/173307.php

 



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