Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Post-Traumatic Stress Disorders: HELP
Articles by Alexander Cowell McFarlane
Based on 72 articles published since 2010
(Why 72 articles?)
||||

Between 2010 and 2020, A. McFarlane wrote the following 72 articles about Stress Disorders, Post-Traumatic.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Editorial The challenges and benefits of conducting linked epidemiological and neurobiological health surveillance into the impacts of military deployment in Australia. 2018

McFarlane, Alexander C / Van Hooff, Miranda. ·Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, SA, Australia. ·Aust N Z J Psychiatry · Pubmed #29216736.

ABSTRACT: -- No abstract --

2 Editorial PTSD: the need to use emerging knowledge to improve systems of care and clinical practice in Australia. 2017

McFarlane, Alexander C / Bryant, Richard A. ·Professor of Psychiatry and Director, The Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, SA, Australia. · Scientia Professor & NHMRC Senior Principal Research Fellow, School of Psychology, University of New South Wales, Sydney, NSW, Australia. ·Australas Psychiatry · Pubmed #28747111.

ABSTRACT: -- No abstract --

3 Editorial Post-traumatic stress disorder is a systemic illness, not a mental disorder: is Cartesian dualism dead? 2017

McFarlane, Alexander C. ·Centre for Traumatic Stress Studies, University of Adelaide, Adelaide, SA alexander.mcfarlane@adelaide.edu.au. ·Med J Aust · Pubmed #28359005.

ABSTRACT: -- No abstract --

4 Editorial Accountability for the Psychological Costs of Military Service: A Benchmark Set by the Canadian Armed Forces. 2016

McFarlane, Alexander. ·University of Adelaide, Adelaide, South Australia, Australia alexander.mcfarlane@adelaide.edu.au. ·Can J Psychiatry · Pubmed #27270745.

ABSTRACT: -- No abstract --

5 Editorial The journey from moral inferiority to post-traumatic stress disorder. 2015

McFarlane, Alexander C / Forbes, David. ·University of Adelaide, Adelaide, SA, Australia. alexander.mcfarlane@adelaide.edu.au. · Australian Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne, VIC, Australia. ·Med J Aust · Pubmed #25877103.

ABSTRACT: -- No abstract --

6 Review Treatment of military-related post-traumatic stress disorder: challenges, innovations, and the way forward. 2019

Forbes, David / Pedlar, David / Adler, Amy B / Bennett, Clare / Bryant, Richard / Busuttil, Walter / Cooper, John / Creamer, Mark C / Fear, Nicola T / Greenberg, Neil / Heber, Alexandra / Hinton, Mark / Hopwood, Mal / Jetly, Rakesh / Lawrence-Wood, Ellie / McFarlane, Alexander / Metcalf, Olivia / O'Donnell, Meaghan / Phelps, Andrea / Richardson, J Don / Sadler, Nicole / Schnurr, Paula P / Sharp, Marie-Louise / Thompson, James M / Ursano, Robert J / Hooff, Miranda Van / Wade, Darryl / Wessely, Simon. ·a Centenary of Anzac Centre, Phoenix Australia-Centre for Posttraumatic Mental Health, Department of Psychiatry , University of Melbourne , Carlton , Australia. · b Canadian Institute for Military and Veteran Health Research , Kingston , ON, Canada. · c Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research , Silver Spring , MD , USA. · d New Zealand Defence Force , Wellington , New Zealand. · e School of Psychology , University of New South Wales , Sydney , Australia. · f Combat Stress , Surrey , UK. · g King's Centre for Military Health Research, King's College London , London , UK. · h Academic Centre for Military Mental Health Research , London , UK. · i Veterans Affairs Canada , Charlottetown , Canada. · j Department of Psychiatry , University of Ottawa , Ottawa , Canada. · k Directorate of Mental Health , Canadian Armed Forces , Ottawa , Canada. · l Centre for Traumatic Stress Studies , University of Adelaide , Adelaide , Australia. · m Department of Psychiatry , Western University , London , Canada. · n McDonald/Franklin OSI Research Centre , London , Canada. · o National Center for PTSD , White River Junction , VT , USA. · p Department of Psychiatry , Geisel School of Medicine , Hanover , NH , USA. · q Department of Public Health Sciences , Queen's University , Kingston , ON , Canada. · r Center for the Study of Traumatic Stress, Department of Psychiatry , Uniformed Services University School of Medicine , Bethesda , MD , USA. ·Int Rev Psychiatry · Pubmed #31043106.

ABSTRACT: Post-traumatic stress disorder (PTSD) is one of the common mental disorders in military and veteran populations. Considerable research and clinical opinion has been focused on understanding the relationship between PTSD and military service and the implications for prevention, treatment, and management. This paper examines factors associated with the development of PTSD in this population, considers issues relating to engagement in treatment, and discusses the empirical support for best practice evidence-based treatment. The paper goes on to explore the challenges in those areas, with particular reference to treatment engagement and barriers to care, as well as treatment non-response. The final section addresses innovative solutions to these challenges through improvements in agreed terminology and definitions, strategies to increase engagement, early identification approaches, understanding predictors of treatment outcome, and innovations in treatment. Treatment innovations include enhancing existing treatments, emerging non-trauma-focused interventions, novel pharmacotherapy, personalized medicine approaches, advancing functional outcomes, family intervention and support, and attention to physical health.

7 Review The Need to Take a Staging Approach to the Biological Mechanisms of PTSD and its Treatment. 2017

McFarlane, Alexander Cowell / Lawrence-Wood, Eleanor / Van Hooff, Miranda / Malhi, Gin S / Yehuda, Rachel. ·Centre for Traumatic Stress Studies, The University of Adelaide, Level 2, 122 Frome Street, Adelaide, 5000, South Australia. alexander.mcfarlane@adelaide.edu.au. · Centre for Traumatic Stress Studies, The University of Adelaide, Level 2, 122 Frome Street, Adelaide, 5000, South Australia. · Department of Psychiatry, Sydney Medical School, The University of Sydney, Edward Ford Building (A27), Fisher Road, University of Sydney, New South Wales, 2006, Australia. · Traumatic Stress Studies Division, Mount Sinai School of Medicine, James J Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY, 110468, USA. ·Curr Psychiatry Rep · Pubmed #28168596.

ABSTRACT: Despite the substantial body of neurobiological research, no specific drug target has been developed to treat PTSD and there are substantial limitations with the available interventions. We propose that advances are likely to depend on the development of better classification of the heterogeneity of PTSD using a staging approach of disease. A primary rationale for staging is to highlight the probability that distinct therapeutic approaches need to be utilised according to the degree of biological progression of the disorder. Prospective studies, particularly of military populations, provide substantial evidence about the emerging biological abnormalities that precede the full-blown disorder. These need to be targeted with tailored interventions to prevent disease progression. Equally, the neurobiology of chronic unremitting PTSD needs to be differentiated from the acute disorder which emerges across a spectrum of severity, and this range of presentations correspondingly needs to be addressed with differing therapeutic strategies. The staging approach also needs to take account of the range of somatic pathological outcomes that are being identified as a consequence of traumatic stress exposure. PTSD should be conceptualised as a systemic disorder underpinned a range of biological dysregulation, including metabolic and altered immune function, reflected in the increased rates of cardiovascular and autoimmune disease. The effectiveness of novel treatments needs to be judged across their effectiveness in addressing the spectrum of trauma-related pathology.

