PCE is widely used in industry and to dry clean clothes. Prior studies suggests PCE is a neurotoxin that can cause mood changes, anxiety, and depression in people who work with it.

Although the long-term effect of this chemical on children exposed to PCE has been less clear, there is some evidence that children of people who work in the dry cleaning industry have an increased risk of schizophrenia.

In a new study, published in BioMed Central’s open access journal Environmental Health, researchers discovered exposure to PCE as a child was associated with an increased risk of bipolar disorder and post-traumatic stress disorder (PTSD).

In the study, researchers from Boston University followed the incidence of mental illness among adults from Cape Cod, born between 1969 and 1983, who were consequently exposed to PCE both before birth and during early childhood.

Researchers studied this geographic cohort because from 1968, until the early 1980s, water companies in Massachusetts installed vinyl-lined (VL/AC) water pipes that were subsequently found to be leaching PCE into the drinking water supply.

While there was no increase seen in the incidence of depression, regardless of PCE exposure, people with prenatal and early childhood exposure to PCE had almost twice the risk of bipolar disorder, compared to an unexposed group, and their risk of PTSD was raised by 50 percent.

Epidemiologist Dr. Ann Aschengrau from Boston University School of Public Health warned, “It is impossible to calculate the exact amount of PCE these people were exposed to – levels of PCE were recorded as high as 1,550 times the currently recommended safe limit.

“While the water companies flushed the pipes to address this problem, people are still being exposed to PCE in the dry cleaning and textile industries, and from consumer products, and so the potential for an increased risk of illness remains real.”

Source: BioMed Central

Glass of water photo by shutterstock.

Vanderbilt University investigators believe Ecstasy produces long-lasting serotonin neurotoxicity in humans. Their findings are reported online in the Archives of General Psychiatry.

“Our study provides some of the strongest evidence to date that the drug causes chronic loss of serotonin in humans,” said Ronald Cowan, M.D., Ph.D., associate professor of psychiatry.

The neurotransmitter serotonin, a critical signaling molecule, has roles in regulating mood, appetite, sleep, learning and memory.

Cowan says knowledge of the effects of MDMA (Ecstasy’s chemical name) is important as the drug may have therapeutic benefits. In fact, MDMA is now being tested as a treatment for post-traumatic stress disorder and anxiety associated with cancer.

“It’s essential that we understand the risk associated with using Ecstasy,” Cowan said. “If news keeps coming out that MDMA is being tested therapeutically and is safe, more people will tend to self-administer the drug. We need to know the dose at which this drug becomes toxic.

“Our studies suggest that if you use Ecstasy recreationally, the more you use, the more brain changes you get.”

In the current study, Cowan and colleagues used positron emission tomography (PET) imaging to examine the levels of serotonin-2A receptors in various brain regions, in females who had used Ecstasy (but not in the 90 days prior to imaging) and in females who had never used the drug.

They limited their studies to females because previous work has shown gender-specific differences in serotonin receptor levels.

They found that Ecstasy users had increased levels of serotonin-2A receptors and that higher lifetime use of the drug (higher doses) correlated with higher serotonin receptor levels. The findings are consistent with some studies in animal models, with receptor levels increasing to compensate for the loss of serotonin, Cowan said.

Earlier this year, Cowan and colleagues discovered Ecstasy increased brain activation in three brain areas associated with visual processing, which suggested a loss in brain efficiency.

Investigators believe the two studies provide strong evidence that Ecstasy causes lasting changes in brain serotonin function.

“It’s really critical to know whether or not this drug is causing long-term brain damage because millions of people are using it,” says Cowan.

The 2010 National Survey on Drug Use and Health estimated that 15.9 million individuals 12 years or older in the United States had used Ecstasy in their lifetime; 695,000 people had used Ecstasy in the month prior to being surveyed.

Cowan and his research team are interested in determining the doses of Ecstasy that are toxic, and whether there are genetic vulnerabilities to toxicity. If clinical trials show that the drug has therapeutic benefits, it’s critical to know the risks, he said.

Source: Vanderbilt University

Ecstasy pills photo by shutterstock.

