Spine surgery patients develop PTSD symptoms

According to a recent Oregon Health & Science University study published in the journal Spine most of the people who underwent low back fusion surgery developed post-traumatic stress disorder symptoms associated with that surgery.

Past studies showed PTSD symptoms in some cancer or trauma and organ transplant patients. But this is the first time to monitor for PTSD symptoms in patients undergoing an elective medical procedure. According to our research the strongest factor in determining whether a spine surgery patient suffered PTSD symptoms after the surgery was whether the patient had a psychiatric disturbance or anxiety disorders before the surgery. It is also found that some patients who had no such pre-surgery diagnoses also suffered PTSD symptoms after the spine surgery.

Our researchers look for other ways to deal with back pain before surgery. As a result of our research it is found that sometimes surgery is the only option. Again spinal fusion is often major surgery that may involve complications and often involves a long recuperation period. However, the majority of patients in the study reported a good experience and had substantial relief of their pre-operative pain.

As a result of our research doctors and surgeons got guidance in advising potential spine surgery patients about the surgery. The result suggests doctors and surgeons might offer treatment for patients at higher risk prior to surgery. Researchers have also identified a potential medical treatment for the cognitive effects of stress-related disorders including post-traumatic stress disorder (PTSD).

 According to our research conducted in a PTSD mouse model showed that an experimental drug called S107 is one of a new class of small-molecule compounds called Rycals, prevented learning and memory deficits associated with stress-related disorders. If you want to know more visit our official web site. Our research as www.newspsychology.com can help you immensely. 

One-fifth of spine surgery patients develop PTSD symptoms

Nearly 20 percent of people who underwent low back fusion surgery developed post-traumatic stress disorder symptoms associated with that surgery, according to a recent Oregon Health & Science University study published in the journal Spine.

Past studies have noted PTSD symptoms in some trauma, cancer and organ transplant patients. But this is the first study, its authors believe, to monitor for PTSD symptoms in patients undergoing an elective medical procedure.

"It is maybe not surprising that significant surgical interventions have psychological as well as physical impacts," said Robert Hart, M.D., an orthopedic surgeon, professor of orthopedics and rehabilitation at OHSU and senior author of the study. "I think it means that we in the medical community need to monitor for these effects in our patients and to manage them when they occur."

The study found that the strongest factor in determining whether a spine surgery patient suffered PTSD symptoms after the surgery was whether the patient had a psychiatric disturbance — depression or anxiety disorders, for example — before the surgery. But some patients who had no such pre-surgery diagnoses also suffered PTSD symptoms after the spine surgery, the study found.

The OHSU study involved 73 of Hart's surgical patients who underwent lumbar spinal fusion surgery, a procedure in which two or more lumbar vertebrae in the back are fused together, usually including implantation of metal screws and rods as part of the procedure.

Surgeons at the OHSU Spine Center always look for other ways to deal with back pain before surgery. But sometimes, surgery is the only option. And spinal fusion is often major surgery that may involve complications and often involves a long recuperation period. The majority of patients in the study reported a good experience and had substantial relief of their pre-operative pain.

Hart said the study results might offer guidance to doctors and surgeons in advising potential spine surgery patients about the surgery. For patients at higher risk, the results suggest doctors and surgeons might offer treatment for them prior to surgery, Hart said.

"At the end of the day, I hope this will make changes in the way we prepare people for surgery, to reduce these psychological impacts. This is analogous to how we currently optimize patients' physical condition before major surgery," Hart said.

Hart said he wants to study that issue next — and measure which pre-surgery interventions might work best to reduce or eliminate any PTSD effects.

Marines' PTSD symptoms reduced via integrative medicine, study shows

 Healing touch combined with guided imagery (HT+GI) provides significant clinical reductions in post-traumatic stress disorder (PTSD) symptoms for combat-exposed active duty military, according to a study released in the September issue of Military Medicine.

