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Objectives: This article describes the neurobiology of psychological injuries—chronic pain, concussion/mild traumatic brain injury (MTBI), and fear/posttraumatic stress disorder (PTSD)—toward elucidating common mechanisms in central and peripheral sensitization that contribute to their onset, exacerbation, and maintenance. Central sensitization refers to central nervous system (CNS) and related processes, while peripheral sensitization is typically referred to as receptor field expansion. The three psychological injury diagnoses/conditions are accompanied by impairments in function after negligent events (such as motor vehicle accidents (MVAs)) that lead to tort court action. Methods: The conducted literature review involved an extensive scoping review of recent neurobiological literature on chronic pain, PTSD, and MTBI. The literature review sought biological markers that distinguish them. Results: For chronic pain, concussion/MTBI, and fear/PTSD, this article reviewed definitions and critical neurobiological research. The literature review did not find evidence of biological markers, but the role of sensitization emerged as important. Conclusions: Common therapeutic processes, such as focusing on sensitization, might be helpful for these conditions. As for causal mechanisms related to sensitization in the causality of psychological injuries, the major ones hypothesized relate to the biopsychosocial model, psychological control, and activation–inhibition coordination.

The Department of Veterans Affairs traumatic brain injury (TBI) screening program is intended to detect and expedite treatment for TBI and postconcussive symptoms. Between April 14, 2007, and May 31, 2012, of 66,089 Iraq and Afghanistan Veterans who screened positive on first-level TBI screening and later completed comprehensive TBI evaluation that includes the Neurobehavioral Symptoms Inventory, 72% reported moderate to very severe cognitive impairment (problems with attention, concentration, memory, etc.) that interfered with daily activities. This included 42% who were found not to have sustained combat-related mild TBI (mTBI). In contrast, 70.0% received a posttraumatic stress disorder (PTSD) diagnosis and 45.8% received a depression diagnosis. Compared with Veterans without mTBI, PTSD, or depression diagnoses, the lowest risk for self-reported cognitive impairment was in Veterans with confirmed mTBI only; a greater risk was found in those with PTSD diagnoses, with the greatest risk in Veterans with PTSD, depression, and confirmed mTBI, suggesting only a weakly additive effect of mTBI. These findings suggest that Veterans with multiple mental health comorbidities, not just those with TBI, report moderate to very severe cognitive impairment. Mental health treatment for conditions such as PTSD and depression (with or without TBI) may result in improvements in cognitive functioning and/or include assessment and support for Veterans experiencing cognitive problems.

Recent studies have found a significant association between PTSD and low heart rate variability (HRV), a biomarker of autonomic dysregulation. Research indicates that respiratory sinus arrhythmia (RSA) biofeedback increases HRV while reducing related pathological symptoms. This controlled pilot study compared RSA biofeedback to progressive muscle relaxation (PMR) as adjunctive interventions for 38 persons with PTSD symptoms in a residential treatment facility for a substance use disorder. Both groups were assessed at pre-intervention and 4-week post-intervention. Group × time interactions revealed significantly greater reductions in depressive symptoms and increases in HRV indices for the RSA group. Both groups significantly reduced PTSD and insomnia symptoms and a statistical trend was observed for reduced substance craving for the RSA group. Increases in HRV were significantly associated with PTSD symptom reduction. Overall, these results provide preliminary support for the efficacy of RSA biofeedback in improving physiological and psychological health for individuals with PTSD.

: Parental post-traumatic stress disorder (PTSD) symptoms are associated with heightened parenting stress, but it is unknown whether this relation depends on the timing (childhood or adulthood) and type of trauma (interpersonal or non-interpersonal). In survivors of childhood interpersonal trauma, PTSD and parenting stress may be more strongly intertwined. : This study examined whether the relation between parental PTSD and parenting stress is moderated by childhood interpersonal trauma. Findings are supplemented with information on the process of performing an individual participant data meta-analysis (IPDMA) and lessons learned. : Using one-stage IPDMA, data from published studies and unpublished datasets were synthesized and analysed using multilevel linear regression. : Twelve datasets were included (  = 1249: 92.5% female, age = 32.8 years, 53.8% ethnic minority). Significant and positive main effects of PTSD and childhood interpersonal trauma on parenting stress were consistently found across studies. A moderating effect of childhood interpersonal trauma on the relation between PTSD and parenting stress was not found, but this finding may be impacted by limited data coverage. The proportion of individual-level variance in parenting stress explained by the model with main and interaction effects while controlling for education level was small to medium (  = .12,  = .003). : This study is the first to investigate relations among parental childhood interpersonal trauma, PTSD, and parenting stress across studies using IPDMA methodology. Despite limitations in data coverage, its findings demonstrated that links among childhood interpersonal trauma, PTSD, and parenting stress were robust across populations and settings. This implies PTSD symptom reduction may be beneficial in reducing parenting stress, regardless of whether the parent experienced childhood interpersonal trauma. Additionally, lessons learned and suggestions for how IPDMA can bring the field of trauma and PTSD research forward are presented.