At the conclusion of a two-year study of women from across the nation, assistant professor Jesse R. Cougle, Ph.D., found that those with PTSD who reported a history of rape or severe childhood physical abuse were more likely to suffer chronic PTSD symptoms.

What’s more, women who reported more “re-experiencing” symptoms, such as nightmares and flashbacks, at the initial assessment were more likely to suffer from persistent PTSD symptoms two years after the study began.

“What makes our findings unique is the recovery component,” Cougle said. “Most studies of this kind have looked at risk and resiliency or the factors that determine who develops PTSD and who doesn’t. We studied factors that influence recovery, or lack thereof, in a sample with PTSD. What we found, interestingly, is that more than half of the women in our sample — 58 percent — recovered within two years.”

Most people will experience at least one potentially traumatic event during their lifetimes that could result in PTSD, he noted. Knowing the factors that predict chronic PTSD will help to identify people who are most in need of assistance and treatment after suffering a traumatic event.

Cougle also found that about half of the women who recovered from PTSD during the study did so without any sort of professional treatment.

“Some women have a natural capacity to recover from PTSD,” Cougle said. “They won’t require treatment to get better.”

In addition to re-experiencing symptoms, a PTSD diagnosis includes avoidance and numbing, such as efforts to avoid thoughts, feelings or conversations associated with the trauma; efforts to avoid activities, places or people that arouse recollections of the trauma; an inability to recall an important aspect of the trauma; and feelings of emotional detachment. Additional symptoms include hyperarousal, such as difficulty concentrating; difficulty falling or staying asleep; irritability; and hypervigilance.

The new research was published in the journal Psychological Trauma: Theory, Research, Practice and Policy.

Source: Florida State Univesity

Researchers discovered individuals who have the greatest rise in the stress hormone cortisol after waking up were more likely to show acute stress symptoms in response to trauma years later as police officers.

The study, led by Dr. Charles Marmar, is one of the largest to identify a possible method for predicting vulnerability to stress during and after a traumatic event. The results are published in journal Biological Psychiatry.

“This study is significant as a potential indicator in determining when people may exhibit stress symptoms in the future,” said Marmar.

“Few studies have prospectively examined the relationships among pre-exposure hypothalamic-pituitary-adrenal activity, acute stress reactions and post traumatic stress disorder (PTSD). The findings may lead us to new insights on how to identify those who are at a higher risk of PTSD.”

Researchers measured cortisol levels in 296 police recruits when they awakened and then 30 minutes later.

The difference between the two levels is known as cortisol awakening response, or CAR. The study found the greater CAR during academy training predicted greater peritraumatic dissociation and acute stress disorder symptoms over the first three years of police service.

Two unique stress responses were associated with greater CAR: dissociation — a feeling of dreamlike unreality during the traumatic event — and acute stress disorder symptoms after the event.

Acute stress disorder is characterized by intrusive memories of the event, increased heart rate, faster breathing, and conscious avoidance of thoughts or feelings related to the event.

“This research is just the tip of the iceberg,” said Marmar. “We need additional studies to determine if early identification of these risk factors will result in intervention which could help reduce or minimize the long-term effects of trauma exposure.”

Source: NYU Langone Medical Center/New York University School of Medicine

University of California, Berkeley researchers discovered that during REM sleep the brain processes emotional experiences and takes the painful edge off difficult memories.

In the study, the researchers determined REM, or the dream phase of the sleep, is a time when stress neurotransmitters were inactive or slowed.

The findings offer a compelling explanation for why people with post-traumatic stress disorder (PTSD), such as war veterans, have a hard time recovering from painful experiences and suffer reoccurring nightmares. They also offer clues into why we dream.

“The dream stage of sleep, based on its unique neurochemical composition, provides us with a form of overnight therapy, a soothing balm that removes the sharp edges from the prior day’s emotional experiences,” said Matthew Walker, senior author of the study.

For people with PTSD, Walker said, this overnight therapy may not be working effectively, so when a “flashback is triggered by, say, a car backfiring, they relive the whole visceral experience once again because the emotion has not been properly stripped away from the memory during sleep.”