The report finds that patients receiving these complementary medicine interventions showed significant improvement in quality of life, as well as reduced depression and cynicism, compared to soldiers receiving treatment as usual alone.

The study, led by the Scripps Center for Integrative Medicine in San Diego, Calif., conducted a randomized controlled trial of returning active-duty Marines at Camp Pendleton, Calif. from July 2008 to August 2010. Participants were separated at random into two groups, one that received treatment as usual (TAU) for PTSD and another that received TAU as well as healing touch (HT), a practitioner-based treatment aimed at eliciting the participant's own healing response, with guided imagery (GI), a self-care therapy aimed at eliciting relaxation as well as enhancing trust and self-esteem.

Significant Improvements Reported

After six sessions within a three-week period with a Scripps practitioner, the HT+GI group reported a significant improvement in PTSD symptoms as a result of these combined complementary therapies.

The principal investigators and designers of the study are Dr. Mimi Guarneri and Rauni King, founders of the Scripps Center for Integrative Medicine. The Samueli Institute of Alexandria,Va., conducted blind data analysis and authored the manuscript.

"Scores for PTSD symptoms decreased substantially, about 14 points and below the clinical cutoffs for PTSD," said Dr. Guarneri. "This indicates that the intervention was not just statistically significant, but actually decreased symptoms below the threshold for PTSD diagnosis. It made a large difference in reducing PTSD symptoms."

Study Criteria

The study included a total of 123 participants — 55 who received TAU and 68 who received HT+GI and TAU. To be eligible for the trial, participants were screened to confirm that they were currently experiencing at least one of the following PTSD symptoms: re-experiencing of trauma via flashbacks, nightmares, intrusive thoughts, exaggerated emotional responses to trauma, emotional numbness, insomnia, irritability, exaggerated startle response, or avoidance of people or places that remind them of the trauma.

"Service members are seeking out non-drug complementary and integrative medicine as part of their overall care and approach to wellness," said Wayne B. Jonas, MD, president and chief executive officer of Samueli Institute. "This treatment pairs deep relaxation with a self-care approach that can be used at home .The results of this study underscore the need to make effective, non-stigmatizing treatments for PTSD available to all our service members."

Healing Touch and Guided Imagery

Healing touch is an energy-based, non-invasive treatment that restores and balances the human biofield to help decrease pain and promote healing. Healing touch is often used as an adjunct to surgery and other medical procedures to assist in pain reduction, decrease anxiety and elicit relaxation.

Guided imagery is a way of using the imagination to help a person, reduce stress, decrease pain and enhance overall well-being through visualization. For the purposes of this study, guided imagery was administered to the subjects through a recorded CD simultaneously with Healing Touch and then listed to independently by subjects at least once daily.

The study, "Healing Touch with Guided Imagery for PTSD in Returning Active Duty Military: A Randomized Controlled Trial" was authored by Shamini Jain, PhD, Samueli Institute; George F. McMahon, CDR, NC, USN; Patricia Hasen, CDR, NC, USN, Valencia Porter, MD, MPH; Rauni King, RN, MIH, CHTP; Mimi Gaurneri, MD.

The study was funded by a grant from The Taylor Family Foundation. Although this was a privately-funded study, it involved a military population and investigator and followed all Department of Defense-relevant research regulations. The views, opinions and/or findings contained in this report are those of the author(s) and should not be construed as an official Department of the Navy position, policy or decision unless so designated by other documentation.


Journal Reference:

  1. Jain, Shamini; McMahon, George F.; Hasen, Patricia; Kozub, Madelyn P.; Porter, Valencia; King, Rauni; Guarneri, Erminia M. Healing Touch With Guided Imagery for PTSD in Returning Active Duty Military: A Randomized Controlled Trial. Military Medicine, 2012; 177 (9): 1015-1021(7) DOI: http://www.ingentaconnect.com/content/amsus/zmm/2012/00000177/00000009/art00016

Mental stress: Unique solutions for unique populations

A mother in jail co-residing with her infant in a prison nursery; a war veteran still picturing the violent trauma. These scenarios are real life and dealt with each day by incarcerated mothers and returning veterans.