8 Review Post-traumatic stress disorder. 2015

Yehuda, Rachel / Hoge, Charles W / McFarlane, Alexander C / Vermetten, Eric / Lanius, Ruth A / Nievergelt, Caroline M / Hobfoll, Stevan E / Koenen, Karestan C / Neylan, Thomas C / Hyman, Steven E. ·James J. Peters Veterans Affairs Medical Center, 130 West Kingsbridge Road, New York, New York 10468, USA. · Icahn School of Medicine at Mount Sinai, New York, New York, USA. · Walter Reed Army Institute of Research, Silver Spring, Maryland, USA. · Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, South Australia, Australia. · Military Mental Health Research Center, Ministry of Defense, Utrecht, The Netherlands. · Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands. · Arq Psychotrauma Expert Group, Diemen, The Netherlands. · Department of Psychiatry, Western University of Canada, London, Ontario, Canada. · Department of Psychiatry, School of Medicine, University of California at San Diego, La Jolla, California, USA. · VA Center of Excellence for Stress and Mental Health (CESAMH), VA San Diego Healthcare System, La Jolla, California, USA. · Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA. · Department of Epidemiology, Harvard T.H. Chan School of Public Health and Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA. · The Stanley Center, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA. · Department of Psychiatry, University of California San Francisco, San Francisco, California, USA. · Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA. · Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA. ·Nat Rev Dis Primers · Pubmed #27189040.

ABSTRACT: Post-traumatic stress disorder (PTSD) occurs in 5-10% of the population and is twice as common in women as in men. Although trauma exposure is the precipitating event for PTSD to develop, biological and psychosocial risk factors are increasingly viewed as predictors of symptom onset, severity and chronicity. PTSD affects multiple biological systems, such as brain circuitry and neurochemistry, and cellular, immune, endocrine and metabolic function. Treatment approaches involve a combination of medications and psychotherapy, with psychotherapy overall showing greatest efficacy. Studies of PTSD pathophysiology initially focused on the psychophysiology and neurobiology of stress responses, and the acquisition and the extinction of fear memories. However, increasing emphasis is being placed on identifying factors that explain individual differences in responses to trauma and promotion of resilience, such as genetic and social factors, brain developmental processes, cumulative biological and psychological effects of early childhood and other stressful lifetime events. The field of PTSD is currently challenged by fluctuations in diagnostic criteria, which have implications for epidemiological, biological, genetic and treatment studies. However, the advent of new biological methodologies offers the possibility of large-scale approaches to heterogeneous and genetically complex brain disorders, and provides optimism that individualized approaches to diagnosis and treatment will be discovered.

9 Review The use of biomarkers in the military: from theory to practice. 2013

Yehuda, Rachel / Neylan, Thomas C / Flory, Janine D / McFarlane, Alexander C. ·Department of Psychiatry, James J. Peters Veterans Affairs Medical Center, Bronx, NY, United States; Department of Psychiatry and Neuroscience, Mount Sinai School of Medicine, New York, NY, United States. Electronic address: rachel.yehuda@va.gov. ·Psychoneuroendocrinology · Pubmed #23927936.

ABSTRACT: This paper provides a summary of relevant issues covered in the conference, "The Use of Biomarkers in the Military: Theory to Practice" held at the New York Academy of Science on September 14, 2012. The conference covered the state of the science in identification of PTSD biomarkers, including, the definition of different classes of biomarkers pertaining to PTSD. The aim of the satellite conference was to bring together researchers who have been supported by the Department of Defense, Veterans Administration, National Institutes of Health, and other agencies around the world, who are interested in the identification of biomarkers for PTSD risk, diagnosis, symptom severity and treatment response, for a discussion of salient issues regarding biomarker development for PTSD, as well as special considerations for the use of biomarkers in the military.

10 Review Blast-related traumatic brain injury. 2013

Rosenfeld, Jeffrey V / McFarlane, Alexander C / Bragge, Peter / Armonda, Rocco A / Grimes, Jamie B / Ling, Geoffrey S. ·Department of Surgery, Monash University, Melbourne, VIC, Australia; Department of Neurosurgery, The Alfred Hospital, Melbourne, VIC, Australia; Centre of Excellence in Traumatic Brain Injury Research, National Trauma Research Institute, Melbourne, VIC, Australia. Electronic address: j.rosenfeld@alfred.org.au. · Centre for Traumatic Stress Studies, University of Adelaide, Adelaide, SA, Australia. · Centre of Excellence in Traumatic Brain Injury Research, National Trauma Research Institute, Melbourne, VIC, Australia. · Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Walter Reed National Military Medical Center, Bethesda, MD, USA. · Defense and Veterans Brain Injury Center, Silver Spring, MD, USA. · Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Department of Neurology, Johns Hopkins Hospital, Baltimore, MD, USA. ·Lancet Neurol · Pubmed #23884075.

ABSTRACT: A bomb blast may cause the full severity range of traumatic brain injury (TBI), from mild concussion to severe, penetrating injury. The pathophysiology of blast-related TBI is distinctive, with injury magnitude dependent on several factors, including blast energy and distance from the blast epicentre. The prevalence of blast-related mild TBI in modern war zones has varied widely, but detection is optimised by battlefield assessment of concussion and follow-up screening of all personnel with potential concussive events. There is substantial overlap between post-concussive syndrome and post-traumatic stress disorder, and blast-related mild TBI seems to increase the risk of post-traumatic stress disorder. Post-concussive syndrome, post-traumatic stress disorder, and chronic pain are a clinical triad in this patient group. Persistent impairment after blast-related mild TBI might be largely attributable to psychological factors, although a causative link between repeated mild TBIs caused by blasts and chronic traumatic encephalopathy has not been established. The application of advanced neuroimaging and the identification of specific molecular biomarkers in serum for diagnosis and prognosis are rapidly advancing, and might help to further categorise these injuries.

11 Review Does neuroimaging research examining the pathophysiology of posttraumatic stress disorder require medication-free patients? 2010

Lanius, Ruth A / Brewin, Chris R / Bremner, J Douglas / Daniels, Judith K / Friedman, Matthew J / Liberzon, Israel / McFarlane, Alexander / Schnurr, Paula P / Shin, Lisa / Stein, Murray / Vermetten, Eric. ·Department of Psychiatry, University of Western Ontario, London, Ont., Canada. ruth.lanius@lhsc.on.ca ·J Psychiatry Neurosci · Pubmed #20184804.