The results offer some of the first insights into the emotional function of Rapid Eye Movement (REM) sleep, which typically takes up 20 percent of a healthy human’s sleeping hours.

Previous brain studies indicate that sleep patterns are disrupted in people with mood disorders such as PTSD and depression.

Scientists have debated the role of sleep for well over a century. Although humans spend one-third of their lives sleeping, there is no scientific consensus on the function of sleep.

This research and other similar studies suggest the role of sleep extends to learning, memory and mood regulation. The current study shows the importance of the REM dream state.

“During REM sleep, memories are being reactivated, put in perspective and connected and integrated, but in a state where stress neurochemicals are beneficially suppressed,” said Els van der Helm, a doctoral student in psychology at UC Berkeley and lead author of the study.

Thirty–five healthy young adults participated in the study. They were divided into two groups, each of whose members viewed 150 emotional images, twice and 12 hours apart, while an MRI scanner measured their brain activity.

Half of the participants viewed the images in the morning and again in the evening, staying awake between the two viewings. The remaining half viewed the images in the evening and again the next morning after a full night of sleep.

Those who slept in between image viewings reported a significant decrease in their emotional reaction to the images. In addition, MRI scans showed a dramatic reduction in reactivity in the amygdala, a part of the brain that processes emotions, allowing the brain’s “rational” prefrontal cortex to regain control of the participants’ emotional reactions.

Researchers also recorded the electrical brain activity of the participants while they slept, using electroencephalograms.

By doing this they found that during REM dream sleep certain electrical activity patterns decreased, showing that reduced levels of stress neurochemicals in the brain soothed emotional reactions to the previous day’s experiences.

“We know that during REM sleep there is a sharp decrease in levels of norepinephrine, a brain chemical associated with stress,” Walker said.

“By reprocessing previous emotional experiences in this neuro-chemically safe environment of low norepinephrine during REM sleep, we wake up the next day, and those experiences have been softened in their emotional strength. We feel better about them, we feel we can cope.”

Walker said he was tipped off to the possible beneficial effects of REM sleep on PTSD patients when a physician at a U.S. Department of Veterans Affairs hospital in the Seattle area told him of a blood pressure drug that was inadvertently preventing reoccurring nightmares in PTSD patients.

It turns out that the generic blood pressure drug had a side effect of suppressing norepinephrine in the brain, thereby creating a more stress-free brain during REM, reducing nightmares and promoting a better quality of sleep. This suggested a link between PTSD and REM sleep, Walker said.

“This study can help explain the mysteries of why these medications help some PTSD patients and their symptoms as well as their sleep,” Walker said. “It may also unlock new treatment avenues regarding sleep and mental illness.”

The study is published in the journal Current Biology.

woman sleeping photo by shutterstock.

Investigators say the study confirms that symptoms associated with the development of PTSD in police officers can be attenuated or prevented with specific and adapted intervention.

The ability to lessened symptoms of PTSD, or harden individuals at risk of experiencing traumatic events (TE) in their work, is a significant finding.

Researchers say intervention can reduce dissociative reactions, emotional and physical reactions, acute stress, depressive symptoms, and can improve emotional coping responses to stress.

“Providing police officers with interventional support shortly after and in the weeks following a TE improves the chances of preventing PTSD,” explained André Marchand, lead author of the study.

“The strategies for adapting to trauma, such as developing a stress-resistant personality and obtaining social support, can be improved through prevention components of police officer training programs,” said Mr. Marchand.

Having a variety of strategies to deal with TE is important as conditions, as well as individuals, differ. Some police officers stated that talking to their colleagues, obtaining peer support and taking part in leisure activities are particularly helpful after a TE.

“The police offers involved in this study even advise their colleagues who experience this kind of event to consult a psychologist and are themselves open to the idea of receiving psychological support if need be,” said Mélissa Martin, co-author and psychologist at the Trauma Study Centre at Louis-H. Lafontaine Hospital.

Researchers say the knowledge from the study gained will help departments create strategies to both develop mechanisms that protect police officers from TE and decrease risk factors.

This study could also have a significant impact on other people with a high risk of experiencing work-related TE (firefighters, paramedics, first-aid workers, first responders, etc.).