Numerous studies have demonstrated explicit and working memory deficits related to posttraumatic stress disorder (PTSD), but few have addressed longitudinal changes in memory functioning. There is some evidence to suggest an interactive effect of PTSD and aging on verbal memory decline in Holocaust survivors (Yehuda et al., 2006). However, the longitudinal trajectory of neuropsychological functioning has not been investigated in Vietnam veterans, a younger but substantial population of aging trauma survivors. We administered tests of visual and verbal memory, and working memory to derive different dependent measures in veterans between the ages of 41 and 63, the majority of whom served in the Vietnam War. Twenty-five veterans with PTSD and 22 veterans without PTSD were assessed over two time points (mean age at follow-up = 54.0; mean inter-test interval = 34 months). The PTSD+ group, consisting of veterans with chronic, primarily combat-related PTSD, did not show a significant change in PTSD symptoms over time. Compared to veterans without PTSD, veterans with PTSD showed a greater decline in delayed facial recognition only, and this decline was extremely subtle. (JINS, 2009, 15, 853–861.)

Question Question How effective is a trauma-focused cognitive-behavioural therapy (TF-CBT) programme for children with post-traumatic stress disorder (PTSD) related to intimate partner violence (IPV)? Secondary outcomes: child scores on a number of cognitive and mental health scales including K-SADS-PL, the Screen for Child Anxiety Related to Emotional Disorders (SCARED), the Children's Depression Inventory, the Child Behaviour Checklist and the Kaufman Brief Intelligence Test.

Abstract Study Objectives Hypnotic medications can adversely affect behavior during unanticipated awakenings during the night. Animals treated with the hypocretin (Hcrt) receptor antagonist almorexant (ALM) have less acute cognitive impairment compared to the GABAA receptor modulator zolpidem (ZOL). This study aimed to determine whether ALM produces less acute cognitive impairment than ZOL in human subjects. Methods Healthy, young adult, unmedicated male and female subjects participated in a controlled trial of a single dose of ALM 100 mg (N = 48), ALM 200 mg (N = 53), ZOL 10 mg (N = 49), and placebo (PBO, N = 52). Results ZOL and both doses of ALM produced similar levels of subjective sleepiness and impaired the ability of subjects to remain awake in a dark, low-stimulus setting relative to PBO. For most cognitive measures, performance under ZOL was significantly worse than ALM or PBO. For tasks involving verbal memory or visual-motor coordination, ZOL impaired performance, whereas the two doses of ALM were no different than PBO. For tasks involving higher-order executive function, ZOL produced impairment in processing speed and inhibitory control, whereas the two doses of ALM were no different than PBO. Performance decrements for ALM were less than ZOL but greater than PBO for some reaction time measures. Conclusions The data provide support for the hypothesis that Hcrt receptor antagonists produce less functional impairment than a benzodiazepine receptor agonist (BzRA). These observations are particularly relevant to patients treated with sedative-hypnotics who are at elevated risk for falls and other untoward events during the intended hours for sleep.

Additionally, the successful creation of 3D printed implants to replace complex soft tissue could significantly impact future work in soft tissue regenerative medicine. 3D printing an ovary structure is similar to a child using Lincoln Logs, says Alexandra Rutz, co-lead author of the study and a former biomedical engineering graduate fellow in Shah's Tissue Engineering and Additive Manufacturing (TEAM) lab at the Simpson Querrey Institute.

Oct. 08--This year at the Chicago Marathon, we can pretty much guarantee the amazingly fast Kenyans or Ethiopians will win (at least if the last five years serve as any indicator), groups upon groups of Chicagoans will come out to cheer on the runners, and at least 50 clueless Chicago drivers will angrily arrive at a barricaded entrance to Lake Shore Drive without having any idea there's a race even happening that day.