ABSTRACT: BACKGROUND: In an attempt to avoid unknown influence, most neuroimaging studies examining the pathophysiology of posttraumatic stress disorder (PTSD) exclude patients taking medications. Here we review the empirical evidence for relevant medications having a confounding effect on task performance or cerebral blood flow (CBF) in this population. The evidence for potentially confounding effects of psychotherapy in PTSD are also discussed. METHODS: The literature that we reviewed was obtained through a PubMed search from 1980 to 2009 using the search terms posttraumatic stress disorder, PTSD, psychotropic medications, neuroimaging, functional magnetic resonance imaging, positron emission tomography, cerebral blood flow, CBF, serotonin-specific reuptake blocker, benzodiazepine, ketamine, methamphetamine, lamotrigine and atypical antipsychotic agents. RESULTS: The empirical evidence for relevant medications having a confounding effect on task performance or CBF in relevant areas remains sparse for most psychotropic medications among patients with PTSD. However, considerable evidence is accumulating for 2 of the most commonly prescribed medication classes (serotonin-specific reuptake inhibitors and benzodiazepines) in healthy controls. Compelling data for the potentially confounding effects on brain areas relevant to PTSD for psychotherapeutic interventions are also accumulating. CONCLUSION: Neuroimaging studies examining the pathophysiology of PTSD should ideally recruit both medicated (assuming that the medication treatment has not resulted in the remission of symptoms) and unmedicated participants, to allow the findings to be generalized with greater confidence to the entire population of patients with PTSD. More research is needed into the independent effects of medications on task performance and CBF in regions of interest in PTSD. Neuroimaging studies should also take into account whether patients are currently engaged in psychotherapeutic treatment.

12 Clinical Trial Cortisol response to acute trauma and risk of posttraumatic stress disorder. 2011

McFarlane, Alexander C / Barton, Christopher A / Yehuda, Rachel / Wittert, Gary. ·Centre for Military and Veterans’ Health, School of Population Health and Clinical Practice, The University of Adelaide, SouthAustralia, Australia. ·Psychoneuroendocrinology · Pubmed #21093988.

ABSTRACT: This study sought to characterize the variability of the acute cortisol response following trauma and its relationship to posttraumatic stress disorder (PTSD). Forty eight participants were recruited within 24h of a traumatic accident requiring hospital admission. A saliva sample was collected at 08.00 h and 16.00 h 2 days, 1 month and 6 months after hospital admission, together with 24-h urine collection. Participants completed a dexamethasone suppression test (0.5mg DEX at 21.00 h) at each follow up, together with self-report questionnaires. The Clinician Administered PTSD Scale (CAPS) was administered at 1 and 6 months to identify PTSD. Prevalence of PTSD was 27% at 1 month and 21% at 6 months. PTSD symptoms at 6 months were negatively correlated with salivary cortisol at 08.00 h on day 2 (r=-0.36, p=0.04), but positively correlated with 16.00 h cortisols (r=0.41, p=0.03). A lower rise in cortisol at 08.00 h on day 2 was associated with an increase in risk of PTSD at both 1 month (OR=1.411 (1.017, 1.957)) and 6 months (OR=1.411 (1.066, 1.866)). At 1 month, 70% of participants with PTSD suppressed cortisol to more than 90% of pre-dex levels compared with 25% without PTSD (χ(2)=6.77, p=0.034). Urinary cortisol excretion was not different between groups at any time point. The findings support a hypothesis that sensitization of the HPA axis and enhanced suppression of cortisol following the dexamethasone suppression test are established early in the disease process.

13 Article A mixed-methods study of psychological distress following an environmental catastrophe: the case of the Hazelwood open-cut coalmine fire in Australia. 2020

Maybery, Darryl / Jones, Rebecca / Dipnall, Joanna F / Berger, Emily / Campbell, Timothy / McFarlane, Alexander / Carroll, Matthew. ·Monash Rural Health Warragul, Monash University, Warragul, Australia. · School of Public Health and Preventive Medicine, Monash University, Melbourne Australia. · IMPACT SRC, School of Medicine, Deakin University, Geelong, Australia. · Faculty of Education, Monash University, Clayton, Australia. · Monash Rural Health Churchill, Monash University, Churchill, Australia. · The Centre for Traumatic Stress Studies, The University of Adelaide, Australia. ·Anxiety Stress Coping · Pubmed #31752536.

ABSTRACT: BACKGROUND AND OBJECTIVES: This study assessed the psychological impacts of six weeks of smoke exposure from the 2014 Hazelwood open-cut coalmine fire in the Latrobe Valley, Victoria, Australia, between two and three years after the incident. Design RESULTS: Morwell residents scored significantly higher on the Impact of Event Scale - Revised (difference = 6.53; 95%CI: 5.37, 7.35, CONCLUSIONS: The elevated psychological distress apparent within the Morwell community over two years after an extended pollution event highlights the need to improve post-incident recovery responses to such events, particularly for supporting residents that are more vulnerable.

14 Article International meta-analysis of PTSD genome-wide association studies identifies sex- and ancestry-specific genetic risk loci. 2019