Source: University of Montreal

Police officer photo by shutterstock.

The study found that when compared to women who weren’t molested or raped as children or teens, women who reported repeated episodes of forced sex in childhood or adolescence had a 62 percent higher risk of cardiovascular disease as adults.

The study also found that severe physical abuse in childhood or adolescence was associated with a 45 percent increased risk of cardiovascular events. Mild to moderate physical or sexual abuse was not associated with increased risk.

“The single biggest factor explaining the link between severe child abuse and adult cardiovascular disease was the tendency of abused girls to have gained more weight throughout adolescence and into adulthood,” said Janet Rich-Edwards, Sc.D., M.P.H., lead author of the study and associate professor in the Department of Medicine at Brigham and Women’s Hospital.

The researchers studied the associations of child and adolescent abuse with confirmed cardiovascular disease events such as heart attacks and strokes from 1989 to 2007 among 67,102 women in the Nurses’ Health Study II. About 11 percent reported forced sexual activity during childhood and adolescence and 9 percent reported severe physical abuse.

Associations of severe abuse were stronger for stroke than for heart attack, the study found. Risk factors such as adult body mass index, smoking, alcohol use, hypertension and diabetes accounted for 41 percent of the association of severe physical abuse and 37 percent of the association of forced sex with cardiovascular disease events.

“These traditional cardiovascular risk factors explain about 40 percent of the association we see between abuse and cardiovascular disease, which suggests that other factors may play an important role, such as increased stress reactivity among people with a history of abuse,” said Rich-Edwards.

Researchers conducted the study with primarily white nurses, so further research should be done with different socio-demographic groups, she said.

“Women who experience abuse need to take special care of their physical and emotional well-being to reduce their risk of chronic disease,” Rich-Edwards said.

“Primary care health professionals need to consider childhood abuse histories of women as they transition into adulthood, but to help the health professionals prevent cardiovascular disease among women with a history of abuse, we need to learn more about specific psychological, lifestyle, and medical interventions to improve the health of abuse survivors.”

Source: American Heart Association 

Sad elderly woman photo by shutterstock.

Sleep paralysis is defined as “a discrete period of time during which voluntary muscle movement is inhibited, yet ocular and respiratory movements are intact.”

Psychologists at Penn State and the University of Pennsylvania say that less than 8 percent of the general population experiences sleep paralysis although two groups experience a greater prevalence — students and psychiatric patients.

The disorder is recognized as influencing fictional and historic events. Alien abductions and incubi and succubi, as well as other demons that attack while people are asleep, are implicated as different cultural interpretations of sleep paralysis.

The Salem witch trials are now thought possibly to involve the townspeople experiencing sleep paralysis. And in the 19th-century novel “Moby-Dick,” the main character Ishmael experiences an episode of sleep paralysis in the form of a malevolent presence in the room.

Researchers noted that some people who experience these episodes may regularly try to avoid going to sleep because of the unpleasant sensations they experience. But other people enjoy the sensations they feel during sleep paralysis.

“I realized that there were no real sleep paralysis prevalence rates available that were based on large and diverse samples,” said psychologist and researcher Dr. Brian A. Sharpless. “So I combined data from my previous study with 34 other studies in order to determine how common it was in different groups.”

He looked at a total of 35 published studies from the past 50 years to find lifetime sleep paralysis rates. These studies surveyed a total of 36,533 people.

Overall he found that about one-fifth of these people experienced an episode at least once. Frequency of sleep paralysis ranged from once in a lifetime to every night.

When looking at specific groups, 28 percent of students reported experiencing sleep paralysis, while nearly 32 percent of psychiatric patients reported experiencing at least one episode.

Panic disorders were often associated with sleep paralysis as almost 35 percent of those surveyed reported experiencing these episodes.

Sleep paralysis also appears to be more common in non-Caucasians.

“Sleep paralysis should be assessed more regularly and uniformly in order to determine its impact on individual functioning and better articulate its relation to other psychiatric and medical conditions,” said Sharpless.

Sharpless performed a multi-national review of the condition and found that people experience three basic types of hallucinations during sleep paralysis: the presence of an intruder, pressure on the chest sometimes accompanied by physical and/or sexual assault experiences and levitation or out-of-body experiences.