The common link — stress — is the focus of Johns Hopkins University School of Nursing (JHUSON) PhD Candidate Jan Kaminsky and Doctor of Nursing Practice (DNP) student Jemma Ayvazian.

Working with a group of mothers who had participated in a co-residential prison nursery program, Kaminsky surveyed to see if an insecure maternal attachment due to incarceration was associated with harsher child discipline practices and higher levels of maternal depression. In collaboration with her mentor Dr. Mary Byrne, Columbia University School of Nursing, and through Byrne's ongoing study with these mothers, Kaminsky administered a 20-question Conflict Tactics Scale to determine what types of discipline (non-violent, psychological, and physical assault) they had administered over the past 12 months after their release from prison.

Kaminsky learned that while all mothers reported some use of non-violent discipline, the majority used psychological aggression and minor physical assault against their children, and mothers who had faced significant depression were more likely to utilize physical assault.

Kaminsky was encouraged that most mothers had a strong understanding of and desire to break the cycle of incarceration and family instability they once experienced. She felt prison nursery use was a way to help improve the lives of these vulnerable families, while advancing each mothers' attachment model with their children. One mother, referring to her daughter, said, "She was very full of herself…that she knows that she can accomplish anything. And…you know…I've taught her that…that she can do anything she wants to do with her life."

Looking at a very different population, Jemma Ayvazian is using a remote Veteran's Administration facility to identify care components necessary to produce positive outcomes for veterans who sustained Polytrauma/Traumatic Brain Injury (TBI) during the Iraq and Afghanistan wars.

Ayvazian hopes to promote recovery and successful reintegration into the community and decrease the time Polytrauma/TBI veterans spend in the post-acute and chronic phase. She is also considering development of a phone application that will provide free health information through text messages to clinicians, family members, care givers, and the veterans themselves.

Ayvazian remembers her husband's deployment to Iraq in March of 2003. "I saw soldiers coming back from the war zone with multiple problems: I wanted to somehow help…Although it is difficult for me to witness what our veterans and their families go through, helping — one at a time — making a meaningful impact on their lives, serving as their advocate, making sure that their voices are heard and their needs are met is the most rewarding experience."

Education, psychological support key for defibrillator patients

Because depression, anxiety and post-traumatic stress disorder are common among people with implanted cardioverter defibrillators, doctors and nurses should provide gender- and age-specific information on the potential psychological impact. Each month, 10,000 people, including children, have a defibrillator implanted to restore normal heart rhythm and prevent sudden cardiac death.

Improved patient education and ongoing psychological support will help people cope with the psychological distress of having an implanted defibrillator, according to a scientific statement from the American Heart Association.

The statement, published in the American Heart Association journal Circulation, is a comprehensive review of the psychosocial and quality of life for people who receive an implantable cardioverter defibrillator (ICD) to restore normal heart rhythm and prevent sudden cardiac death. It includes recommendations for improved patient care and identifies areas where more research is needed.

The authors recommend routine screening and appropriate treatment for anxiety, depression and post-traumatic stress disorder, which patients with ICDs often experience.

"A shock from an ICD can be lifesaving, but it can also affect a person's quality of life and psychological state," said Sandra B. Dunbar, R.N., D.S.N., chair of the statement writing group. "It's important to look at this issue now because 10,000 people have an ICD implanted each month. They range from older people with severe heart failure to healthy children who have a gene that increases the risk of sudden cardiac arrest."

Before implantation, clinicians should provide clear information about the benefits and limitations of the ICD, prognosis and impact on lifestyle including activity and occupation.