Nievergelt, Caroline M / Maihofer, Adam X / Klengel, Torsten / Atkinson, Elizabeth G / Chen, Chia-Yen / Choi, Karmel W / Coleman, Jonathan R I / Dalvie, Shareefa / Duncan, Laramie E / Gelernter, Joel / Levey, Daniel F / Logue, Mark W / Polimanti, Renato / Provost, Allison C / Ratanatharathorn, Andrew / Stein, Murray B / Torres, Katy / Aiello, Allison E / Almli, Lynn M / Amstadter, Ananda B / Andersen, Søren B / Andreassen, Ole A / Arbisi, Paul A / Ashley-Koch, Allison E / Austin, S Bryn / Avdibegovic, Esmina / Babić, Dragan / Bækvad-Hansen, Marie / Baker, Dewleen G / Beckham, Jean C / Bierut, Laura J / Bisson, Jonathan I / Boks, Marco P / Bolger, Elizabeth A / Børglum, Anders D / Bradley, Bekh / Brashear, Megan / Breen, Gerome / Bryant, Richard A / Bustamante, Angela C / Bybjerg-Grauholm, Jonas / Calabrese, Joseph R / Caldas-de-Almeida, José M / Dale, Anders M / Daly, Mark J / Daskalakis, Nikolaos P / Deckert, Jürgen / Delahanty, Douglas L / Dennis, Michelle F / Disner, Seth G / Domschke, Katharina / Dzubur-Kulenovic, Alma / Erbes, Christopher R / Evans, Alexandra / Farrer, Lindsay A / Feeny, Norah C / Flory, Janine D / Forbes, David / Franz, Carol E / Galea, Sandro / Garrett, Melanie E / Gelaye, Bizu / Geuze, Elbert / Gillespie, Charles / Uka, Aferdita Goci / Gordon, Scott D / Guffanti, Guia / Hammamieh, Rasha / Harnal, Supriya / Hauser, Michael A / Heath, Andrew C / Hemmings, Sian M J / Hougaard, David Michael / Jakovljevic, Miro / Jett, Marti / Johnson, Eric Otto / Jones, Ian / Jovanovic, Tanja / Qin, Xue-Jun / Junglen, Angela G / Karstoft, Karen-Inge / Kaufman, Milissa L / Kessler, Ronald C / Khan, Alaptagin / Kimbrel, Nathan A / King, Anthony P / Koen, Nastassja / Kranzler, Henry R / Kremen, William S / Lawford, Bruce R / Lebois, Lauren A M / Lewis, Catrin E / Linnstaedt, Sarah D / Lori, Adriana / Lugonja, Bozo / Luykx, Jurjen J / Lyons, Michael J / Maples-Keller, Jessica / Marmar, Charles / Martin, Alicia R / Martin, Nicholas G / Maurer, Douglas / Mavissakalian, Matig R / McFarlane, Alexander / McGlinchey, Regina E / McLaughlin, Katie A / McLean, Samuel A / McLeay, Sarah / Mehta, Divya / Milberg, William P / Miller, Mark W / Morey, Rajendra A / Morris, Charles Phillip / Mors, Ole / Mortensen, Preben B / Neale, Benjamin M / Nelson, Elliot C / Nordentoft, Merete / Norman, Sonya B / O'Donnell, Meaghan / Orcutt, Holly K / Panizzon, Matthew S / Peters, Edward S / Peterson, Alan L / Peverill, Matthew / Pietrzak, Robert H / Polusny, Melissa A / Rice, John P / Ripke, Stephan / Risbrough, Victoria B / Roberts, Andrea L / Rothbaum, Alex O / Rothbaum, Barbara O / Roy-Byrne, Peter / Ruggiero, Ken / Rung, Ariane / Rutten, Bart P F / Saccone, Nancy L / Sanchez, Sixto E / Schijven, Dick / Seedat, Soraya / Seligowski, Antonia V / Seng, Julia S / Sheerin, Christina M / Silove, Derrick / Smith, Alicia K / Smoller, Jordan W / Sponheim, Scott R / Stein, Dan J / Stevens, Jennifer S / Sumner, Jennifer A / Teicher, Martin H / Thompson, Wesley K / Trapido, Edward / Uddin, Monica / Ursano, Robert J / van den Heuvel, Leigh Luella / Van Hooff, Miranda / Vermetten, Eric / Vinkers, Christiaan H / Voisey, Joanne / Wang, Yunpeng / Wang, Zhewu / Werge, Thomas / Williams, Michelle A / Williamson, Douglas E / Winternitz, Sherry / Wolf, Christiane / Wolf, Erika J / Wolff, Jonathan D / Yehuda, Rachel / Young, Ross McD / Young, Keith A / Zhao, Hongyu / Zoellner, Lori A / Liberzon, Israel / Ressler, Kerry J / Haas, Magali / Koenen, Karestan C. ·University of California San Diego, Department of Psychiatry, La Jolla, CA, USA. cnievergelt@ucsd.edu. · Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA. cnievergelt@ucsd.edu. · Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA. cnievergelt@ucsd.edu. · University of California San Diego, Department of Psychiatry, La Jolla, CA, USA. · Veterans Affairs San Diego Healthcare System, Center of Excellence for Stress and Mental Health, San Diego, CA, USA. · Veterans Affairs San Diego Healthcare System, Research Service, San Diego, CA, USA. · Harvard Medical School, Department of Psychiatry, Boston, MA, USA. · McLean Hospital, Belmont, MA, USA. · University Medical Center Goettingen, Department of Psychiatry, Göttingen, DE, Germany. · Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, MA, USA. · Massachusetts General Hospital, Analytic and Translational Genetics Unit, Boston, MA, USA. · Massachusetts General Hospital, Psychiatric and Neurodevelopmental Genetics Unit (PNGU), Boston, MA, USA. · Massachusetts General Hospital, Department of Psychiatry, Boston, MA, USA. · Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, USA. · King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, GB, USA. · King's College London, NIHR BRC at the Maudsley, London, GB, USA. · University of Cape Town, SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Cape Town, Western Cape, ZA, USA. · Stanford University, Department of Psychiatry and Behavioral Sciences, Stanford, CA, USA. · US Department of Veterans Affairs, Department of Psychiatry, West Haven, CT, USA. · Yale University School of Medicine, Department of Genetics and Neuroscience, New Haven, CT, USA. · VA Connecticut Healthcare Center, West Haven, CT, USA. · Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA. · VA Boston Healthcare System, National Center for PTSD, Boston, MA, USA. · Cohen Veterans Bioscience, Cambridge, MA, USA. · Veterans Affairs San Diego Healthcare System, Million Veteran Program, San Diego, CA, USA. · Veterans Affairs San Diego Healthcare System, Psychiatry Service, San Diego, CA, USA. · Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, NC, USA. · Emory University, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA. · Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Richmond, VA, USA. · The Danish Veteran Centre, Research and Knowledge Centre, Ringsted, Sjaelland, Denmark. · University of Oslo, Institute of Clinical Medicine, Oslo, NO, Norway. · Minneapolis VA Health Care System, Mental Health Service Line, Minneapolis, MN, USA. · Duke University, Duke Molecular Physiology Institute, Durham, NC, USA. · Boston Children's Hospital, Division of Adolescent and Young Adult Medicine, Boston, MA, USA. · Brigham and Women's Hospital, Channing Division of Network Medicine, Boston, MA, USA. · Harvard School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, USA. · University Clinical Center of Tuzla, Department of Psychiatry, Tuzla, BA, Bosnia and Herzegovina. · University Clinical Center of Mostar, Department of Psychiatry, Mostar, BA, Bosnia and Herzegovina. · Statens Serum Institut, Department for Congenital Disorders, Copenhagen, DK, Denmark. · The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, DK, Denmark. · Durham VA Medical Center, Research, Durham, NC, USA. · Duke University, Department of Psychiatry and Behavioral Sciences, Durham, NC, USA. · VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Genetics Research Laboratory, Durham, NC, USA. · Washington University in Saint Louis School of Medicine, Department of Psychiatry, Saint Louis, MO, USA. · Cardiff University, National Centre for Mental Health, MRC Centre for Psychiatric Genetics and Genomics, Cardiff, UK. · UMC Utrecht Brain Center Rudolf Magnus, Department of Translational Neuroscience, Utrecht, Utrecht, NL, Netherlands. · Aarhus University, Centre for Integrative Sequencing, iSEQ, Aarhus, DK, Denmark. · Aarhus University, Department of Biomedicine - Human Genetics, Aarhus, DK, Denmark. · Atlanta VA Health Care System, Mental Health Service Line, Decatur, GA, USA. · Louisiana State University Health Sciences Center, School of Public Health and Department of Epidemiology, New Orleans, LA, USA. · University of New South Wales, Department of