According to the researchers, little research has been conducted on how to alleviate sleep paralysis or whether or not people experience episodes throughout their lives.

“I want to better understand how sleep paralysis affects people, as opposed to simply knowing that they experience it,” said Sharpless. “I want to see how it impacts their lives.”

Future research will look at relationships between sleep paralysis and post-traumatic stress disorder, says Sharpless.

Source: Penn State University

The search for innovative methods to treat PTSD is driven in part by the escalation of the disorder among soldiers returning from Afghanistan and Iraq as well as among civilians who have experienced trauma.

Furthermore, current treatment approaches are expensive and display marginal outcomes.

The new intervention is based upon the knowledge that our body will naturally increase secretion of the hormone cortisol after a traumatic event.

In the study, Joseph Zohar, M.D., of Tel Aviv University, in collaboration with Hagit Cohen, Ph.D., from Ben-Gurion University, set out to discover what a single dose of cortisone — a closely related precursor of cortisol – could do, when administered up to six hours after test subjects experienced a traumatizing event.

Among animal models and a small sample of human subjects, the likelihood of development of PTSD reduced by 60 percent.

The results will be published in the journal European Neuropsychopharmacology in October 2011.

Unlike most psychiatric conditions, PTSD is unique in that is has an easily established timeline — the precise point at which the disorder manifested. This makes PTSD eligible for treatment in the “golden hours” — a medical term that defines the precious few hours in which treatment can be most beneficial following a trauma, heart attack, stroke, or medical event, said Zohar.

Receiving treatment in this window of opportunity can result in dramatic outcomes.

In animal research, Zohar and his fellow researchers first began treating PTSD in the window of opportunity up to six hours after a traumatic event. Two groups of rats were exposed to the smell of a cat, and one group was treated with cortisone after the event.

Following promising results with the rats, the researchers initiated a double-blind pilot study in an emergency room, in which trauma victims entering the hospital were randomly assigned to receive a placebo or the cortisone treatment.

Follow-up exams took place two weeks, one month, and three months after the event.

Those patients who had received a shot of cortisone were more than 60 percent less likely to develop PTSD, they discovered.

Zohar believes the right dose of cortisone at the right time could prove a source of secondary prevention for PTSD, he posited, helping along a natural process.

Currently, traumatized patients are often given medications such as Valium or Xanax, aimed at calming them down. Zohar said these drugs interfere with our natural and potent recovery process, hindering the secretion of cortisone.

“Looking at the long-term effect, people who received these medications had a greater chance of developing PTSD than those who did not,” he said.

The National Institutes of Health has awarded Zohar a $1.3 million dollar grant to expand the small pilot study.

Source: Tel Aviv University

The brain learns through changes in the strength of its synapses — the connections between neurons — in response to stimuli. Now, in a discovery that challenges conventional wisdom on the brain mechanisms of learning, UCLA neurophysicists have found there is an optimal brain “rhythm,” or frequency, for changing synaptic strength.

And, like stations on a radio dial, each synapse is tuned to a different optimal frequency for learning.

Researchers believe the findings may lead to a unified theory of the mechanisms that underlie learning in the brain – a discovery that could possible lead to new therapies for treating learning disabilities.

The study appears in the current issue of the journal Frontiers in Computational Neuroscience.

“Many people have learning and memory disorders, and beyond that group, most of us are not Einstein or Mozart,” said Mayank R. Mehta, Ph.D., the paper’s senior author. “Our work suggests that some problems with learning and memory are caused by synapses not being tuned to the right frequency.”

A change in the strength of a synapse in response to stimuli — known as synaptic plasticity — is induced through so-called “spike trains,” series of neural signals that occur with varying frequency and timing.

Prior experiments used hundreds of consecutive spikes in the very high-frequency range to induce plasticity. However, this is not the case when the brain is activated during real-life behavioral tasks, as neurons fire only about 10 consecutive spikes, not several hundred. And they do so at a much lower frequency — typically in the 50 spikes-per-second range.

Until now, researchers had been unable to conduct experiments that simulated more naturally occurring levels.