"Education and support need to include the patient and the family and be broader than just a focus on maintaining the device. Providers need to help patients address ICD-specific concerns about symptoms, heart disease treatment, physical activities and end-of-life issues," said Dunbar, who is also the Charles Howard Candler Professor at the Nell Hodgson Woodruff School of Nursing at Emory University in Atlanta.

Among the statement's recommendations to improve psychological outcomes, physicians and nurses should:

  • Emphasize that the ICD protects against sudden death, but does not improve your underlying heart condition unless the device does other things, such as certain types of pacing.
  • Assess the patient's concerns and psychological status at each follow-up visit.
  • Develop a clear "shock plan" so patients and family members know what to do in the event of a shock.
  • Help patients and their families deal with stressful situations that may develop with an ICD.
  • Provide gender-specific, age-appropriate information for children and their families.

Although pediatric ICD recipients make up less than 1 percent of the ICD population, complications are more frequent and these patients will live with the defibrillators for a much longer period of time, according to the statement.

"Experiencing a shock is distressing and patients have a wide variety of responses," Dunbar said. "Some find it very reassuring that it's working, while others find the actual physical sensations frightening and overwhelming. That's why we suggest that clinicians provide an ongoing assessment of ICD patients' psychological needs."

The statement identified several areas for further research, including predicting which patients are likely to experience psychological distress and how to alleviate it; the level of sports participation and physical activity appropriate for children and teens with ICDs; and when and how to discuss potential ICD deactivation near the end of life.

Co-writers include Cynthia Dougherty, R.N., Ph.D.; Samuel Sears, Ph.D.; Diane L. Carroll, R.N., Ph.D.; Nathan Goldstein, M.D.; Daniel Mark, M.D.; George McDaniel, M.D.; Susan J. Pressler, R.N., Ph.D.; Eleanor Schron, R.N., Ph.D.; Paul Wang, M.D. and Vicki Zeigler, R.N., Ph.D.

Study challenges assumptions on wartime sexual violence

A new study by the Simon Fraser University-based Human Security Report Project (HSRP), released October 10 at the United Nations headquarters in New York, finds that there is no compelling evidence to support a host of widely held beliefs regarding wartime sexual violence.

The study, presented by HSRP director Andrew Mack, disputes the common assumption that conflict-related sexual violence is on the rise, and argues that the experience of a small number of countries afflicted by extreme levels of sexual violence is not the norm for all war-affected countries.

Key findings include:

  • In more than half of the years in which countries around the world experienced conflict between 2000-2009, levels of reported conflict-related sexual violence were low to negligible.
  • There is no evidence to support frequent claims that rape as a "weapon of war" is widespread, nor that its incidence has been growing.
  • Domestic sexual violence victimizes far more women in war-affected countries than does the conflict-related sexual violence that is perpetrated by combatants.
  • Recent studies show that male victims and female perpetrators may be more numerous than generally believed.
  • The study also finds that the mainstream view of the impact of war on children's education as highly damaging is incorrect, and that educational outcomes in war-affected countries improve over time despite fighting, even in regions most affected by war.

Potential treatment for cognitive effects of stress-related disorders, including PTSD

Columbia University Medical Center (CUMC) researchers have identified a potential medical treatment for the cognitive effects of stress-related disorders, including post-traumatic stress disorder (PTSD). The study, conducted in a PTSD mouse model, shows that an experimental drug called S107, one of a new class of small-molecule compounds called Rycals, prevented learning and memory deficits associated with stress-related disorders.

The findings were published August 30 in the online edition of Cell.

"With the dramatic rise in cases of PTSD among our combat veterans, and following common afflictions such as heart attacks, there is a pressing need for new and better therapies for this debilitating disorder," said study leader Andrew R. Marks, MD, chair and professor of physiology and cellular biophysics, the Clyde and Helen Wu Professor of Medicine, and director of the Wu Center for Molecular Cardiology at CUMC. "Our study provides new insight regarding the mechanism of stress-related cognitive disorders, as well as a potential treatment based on the understanding of this mechanism."