Psychology, Sydney, NSW, Australia. · University of Michigan Medical School, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ann Arbor, MI, USA. · University Hospitals, Department of Psychiatry, Cleveland, OH, USA. · CEDOC -Chronic Diseases Research Centre, Lisbon Institute of Global Mental Health, Lisbon, PT, Portugal. · University of California San Diego, Department of Radiology, Department of Neurosciences, La Jolla, CA, USA. · Icahn School of Medicine at Mount Sinai, Department of Psychiatry, New York, NY, USA. · University Hospital of Würzburg, Center of Mental Health, Psychiatry, Psychosomatics and Psychotherapy, Würzburg, DE, Germany. · Kent State University, Department of Psychological Sciences, Kent, OH, USA. · Kent State University, Research and Sponsored Programs, Kent, OH, USA. · Minneapolis VA Health Care System, Research Service Line, Minneapolis, MN, USA. · Medical Center-University of Freiburg, Faculty of Medicine, Department of Psychiatry and Psychotherapy, Freiburg, DE, Germany. · University of Freiburg, Faculty of Medicine, Centre for Basics in Neuromodulation, Freiburg, DE, Germany. · University Clinical Center of Sarajevo, Department of Psychiatry, Sarajevo, BA, Bosnia and Herzegovina. · University of Minnesota, Department of Psychiatry, Minneapolis, MN, USA. · Minneapolis VA Health Care System, Center for Care Delivery and Outcomes Research (CCDOR), Minneapolis, MN, USA. · Cardiff University, National Centre for Mental Health, MRC Centre for Psychiatric Genetics and Genomics, Cardiff, South Glamorgan, GB, USA. · Boston University School of Medicine, Department of Medicine, Boston, MA, USA. · Case Western Reserve University, Department of Psychological Sciences, Cleveland, OH, USA. · University of Melbourne, Department of Psychiatry, Melbourne, VIC, AU, USA. · Boston University, Department of Psychological and Brain Sciences, Boston, MA, USA. · Netherlands Ministry of Defence, Brain Research and Innovation Centre, Utrecht, Utrecht, NL, Netherlands. · UMC Utrecht Brain Center Rudolf Magnus, Department of Psychiatry, Utrecht, Utrecht, NL, Netherlands. · University Clinical Centre of Kosovo, Department of Psychiatry, Prishtina, Kosovo, XK, USA. · QIMR Berghofer Medical Research Institute, Department of Genetics and Computational Biology, Brisbane, Queensland, Australia. · US Army Medical Research and Materiel Command, USACEHR, Fort Detrick, MD, USA. · Washington University in Saint Louis School of Medicine, Department of Genetics, Saint Louis, MO, USA. · Stellenbosch University Faculty of Medicine and Health Sciences, Department of Psychiatry, Cape Town, Western Cape, ZA, South Africa. · University Hospital Center of Zagreb, Department of Psychiatry, Zagreb, HR, USA. · RTI International, Behavioral Health and Criminal Justice Division, Research Triangle Park, NC, USA. · University of Copenhagen, Department of Psychology, Copenhagen, DK, Denmark. · Harvard Medical School, Department of Health Care Policy, Boston, MA, USA. · University of Michigan Medical School, Department of Psychiatry, Ann Arbor, MI, USA. · University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA. · Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA, USA. · Queensland University of Technology, Institute of Health and Biomedical Innovation, Kelvin Grove, QLD, AU, Australia. · Queensland University of Technology, School of Biomedical Sciences, Kelvin Grove, QLD, AU, Australia. · UNC Institute for Trauma Recovery, Department of Anesthesiology, Chapel Hill, NC, USA. · Emory University, Department of Gynecology and Obstetrics, Atlanta, GA, USA. · Boston University, Dean's Office, Boston, MA, USA. · New York University School of Medicine, Department of Psychiatry, New York, NY, USA. · United States Army, Command, Fort Sill, OK, USA. · University of Adelaide, Department of Psychiatry, Adelaide, South Australia, AU, Australia. · VA Boston Health Care System, GRECC/TRACTS, Boston, MA, USA. · Harvard University, Department of Psychology, Boston, MA, USA. · UNC Institute for Trauma Recovery, Department of Emergency Medicine, Chapel Hill, NC, USA. · Gallipoli Medical Research Institute, PTSD Initiative, Greenslopes, Queensland, AU, Australia. · Queensland University of Technology, School of Psychology and Counseling, Faculty of Health, Kelvin Grove, QLD, AU, Australia. · Aarhus University Hospital, Psychosis Research Unit, Risskov, DK, Denmark. · Aarhus University, Centre for Integrated Register-based Research, Aarhus, DK, Denmark. · Aarhus University, National Centre for Register-Based Research, Aarhus, DK, Denmark. · University of Copenhagen, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Copenhagen, DK, Denmark. · Veterans Affairs San Diego Healthcare System, Department of Research and Psychiatry, San Diego, CA, USA. · National Center for Post Traumatic Stress Disorder, Executive Division, White River Junction, San Diego, VT, USA. · Northern Illinois University, Department of Psychology, DeKalb, IL, USA. · University of Texas Health Science Center at San Antonio, Department of Psychiatry, San Antonio, TX, USA. · University of Washington, Department of Psychology, Seattle, WA, USA. · U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, West Haven, CT, USA. · Minneapolis VA Health Care System, Department of Mental Health, Minneapolis, MN, USA. · Minneapolis VA Health Care System, Department of Psychology, Minneapolis, MN, USA. · Charité - Universitätsmedizin, Department of Psychiatry and Psychotherapy, Berlin, GE, Germany. · Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA. · Medical University of South Carolina, Department of Nursing and Department of Psychiatry, Charleston, SC, USA. · Maastricht Universitair Medisch Centrum, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht, Limburg, NL, Netherlands. · Universidad Peruana de Ciencias Aplicadas Facultad de Ciencias de la Salud, Department of Medicine, Lima, Lima, PE, USA. · University of Michigan, School of Nursing, Ann Arbor, MI, USA. · University of New South Wales, Department of Psychiatry, Sydney, NSW, AU, USA. · Columbia University Medical Center, Department of Medicine, New York, NY, USA. · Mental Health Centre Sct. Hans, Institute of Biological Psychiatry, Roskilde, DK, Denmark. · Oslo University Hospital, KG Jebsen Centre for Psychosis Research, Norway Division of Mental Health and Addiction, Oslo, NO, USA. · University of South Florida College of Public Health, Genomics Program, Tampa, FL, USA. · Uniformed Services University, Department of Psychiatry, Bethesda, Maryland, USA. · Arq, Psychotrauma Reseach Expert Group, Diemen, NH, Netherlands. · Leiden University Medical Center, Department of Psychiatry, Leiden, ZH, NL, Netherlands. · Netherlands Defense Department, Research Center, Utrecht, UT, Netherlands. · Amsterdam UMC (location VUmc), Department of Anatomy and Neurosciences, Amsterdam, Holland, NL, Netherlands. · Amsterdam UMC (location VUmc), Department of Psychiatry, Amsterdam, Holland, NL, Netherlands. · Ralph H Johnson VA Medical Center, Department of Mental Health, Charleston, SC, USA. · Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Charleston, SC, USA. · University of Copenhagen, Department of Clinical Medicine, Copenhagen, Denmark. · James J Peters VA Medical Center, Department of Mental Health, Bronx, NY, USA. · Baylor Scott and White Central Texas, Department of Psychiatry, Temple, TX, USA. · CTVHCS, COE for Research on Returning War Veterans, Waco, TX, USA. · Yale University, Department of Biostatistics, New Haven, CT, USA. · University of Washington, Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA. · Harvard School of Public Health, Department of Epidemiology, Boston, MA, USA. ·Nat Commun · Pubmed #31594949.