In the new study, Mehta and co-author Arvind Kumar, Ph.D., were able to obtain these measurements for the first time using a sophisticated mathematical model they developed and validated with experimental data.

Contrary to what was previously assumed, Mehta and Kumar found that when it comes to stimulating synapses with naturally occurring spike patterns, stimulating the neurons at the highest frequencies was not the best way to increase synaptic strength.

“To our surprise, we found that beyond the optimal frequency, synaptic strengthening actually declined as the frequencies got higher.”

The knowledge that a synapse has a preferred frequency for maximal learning led the researchers to compare optimal frequencies based on the location of the synapse on a neuron.

Neurons are shaped like trees, with the nucleus being the base of the tree, the dendrites resembling the extensive branches and the synapses resembling the leaves on those branches.

When Mehta and Kumar compared synaptic learning based on where synapses were located on the dendritic branches, what they found was significant: The optimal frequency for inducing synaptic learning changed depending on where the synapse was located. The farther the synapse was from the neuron’s cell body, the higher its optimal frequency.

“Incredibly, when it comes to learning, the neuron behaves like a giant antenna, with different branches of dendrites tuned to different frequencies for maximal learning,” Mehta said.

The researchers found that not only does each synapse have a preferred frequency for achieving optimal learning, but for the best effect, the frequency needs to be perfectly rhythmic — timed at exact intervals. Even at the optimal frequency, if the rhythm was thrown off, synaptic learning was substantially diminished.

Their research also showed that once a synapse learns, its optimal frequency changes. In other words, if the optimal frequency for a naïve synapse — one that has not learned anything yet — was, say, 30 spikes per second, after learning, that very same synapse would learn optimally at a lower frequency, say 24 spikes per second. Thus, learning itself changes the optimal frequency for a synapse.

This learning-induced “detuning” process has important implications for treating disorders related to forgetting, such as post-traumatic stress disorder, the researchers said.

Although much more research is needed, the findings raise the possibility that drugs could be developed to “retune” the brain rhythms of people with learning or memory disorders, or that many more of us could become Einstein or Mozart if the optimal brain rhythm was delivered to each synapse.

“We already know there are drugs and electrical stimuli that can alter brain rhythms,” Mehta said. “Our findings suggest that we can use these tools to deliver the optimal brain rhythm to targeted connections to enhance learning.”

Source: UCLA

For instance, the new research — which included 162 trials with efficacy outcomes and 231 trials or large observational studies with adverse events — found no support for the use of atypical antipsychotic medications for eating disorders or substance abuse.

Atypical antipsychotic medications are commonly used for off-label conditions such as behavioral symptoms of dementia, anxiety, and obsessive-compulsive disorder.

Off-label indications, meaning those without FDA approval for these indications, doubled from 1995 to 2008.

“Atypical antipsychotic medications are approved for marketing and labeling by the U.S. Food and Drug Administration (FDA) for treating schizophrenia, bipolar disorder, and depression under drug-specific circumstances,” according to the researchers.

Alicia Ruelaz Maher, M.D., of RAND Health, and colleagues conducted a systemic review and meta-analysis to examine the efficacy and adverse events associated with off-label use of atypical antipsychotic medications for behavioral symptoms in dementia, anxiety, obsessive-compulsive disorder (OCD), eating disorders, posttraumatic stress disorder (PTSD), insomnia, personality disorders, depression, and substance abuse.

The authors searched the medical literature for controlled trials comparing an atypical antipsychotic medication (risperidone, olanzapine, quetiapine, aripiprazole, ziprasidone, asenapine, iloperidone, or paliperidone) with placebo, another atypical antipsychotic medication, or other pharmacotherapy for adult off-label conditions. Observational studies with sample sizes of greater than 1,000 patients were included to assess adverse events.

The research found that aripiprazole, olanzapine, and risperidone were associated with small but statistically significant benefits for the treatment in elderly patients of behavioral symptoms of dementia, such as psychosis, mood alterations, and aggression.

For generalized anxiety disorder, a pooled analysis of 3 trials showed that quetiapine was associated with a 26 percent increase in the chance of a favorable response at 8 weeks compared with placebo.