PTSD is a disabling anxiety disorder triggered by a traumatic experience, ranging from a one-time event such as physical assault to chronic stresses such as those experienced during warfare. Patients are commonly treated with supportive therapies, including antipsychotics, antidepressants, anti-anxiety medications, and psychotherapy. However, there is currently no specific treatment for PTSD and related disorders.

Several studies have shown that chronic stress could affect the structure and function of neurons in the brain. Researchers have proposed that these effects could contribute to neuropsychiatric disorders, including PTSD, which involves symptoms of cognitive dysfunction. However, exactly how the cognitive dysfunction arises (which manifests as impaired learning and memory) has not been clear.

Based on his earlier work in heart and muscle disorders, Dr. Marks reasoned that chronic stress could lead to PTSD by destabilizing type 2 ryanodine receptors (RyR2) in the hippocampus, the brain region that plays a central role in learning and memory. RyR2 are channels that regulate the level of calcium in neurons, which is vital to cell survival and function.

In earlier mouse studies, Dr. Marks and his team showed that stress can cause RyR2 channels in heart muscle to leak calcium resulting in heart failure and arrhythmias. Subsequent studies in mouse models conducted by Dr. Marks' lab showed that leaky RyR1 channels (a closely related calcium channel) in skeletal muscle can contribute to Duchenne muscular dystrophy, limb-girdle muscular dystrophy and age-related muscle weakness.

To ascertain whether leaky RyR2 channels are a factor in stress-related cognitive disorders, the researchers used a classic model for PTSD that involves subjecting mice to stressful conditions for three weeks. This raises their corticosteroid levels (a classic marker of stress) and activates genes known to be expressed in response to stress.

"When we examined the hippocampal neurons of the stressed mice, we found that their RyR2 channels had become destabilized and leaky compared with channels from normal non-stressed mice which were not leaky. There was a remodeling of the channels that we had previously seen in heart and skeletal muscles from animal models of chronic diseases including heart failure and muscular dystrophy. We found these same leaky channels in samples from patients with these disorders but not in those from healthy humans," said Dr. Marks.

"The next question was: Do the leaky channels affect memory and learning, two functions that are impaired in individuals with PTSD?" said Dr. Marks. "Using classic behavioral and cognitive function tests, including a water-maze and object-recognition tests, we found that the stressed mice developed profound cognitive abnormalities affecting both learning and memory."

The researchers confirmed that hippocampal RyR2 channels were involved in the cognitive decline of the mice in two ways. First, when the mice were given Rycal S107, a novel drug designed in Dr. Marks' lab that prevents the calcium leak by stabilizing RyR2 channels, cognitive function was not affected by exposure to chronic stress. Second, the researchers created a strain of mice in which stress signals cannot destabilize hippocampal RyR2 channels. When these mice were subjected to chronic stress, they showed no signs of cognitive impairment.

Dr. Marks expects that clinical trials with S107, or a similar Rycal, for the treatment of PTSD could begin within several years. Another Rycal is currently being tested in patients with heart failure and arrhythmias.

The researchers are also examining the role of these RyR2 channels in neurodegenerative diseases, including Alzheimer's.

This research was supported by National Institutes of Health grants RO1-HL56180 and RO1-NS049442.


Journal Reference:

  1. Xiaoping Liu, Matthew J. Betzenhauser, Steve Reiken, Albano C. Meli, Wenjun Xie, Bi-Xing Chen, Ottavio Arancio, Andrew R. Marks. Role of Leaky Neuronal Ryanodine Receptors in Stress- Induced Cognitive Dysfunction. Cell, 2012; 150 (5): 1055 DOI: 10.1016/j.cell.2012.06.052

War is not necessarily the cause of post-traumatic stress disorder

NewsPsychology (Aug. 17, 2012) — Recent research carried out at Business and Social Sciences, Aarhus University shows that surprisingly, the majority of soldiers exhibiting symptoms of post-traumatic stress syndrome were suffering from poor mental health before they were posted to a war zone.