ABSTRACT: The risk of posttraumatic stress disorder (PTSD) following trauma is heritable, but robust common variants have yet to be identified. In a multi-ethnic cohort including over 30,000 PTSD cases and 170,000 controls we conduct a genome-wide association study of PTSD. We demonstrate SNP-based heritability estimates of 5-20%, varying by sex. Three genome-wide significant loci are identified, 2 in European and 1 in African-ancestry analyses. Analyses stratified by sex implicate 3 additional loci in men. Along with other novel genes and non-coding RNAs, a Parkinson's disease gene involved in dopamine regulation, PARK2, is associated with PTSD. Finally, we demonstrate that polygenic risk for PTSD is significantly predictive of re-experiencing symptoms in the Million Veteran Program dataset, although specific loci did not replicate. These results demonstrate the role of genetic variation in the biology of risk for PTSD and highlight the necessity of conducting sex-stratified analyses and expanding GWAS beyond European ancestry populations.

15 Article Associations of childhood trauma and childhood mental disorder with past-year mental disorder in military and civilian employed men. 2019

Sheriff, Rebecca Syed / Van Hooff, Miranda / Malhi, Gin / Grace, Blair / McFarlane, Alexander. ·Centre for Traumatic Stress Studies (CTSS), Level 1, Helen Mayo North, 30 Frome Road, University of Adelaide, Adelaide, SA 5000, Australia; Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom; Child and Adolescent Psychiatric Unit, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand. Electronic address: rebecca_syed@hotmail.com. · Centre for Traumatic Stress Studies (CTSS), Level 1, Helen Mayo North, 30 Frome Road, University of Adelaide, Adelaide, SA 5000, Australia. · Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia; Sydney Medical School Northern, University of Sydney, NSW, Australia; CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia. · Department of Education and Child Development, 31 Flinders St, Adelaide, Australia. ·Psychiatry Res · Pubmed #31377663.

ABSTRACT: Childhood factors are pivotal to understanding mental health over the lifespan. However, there is a dearth of research exploring childhood trauma and childhood disorder simultaneously in determining adult mental disorder. We aimed to analyze childhood trauma and childhood disorder in determining past-year disorder in military and civilian employed men aged 18-60 years. Data derived from the 2010 Australian Defence Force (ADF) Mental Health Prevalence and Wellbeing Study, and the 2007 Australian Bureau of Statistics National Survey of Mental Health and Wellbeing were analysed using logistic regression and Generalised Structural Equation Modelling (GSEM). All major findings were consistent across both populations. The association between childhood disorder and past-year disorder remained after controlling for demographics, childhood and adult trauma (and service factors in the ADF). Childhood non-interpersonal trauma was not associated with past-year disorder in either population. The pathway between childhood trauma and past-year disorder was fully mediated by the spectrum of common childhood disorders, but not by childhood anxiety, depression or alcohol use disorders alone. Identification, intervention and prevention of childhood disorders is imperative. Investment in interventions targeting the influence of childhood traumatic events on the whole spectrum of childhood disorder, not only PTSD or anxiety, is a priority.

16 Article Identifying distinctive psychological symptom profiles among a nationally representative sample of refugees resettled in Australia. 2019

Nickerson, Angela / Hadzi-Pavlovic, Dusan / Edwards, Ben / O'Donnell, Meaghan / Creamer, Mark / Felmingham, Kim L / Forbes, David / McFarlane, Alexander C / Silove, Derrick / Steel, Zachary / van Hoof, Miranda / Bryant, Richard A. ·1 School of Psychology, University of New South Wales, Sydney, NSW, Australia. · 2 School of Psychiatry, University of New South Wales, Sydney, NSW, Australia. · 3 Centre for Social Research & Methods, The Australian National University, Canberra, ACT, Australia. · 4 Phoenix Australia, University of Melbourne, Melbourne, VIC, Australia. · 5 School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia. · 6 Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, SA, Australia. · 7 St John of God Health Care, Richmond Hospital, North Richmond, NSW, Australia. ·Aust N Z J Psychiatry · Pubmed #31032626.

ABSTRACT: OBJECTIVE: The number of refugees worldwide is unprecedented in recent history. Little is known, however, about profiles of psychological symptoms following persecution and displacement. METHODS: This study reports on a latent class analysis that identified profiles of posttraumatic stress disorder (PTSD), depression and anxiety symptoms in a nationally representative sample of 1625 refugees in Australia. The association between specific symptom profiles, exposure to potentially traumatic events and post-migration stressors, and overall health and help-seeking was examined. RESULTS: Latent class analysis yielded an optimal five-class solution. These classes comprised the Pervasive Symptom class (19.2%), the High PTSD Symptom class (17.1%), the High Depression/Anxiety Symptom class (16.4%), the Moderate PTSD Symptom class (16.2%) and the Low Symptom class (31.1%). Participants in the symptomatic classes were more likely to be female, older and report greater post-migration stressors than those in the Low Symptom class. In addition, individuals in classes characterized by PTSD symptoms had been exposed to more types of potentially traumatic events. Membership in symptomatic classes was associated with poorer overall heath and greater help-seeking. CONCLUSION: Qualitatively distinct symptom profiles were observed in a nationally representative sample of refugees. In addition to a group of people who reported high symptoms across psychological disorders and may warrant clinical intervention, we identified two subclinical classes who may be missed by existing diagnostic classification systems. Post-migration stressors play an important role in influencing refugee symptom profiles over and above exposure to potentially traumatic events. Clinicians should consider specific symptom profiles and contextual factors when planning interventions with refugees.