For obsessive-compulsive disorder, three pooled studies of risperidone resulted in an approximately four-fold increase in the chance of responding compared with placebo.

“In elderly patients, adverse events included an increased risk of death (number needed to harm [NNH] = 87), stroke (NNH = 53 for risperidone), extrapyramidal symptoms [movement disorders; NNH = 10 for olanzapine; NNH = 20 for risperidone], and urinary tract symptoms (NNH range: 16-36),” noted the researchers. Number needed to harm (NNH) refers to the number of patients that need to be treated before one patient is harmed; a lower number suggests a far greater risk of the medication than a larger number.

Adverse events in younger and middle-aged adults included weight gain (particularly with olanzapine), fatigue, sedation, akathisia — the inability to remain motionless — (for aripiprazole), and extrapyramidal symptoms.

“This evidence should prove useful for clinicians considering off-label prescribing of atypical antipsychotic medications, and should contribute to optimal treatment decision making for individual patients with specific clinical symptoms and unique risk profiles.”

According to the study, the use of atypical antipsychotic medications is rapidly increasing in the United States, with previous research estimating an increase from 6.2 million to 14.3 million treatment visits between 1995 and 2008.

The new study appears in the September 28 issue of JAMA.

Source: JAMA

Experts evaluated how the attacks impacted the psychological processes of those not directly exposed to the event.

Researchers studied college students in Massachusetts and found that even those who were not directly connected to New York or Washington showed increased stress responses to run-of-the-mill visual images.

“Other studies have shown that the 9/11 attacks resulted in a wave of stress and anxiety across the United States,” said researcher Ivy Tso, a doctoral student in clinical psychology at the University of Michigan.

“Eight to 10 percent of the residents of New York City reported symptoms consistent with posttraumatic stress disorder (PTSD) and depression while 40 percent of Americans across the country experienced significant symptoms of stress related to the attacks.”

Study findings are published in the Journal of Traumatic Stress.

Tso and her colleagues’ study, which took place within one week of the attacks, assessed a sample of 31 university students in Boston who were not directly connected to the attacks in New York and therefore represented the wider American public.

Researchers evaluated the brain activity of the participants to detect signs of anxiety and stress as they were shown a series of 90 pictures.

Thirty of the pictures contained images of the attacks while the others were defined as either “negative” but not related to the attacks, or “neutral.”

“The results of our study indicate that participants’ brain wave responses during processing of the images deviated from normal in proportion to their self-report distress level directly related to the 9/11 attacks,” said Tso.

The abnormal brain activity is similar to what is observed in individuals with PTSD (e.g., diminished attention, hypervigilance, suppression of unwanted thoughts).

“This finding is significant as our participants were young, unmedicated, highly functional individuals and while their distress was clearly below clinical threshold, their brain responses to emotional information were affected the same way, though not to the same degree, as in PTSD,” concluded Tso.

“This makes us rethink whether distress reactions should be considered a spectrum of severity, rather than simply divided into normal vs. clinical categories.”

Source: University of Michigan Health System

The study on biochemical changes within the brain associated with PTSD is published in Archives of General Psychiatry, one of the JAMA/Archives journals.

Alexander Neumeister, M.D. at Mount Sinai School of Medicine and colleagues collaborated with the Yale Positron Emission Tomography (PET) Center to evaluate 96 patients: 49 with PTSD; 20 who were exposed to trauma but did not have PTSD; and 27 healthy adults.

All patients were injected with a tracer to provide a clear picture of levels of the neurotransmitter serotonin 1B. PET scans were then performed that produced advanced images of their brains.

Upon analysis, researchers found that serotonin 1B levels were substantially lower in the group of patients diagnosed with PTSD than in patients who did not have PTSD, and slightly lower in the patients who had been exposed to trauma but did not have PTSD.

“Our research provides the first evidence of a novel mechanism in the brain, and sets the stage for the development of therapies that target serotonin 1B receptors, offering the potential to minimize the disabling effects of PTSD,” said Neumeister.

“Currently, the only medical treatment options for the nearly eight million American adults with PTSD are antidepressants and anti-anxiety medications, which show little benefit in improving the mental health of these patients.”