A large-scale survey of the mental condition of military personnel before, during and after their posting to Afghanistan has proved thought-provoking. In total, 746 Danish soldiers took part in the survey. The soldiers completed a questionnaire five times in all — before their posting, during their time in Afghanistan and three times after their return to Denmark.

Professor Dorthe Berntsen of the Center on Autobiographical Memory Research — CON AMORE, Department of Psychology, Aarhus University, Business and Social Sciences, is responsible for the study, together with military psychologists at the Danish Centre for Defence Veterans and researchers from Duke University in North Carolina. The survey has produced some surprising results.

“Typically, it is not the experience of war that triggers the symptoms of post-traumatic stress disorder (PSTD),” explains Dorthe Berntsen.

“In the case of soldiers in Afghanistan, we might well expect that it was their experiences of war there that triggered PSTD. However, the situation is not so simple. We need to look at the soldiers’ experiences in a lifetime perspective. The study has provided new information, because the survey includes data on the soldiers’ state of health before their departure, during their tour of duty and several times after their return. It shows that many of the soldiers had already experienced trauma before they went to Afghanistan, and that this has affected the way they reacted during their posting.

“It has long been generally thought that PTSD occurs after violent experiences. Our survey thus provides new knowledge,” says Dorthe Berntsen.

“War in itself is not the crucial factor in making soldiers ill. It can be a contributing factor, but it is not the decisive factor.”

Research can help

Dorthe Berntsen explains that PTSD sufferers experience among other symptoms involuntary intrusive recollections. These are very negative memories that force themselves into the consciousness, and they can be very disabling for the individual concerned. They may, for example, take the form of unpleasant flash-backs from the war that can cause mood changes, and can lead some individuals to lose confidence in themselves to a greater or lesser degree and to begin to dwell too much on their situation.

“Our research into involuntary recall shows that this type of recollection and the way it normally occurs can help us to understand the dysfunctional involuntary recollections that occur in disorders like PTSD.”

Research conducted at the basic research centre CON AMORE, where Dorthe Berntsen is the director, shows that people have many pleasant involuntary recall experiences every day; the knowledge that the researchers have concerning ordinary involuntary recall can be used in understanding the dysfunctional, intrusive recollections that some soldiers experience when they return from war.

Differences among soldiers

The experiences of war do not cause negative effects in all soldiers. The majority of military personnel are resistant, and do not experience their combat-zone posting as a great problem. Soldiers can be grouped into three categories.

A small proportion of the soldiers in the survey felt better as a result of their posting. They had a high level of PSTD before their tour of duty, and this level decreased during or immediately after their posting to Afghanistan, after which it rose again. This group of soldiers were less well educated than the others, with many of them having only attended lower secondary school, explains Dorthe Berntsen.

“Being sent abroad in the military services can be an attractive opportunity for this group of young people to escape from their everyday lives in Denmark. We presume that they are attracted by the camaraderie and by working with others.”

According to Dorthe Berntsen, by far the largest proportion of soldiers in the survey fell into the category termed robust. They are a resistant group, and do not allow themselves to be affected by their everyday situation either before their posting, during their tour in Afghanistan or after returning home.

Around five percent of the soldiers in the survey proved to be different to those in the two groups above, and not in a positive sense. They were like the robust soldiers before going to the war zone, but their mental state deteriorated while they were there, and did not recover after their return home, says Dorthe Berntsen.

– We cannot rule out the possibility that they were exposed to different experiences than the robust group of soldiers in Afghanistan. But this is probably not the case. According to Dorthe Berntsen, this group of soldiers differ from the robust group in that there were more childhood traumas in their backgrounds.

What do the soldiers think?

It is Dorthe Berntsen’s impression that the soldiers who participated in the study were generally pleased to have done so.