17 Article Longitudinal association between trust, psychological symptoms and community engagement in resettled refugees. 2019

Nickerson, Angela / Liddell, Belinda J / Keegan, David / Edwards, Ben / Felmingham, Kim L / Forbes, David / Hadzi-Pavlovic, Dusan / McFarlane, Alexander C / O'Donnell, Meaghan / Silove, Derrick / Steel, Zachary / van Hooff, Miranda / Bryant, Richard A. ·School of Psychology,University of New South Wales,Sydney,Australia. · HOST International,Sydney,Australia. · Centre for Social Research, The Australian National University,Canberra,Australia. · School of Psychological Sciences, University of Melbourne,Melbourne,Victoria,Australia. · Department of Psychiatry,University of Melbourne,Parkville,Victoria,Australia. · The Centre for Traumatic Stress, University of Adelaide,Adelaide,SouthAustralia,Australia. · School of Psychiatry,University of New South Wales,Sydney,Australia. ·Psychol Med · Pubmed #30160232.

ABSTRACT: BACKGROUND: The mental health and social functioning of millions of forcibly displaced individuals worldwide represents a key public health priority for host governments. This is the first longitudinal study with a representative sample to examine the impact of interpersonal trust and psychological symptoms on community engagement in refugees. METHODS: Participants were 1894 resettled refugees, assessed within 6 months of receiving a permanent visa in Australia, and again 2-3 years later. Variables measured included post-traumatic stress disorder symptoms, depression/anxiety symptoms, interpersonal trust and engagement with refugees' own and other communities. RESULTS: A multilevel path analysis was conducted, with the final model evidencing good fit (Comparative Fit Index = 0.97, Tucker-Lewis Index = 0.89, Root Mean Square Error of Approximation = 0.05, Standardized Root-Mean-Square-Residual = 0.05). Findings revealed that high levels of depression symptoms were associated with lower subsequent engagement with refugees' own communities. In contrast, low levels of interpersonal trust were associated with lower engagement with the host community over the same timeframe. CONCLUSIONS: Findings point to differential pathways to social engagement in the medium-term post-resettlement. Results indicate that depression symptoms are linked to reduced engagement with one's own community, while interpersonal trust is implicated in engagement with the broader community in the host country. These findings have potentially important implications for policy and clinical practice, suggesting that clinical and support services should target psychological symptoms and interpersonal processes when fostering positive adaptation in resettled refugees.

18 Article The impact of post-traumatic stress disorder symptomatology on quality of life: The sentinel experience of anger, hypervigilance and restricted affect. 2019

Forbes, David / Nickerson, Angela / Bryant, Richard A / Creamer, Mark / Silove, Derrick / McFarlane, Alexander C / Van Hooff, Miranda / Phelps, Andrea / Felmingham, Kim L / Malhi, Gin S / Steel, Zachary / Fredrickson, Julia / Alkemade, Nathan / O'Donnell, Meaghan. ·1 Phoenix Australia Centre for Posttraumatic Mental Health and Department of Psychiatry, The University of Melbourne, Carlton, VIC, Australia. · 2 School of Psychology, University of New South Wales, Sydney, NSW, Australia. · 3 School of Psychiatry, University of New South Wales, Sydney, NSW, Australia. · 4 Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, SA, Australia. · 5 Division of Psychology, School of Medicine, University of Tasmania, Hobart, TAS, Australia. · 6 Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia. ·Aust N Z J Psychiatry · Pubmed #29726277.

ABSTRACT: BACKGROUND: It is unclear which specific symptoms of post-traumatic stress disorder are related to poor perceived quality of life. OBJECTIVE: To investigate the influence of post-traumatic stress disorder symptomatology on quality of life in traumatic injury survivors. METHOD: Traumatic injury survivors completed questionnaires on post-traumatic stress disorder symptomatology and quality of life at 3 months ( n = 987), 12 months ( n = 862), 24 months ( n = 830) and 6 years ( n = 613) post trauma. RESULTS: Low quality of life was reported by 14.5% of injury survivors at 3 months and 8% at 6 years post event. The post-traumatic stress disorder symptom clusters that contributed most to poor perceived quality of life were numbing and arousal, the individual symptoms that contributed most were anger, hypervigilance and restricted affect. CONCLUSIONS: There was variability in the quality of life of traumatic injury survivors in the 6 years following trauma and a consistent proportion reported low quality of life. Early intervention to reduce anger, hypervigilance and restricted affect symptoms may provide a means to improving the quality of life of traumatic injury survivors.

19 Article The role of site and severity of injury as predictors of mental health outcomes following traumatic injury. 2018

Baecher, Katharine / Kangas, Maria / Taylor, Alan / O'Donnell, Meaghan L / Bryant, Richard A / Silove, Derrick / McFarlane, Alexander C / Wade, Darryl. ·Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia. · Department of Psychology, Macquarie University, Sydney, NSW, Australia. · Phoenix Australia: Centre for Posttraumatic Mental Health, Carlton, VIC, Australia. · Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia. · School of Psychology, University of New South Wales, Sydney, NSW, Australia. · Mental Health Centre, Liverpool, NSW, Australia. · School of Psychiatry, University of New South Wales, Sydney, NSW, Australia. · Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, SA, Australia. ·Stress Health · Pubmed #29856110.

ABSTRACT: The aim of this study was to investigate the influence of injury site and severity as predictors of mental health outcomes in the initial 12 months following traumatic injury. Using a multisite, longitudinal study, participants with a traumatic physical injury (N = 1,098) were assessed during hospital admission and followed up at 3 months (N = 932, 86%) and at 12 months (N = 715, 71%). Injury site was measured using the Abbreviated Injury Scale 90, and objective injury severity was measured using the Injury Severity Score. Participants also completed the Hospital Anxiety and Depression Scale and the Clinician Administered Post-traumatic Stress Disorder (PTSD) Scale. A random intercept mixed modelling analysis was conducted to evaluate the effects of site and severity of injury in relation to anxiety, PTSD, and depressive symptoms. Injury severity, as well as head and facial injuries, was predictive of elevated PTSD symptoms, and external injuries were associated with both PTSD and depression severity. In contrast, lower extremity injuries were associated with depressive and anxiety symptoms. The findings suggest that visible injuries are predictive of reduced mental health, particularly PTSD following traumatic injury. This has clinical implications for further advancing the screening for vulnerable injured trauma survivors at risk of chronic psychopathology.

20 Article The effect of post-traumatic stress disorder on refugees' parenting and their children's mental health: a cohort study. 2018

Bryant, Richard A / Edwards, Ben / Creamer, Mark / O'Donnell, Meaghan / Forbes, David / Felmingham, Kim L / Silove, Derrick / Steel, Zachary / Nickerson, Angela / McFarlane, Alexander C / Van Hooff, Miranda / Hadzi-Pavlovic, Dusan. ·School of Psychology, University of New South Wales, Sydney, NSW, Australia; Westmead Institute for Medical Research, Sydney, NSW, Australia. Electronic address: r.bryant@unsw.edu.au. · Centre for Social Research and Methods, Australian National University, Canberra, Australian Capital Territory, Australia. · Phoenix Australia, University of Melbourne, Melbourne, VIC, Australia. · School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia. · School of Psychiatry, University of New South Wales, Sydney, NSW, Australia. · School of Psychology, University of New South Wales, Sydney, NSW, Australia. · Centre for Traumatic Stress Studies, University of Adelaide, Adelaide, SA, Australia. ·Lancet Public Health · Pubmed #29731158.