Researchers performed a detailed review of the data, including patients’ age, age at first traumatic experience, number of traumatic experiences, sex, body mass index and comorbid depression (which is often present with PTSD).

From this review, Dr. Neumeister and his team discovered the age at first trauma and the severity of the trauma appeared to play a key factor in reducing 1B receptors.

Consequently, they believe early trauma causes long-lasting neurobiological and psychological effects in survivors with PTSD.

“The patients in our study included victims of childhood abuse, domestic violence, and military veterans,” said Neumeister. “For these patients and the millions like them, treatment with currently available medications or psychotherapy is often ineffective.

“Unfortunately, people with PTSD often have additional psychiatric illnesses such as major depression or may develop substance use problems as an avenue for relieving their symptoms.

“Our research opens new doors in understanding PTSD and developing treatments for it, and may provide hope for these severely ill patients to be well.”

Source: The Mount Sinai Hospital/Mount Sinai School of Medicine

Researchers determined certain variants of a gene that helps regulate serotonin (a brain chemical related to mood), may serve as a useful predictor of risk for symptoms related to post-traumatic stress disorder (PTSD) following a trauma.

“One of the critical questions surrounding PTSD is why some individuals are at risk for developing the disorder following a trauma, while others appear to be relatively resilient,” said lead author Kerry J. Ressler, M.D., Ph.D.

“It is known that genetic heritability is one component of the differential risk for PTSD, but the mechanisms remain relatively unknown.”

In this study, the researchers compared psychological data taken from college students who had been interviewed for a study prior to a 2008 mass shooting on the Northern Illinois University campus, and then were interviewed afterward.

Then researchers compared the psychological data with the genetic variants of the serotonin transporter gene found in students who developed PTSD/acute stress disorder symptoms.

“We believe that the strength of this study is the availability of the same validated survey measure to assess PTSD symptoms prior to and after a shared acute traumatic event,” said Ressler.

The data suggest that some functions of the serotonin transporter gene may mitigate or accentuate response to a severe trauma.

According to the authors, this is consistent with current pharmacological treatment of PTSD with selective serotonin reuptake inhibitors (SSRIs).

Additionally, variants in the gene have previously been shown to be associated with different risk for depression following life stress.

The researchers concluded that when examined in a relatively homogenous sample with shared trauma and known prior levels of child and adult trauma, this serotonin transporter genotype may serve as a useful predictor of risk for PTSD related symptoms in the weeks and months following trauma.

Importantly, noted Ressler, this is one of likely a number of genes that will ultimately be found to contribute to risk and resilience.

As more of these gene pathways are understood, it is hoped that such findings will contribute to improved treatment and prevention as well as better prediction of risk for PTSD following traumatic exposure.

Source: Emory University

This limitation is significant as facial expressions convey strong cues for someone’s emotional state and the ability to interpret these cues is crucial in social interaction.

This burden is a characteristic of many psychiatric and neurological disorders, such as social anxiety or Korsakoff’s syndrome.

Researchers believe PTSD changes the way the brain processes specific emotions with the altered processing of emotional cues leading to PTSD limitations.

The research findings are reported in the journal Cortex.

In the study, Dr. Ervin Poljac together with Dr. Barbara Montagne and Prof. Edward de Haan investigated emotional processing in a group of war veterans with symptoms developed after prolonged exposure to combat-related traumatic events.

PTSD is already known to be associated with difficulties in experiencing, identifying, and describing emotions; the new study, however, specifically examined the participants’ ability to recognize particular emotional facial expressions.

Participants were shown short video clips of emotional faces representing one of the six basic emotions (happiness, anger, fear, surprise, disgust and sadness).

Compared to healthy subjects, the participants with PTSD were less able to recognize two emotions in particular: fear and sadness.

This is the first study to show impairment in the processing of specific emotions in PTSD.

The researchers believe this knowledge will provide further insights into the disorder and also set the stage for new methods to assess PTSD.

In summary, experts believe the development of a more detailed prognostic model for PTSD will improve therapeutic interventions for the disorder.

Source: Elsevier