“The troops were pleased that the Defence Command was interested in their welfare and wellbeing before, during and after their posting to Afghanistan. The survey participants were guaranteed anonymity throughout the survey process,'” concludes Dorthe Berntsen.

In brief

  • Professor Dorthe Berntsen is a professor at the Department of Psychology, Aarhus University, Business and Social Sciences and is director of the Center on Autobiographical Memory Research — CON AMORE
  • CON AMORE is a basic research centre established under the auspices of the Danish National Research Foundation and is located in the Department of Psychology, Aarhus University, Business and Social Sciences.
  • 746 military personnel participated in the study.
  • The survey was carried out in cooperation with the Danish Defence Command.
  • The results of the study have been accepted for publication in the academic journal Psychological Science.

Story Source:

The above story is reprinted from materials provided by Aarhus University.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.


Heavy drinking rewires brain, increasing susceptibility to anxiety problems

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Heavy alcohol use rewires brain circuitry, making it harder for alcoholics to recover psychologically following a traumatic experience, new research suggests. (Credit: © line-of-sight / Fotolia)

Doctors have long recognized a link between alcoholism and anxiety disorders such as post-traumatic stress disorder (PTSD). Those who drink heavily are at increased risk for traumatic events like car accidents and domestic violence, but that only partially explains the connection. New research using mice reveals heavy alcohol use actually rewires brain circuitry, making it harder for alcoholics to recover psychologically following a traumatic experience.

"There's a whole spectrum to how people react to a traumatic event," said study author Thomas Kash, PhD, assistant professor of pharmacology at the University of North Carolina School of Medicine. "It's the recovery that we're looking at — the ability to say 'this is not dangerous anymore.' Basically, our research shows that chronic exposure to alcohol can cause a deficit with regard to how our cognitive brain centers control our emotional brain centers."

The study, which was published online on Sept. 2, 2012 by the journal Nature Neuroscience, was conducted by scientists at the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and UNC's Bowles Center for Alcohol Studies.

"A history of heavy alcohol abuse could impair a critical mechanism for recovering from a trauma, and in doing so put people at greater risk for PTSD," said NIAAA scientist Andrew Holmes, PhD, the study's senior author. "The next step will be to test whether our preclinical findings translate to patients currently suffering from comorbid PTSD and alcohol abuse. If it does, then this could lead to new thinking about how we can better treat these serious medical conditions."

Over the course of a month, the researchers gave one group of mice doses of alcohol equivalent to double the legal driving limit in humans. A second group of mice was given no alcohol. The team then used mild electric shocks to train all the mice to fear the sound of a brief tone.

When the tone was repeatedly played without the accompanying electric shock, the mice with no alcohol exposure gradually stopped fearing it. The mice with chronic alcohol exposure, on the other hand, froze in place each time the tone was played, even long after the electric shocks had stopped.

The pattern is similar to what is seen in patients with PTSD, who have trouble overcoming fear even when they are no longer in a dangerous situation.

The researchers traced the effect to differences in the neural circuitry of the alcohol-exposed mice. Comparing the brains of the mice, researchers noticed nerve cells in the prefrontal cortex of the alcohol-exposed mice actually had a different shape than those of the other mice. In addition, the activity of a key receptor, NMDA, was suppressed in the mice given heavy doses of alcohol.

Holmes said the findings are valuable because they pinpoint exactly where alcohol causes damage that leads to problems overcoming fear. "We're not only seeing that alcohol has detrimental effects on a clinically important emotional process, but we're able to offer some insight into how alcohol might do so by disrupting the functioning of some very specific brain circuits," said Holmes.

Understanding the relationship between alcohol and anxiety at the molecular level could offer new possibilities for developing drugs to help patients with anxiety disorders who also have a history of heavy alcohol use. "This study is exciting because it gives us a specific molecule to look at in a specific brain region, thus opening the door to discovering new methods to treat these disorders," said Kash.

Study co-authors include Kristen Pleil, Chia Li and Catherine Marcinkiewcz of UNC and Paul Fitzgerald, Kathryn MacPherson, Lauren DeBrouse, Giovanni Colacicco, Shaun Flynn, Sophie Masneuf, Ozge Gunduz-Cinar and Marguerite Camp of NIAAA.

 

Journal Reference:

  1. Andrew Holmes, Paul J Fitzgerald, Kathryn P MacPherson, Lauren DeBrouse, Giovanni Colacicco, Shaun M Flynn, Sophie Masneuf, Kristen E Pleil, Chia Li, Catherine A Marcinkiewcz, Thomas L Kash, Ozge Gunduz-Cinar, Marguerite Camp. Chronic alcohol remodels prefrontal neurons and disrupts NMDAR-mediated fear extinction encoding. Nature Neuroscience, 2012; DOI: 10.1038/nn.3204

Repeated exposure to traumatic images may be harmful to health

 Repeated exposure to violent images from the terrorist attacks of September 11 and the Iraq War led to an increase in physical and psychological ailments in a nationally representative sample of U.S. adults, according to a new UC Irvine study.

The study sheds light on the lingering effects of "collective traumas" such as natural disasters, mass shootings and terrorist attacks. A steady diet of graphic media images may have long-lasting mental and physical health consequences, says study author Roxane Cohen Silver, UCI professor of psychology & social behavior, medicine and public health.

"I would not advocate restricting nor censoring war images for the psychological well-being of the public," Silver said. "Instead, I think it's important for people to be aware that there is no psychological benefit to repeated exposure to graphic images of horror."

People who watched more than four hours a day of 9/11- and Iraq War-related television coverage (in the weeks after the attacks and at the start of the war) reported both acute and post-traumatic stress symptoms over time. Those who watched more than four hours a day of 9/11-related coverage in the weeks after the attacks reported physician-diagnosed physical health ailments two to three years later.

Seeing two particular kinds of images in the early days of the Iraq War was associated with post-traumatic stress symptoms over time: soldiers engaged in battle and dead U.S. and Allied soldiers.

The study included assessments of participants' mental and physical health before the 9/11 attacks and information about their media exposure and acute stress responses immediately after the attacks and after the initiation of the Iraq War. Researchers conducted follow up assessments in the three years after 9/11.

The acute stress period refers to the first few weeks after the event and post-traumatic stress is any time after one month. Researchers started to measure stress nine to 14 days after 9/11 and within a few days after the start of the Iraq War.

Almost 12 percent of the 1,322 participants reported high levels of acute stress related to 9/11 and about 7 percent reported high levels of acute stress related to the Iraq War. After taking pre-9/11 mental health, demographic characteristics, and lifetime trauma exposure into account, people who watched four or more hours of 9/11- or Iraq War-related television were more likely to experience symptoms of acute stress.

"The results suggest that exposure to graphic media images may be an important mechanism through which the impact of collective trauma is dispersed widely," Silver says. "Our findings are both relevant and timely as vivid images reach larger audiences than ever before through YouTube, social media and smartphones."

Funded by the National Science Foundation, the study appears in a forthcoming issue of Psychological Science, the flagship journal of the Association for Psychological Science. It was co-authored by Alison Holman, assistant professor of nursing at UCI; Judith Pizarro Andersen of the University of Toronto, Mississauga; Michael Poulin of the University at Buffalo; Daniel McIntosh of the University of Denver; and Virginia Gil-Rivas of the University of North Carolina, Charlotte.

"When we consider that graphic images of individuals being overcome by the 2011 tsunami in Japan were shown repeatedly, that a vigorous debate occurred last year regarding the release of the gruesome death photos of Osama bin Laden, and that vivid and disturbing images of 9/11 will likely appear on our television screens marking the anniversary of the attacks, we believe that our paper has something important to say regarding the impact of repeated exposure to graphic traumatic images," Silver said.