ABSTRACT: BACKGROUND: Children and adolescents, who account for most of the world's refugees, have an increased prevalence of psychological disorders. The mental health of refugee children is often associated with the severity of post-traumatic stress disorder (PTSD) in their caregivers. Despite the potential for refugee caregivers' PTSD to affect child mental health, little evidence exists concerning the underlying mechanisms of this association. This study tested the effect of refugee caregivers' previous trauma and levels of ongoing stressors on current PTSD, and in turn how this influences parenting behaviour and consequent child psychological health. METHODS: This cohort study recruited participants from the Building a New Life in Australia study, a population-based prospective cohort study of refugees admitted to 11 sites in Australia between October, 2013, and February, 2014. Eligible participants were aged 18 years or older and the principal or secondary applicant (ie, the refugee applicant within a migrating family unit) for a humanitarian visa awarded between May, 2013, and December, 2013. Primary caregiver PTSD and postmigration difficulties were assessed at Wave 1 (in 2013), and caregiver PTSD was reassessed at Wave 2 (in 2014). At Wave 3, between October, 2015, and February, 2016, primary caregivers repeated measures of trauma history, postmigration difficulties, probable PTSD, and harsh and warm parenting style, and completed the Strengths and Difficulties Questionnaire for their child. We used path analysis to investigate temporal patterns in PTSD, trauma history, postmigration stressors, parenting style, and children's psychological difficulties. FINDINGS: The current data comprised 411 primary caregivers who provided responses in relation to at least one child (660 children). 394 primary caregivers with 639 children had data on independent variables and were included in the final model. Path analyses revealed that caregivers' trauma history and postmigration difficulties were associated with greater subsequent PTSD, which in turn was associated with greater harsh parenting and in turn, higher levels of child conduct problems (β=0·049, p=0·0214), hyperactivity (β=0·044, p=0·0241), emotional symptoms (β=0·041, p=0·0218), and peer problems (β=0·007, p=0·047). There was also a direct path from primary caregiver PTSD to children's emotional problems (β=0·144, p=0·0001). INTERPRETATION: PTSD in refugees is associated with harsh parenting styles, leading to adverse effects on their children's mental health. Programmes to enhance refugee children's mental health should account for PTSD in parents and caregivers, and the parenting behaviours that these children are exposed to. FUNDING: National Health and Medical Research Council.

21 Article Neural activity and emotional processing following military deployment: Effects of mild traumatic brain injury and posttraumatic stress disorder. 2017

Zuj, Daniel V / Felmingham, Kim L / Palmer, Matthew A / Lawrence-Wood, Ellie / Van Hooff, Miranda / Lawrence, Andrew J / Bryant, Richard A / McFarlane, Alexander C. ·Division of Psychology, School of Medicine, University of Tasmania, Australia. Electronic address: Daniel.Zuj@utas.edu.au. · School of Psychological Science, University of Melbourne, Melbourne, Australia. · Division of Psychology, School of Medicine, University of Tasmania, Australia. · Centre for Traumatic Stress Studies, School of Medicine, University of Adelaide, Adelaide, Australia. · School of Psychology, University of New South Wales, Sydney, Australia. ·Brain Cogn · Pubmed #28738210.

ABSTRACT: Posttraumatic Stress Disorder (PTSD) and mild traumatic brain injury (mTBI) are common comorbidities during military deployment that affect emotional brain processing, yet few studies have examined the independent effects of mTBI and PTSD. The purpose of this study was to examine distinct differences in neural responses to emotional faces in mTBI and PTSD. Twenty-one soldiers reporting high PTSD symptoms were compared to 21 soldiers with low symptoms, and 16 soldiers who reported mTBI-consistent injury and symptoms were compared with 16 soldiers who did not sustain an mTBI. Participants viewed emotional face expressions while their neural activity was recorded (via event-related potentials) prior to and following deployment. The high-PTSD group displayed increased P1 and P2 amplitudes to threatening faces at post-deployment compared to the low-PTSD group. In contrast, the mTBI group displayed reduced face-specific processing (N170 amplitude) to all facial expressions compared to the no-mTBI group. Here, we identified distinctive neural patterns of emotional face processing, with attentional biases towards threatening faces in PTSD, and reduced emotional face processing in mTBI.

22 Article The impact of antecedent trauma exposure and mental health symptoms on the post-deployment mental health of Afghanistan-deployed Australian troops. 2017

Searle, Amelia K / Van Hooff, Miranda / Lawrence-Wood, Ellie R / Grace, Blair S / Saccone, Elizabeth J / Davy, Carol P / Lorimer, Michelle / McFarlane, Alexander C. ·Centre for Traumatic Stress Studies, The University of Adelaide, South Australia, Australia. Electronic address: amelia.searle@adelaide.edu.au. · Centre for Traumatic Stress Studies, The University of Adelaide, South Australia, Australia. · South Australian Health and Medical Research Institute (SAHMRI), South Australia, Australia. ·J Affect Disord · Pubmed #28599187.

ABSTRACT: BACKGROUND: Both traumatic deployment experiences and antecedent traumas increase personnel's risk of developing PTSD and depression. However, only cross-sectional studies have assessed whether antecedent trauma moderates stress reactions to deployment experiences. This study prospectively examines whether antecedent trauma moderates the association between deployment trauma and post-deployment PTSD and depressive symptoms after accounting for antecedent mental health problems, in a large Australian Defence Force (ADF) sample. METHODS: In the ADF Middle East Area of Operations Prospective Study, currently-serving military personnel deployed to Afghanistan across 2010-2012 (n = 1122) completed self-reported measures at pre-deployment and post-deployment. RESULTS: Within multivariable regressions, associations between deployment trauma and PTSD and depressive symptoms at post-deployment were stronger for personnel with greater antecedent trauma. However, once adjusting for antecedent mental health problems, these significant interaction effects disappeared. Instead, deployment-related trauma and antecedent mental health problems showed direct associations with post-deployment mental health problems. Antecedent trauma was also indirectly associated with post-deployment mental health problems through antecedent mental health problems. Similar associations were seen with prior combat exposure as a moderator. LIMITATIONS: Antecedent and deployment trauma were reported retrospectively. Self-reports may also suffer from social desirability bias, especially at pre-deployment. CONCLUSIONS: Our main effects results support the pervasive and cumulative negative effect of trauma on military personnel, regardless of its source. While antecedent trauma does not amplify personnel's psychological response to deployment trauma, it is indirectly associated with increased post-deployment mental health problems. Antecedent mental health should be considered within pre-deployment prevention programs, and deployment-trauma within post-operational screening.

23 Article Separation from parents during childhood trauma predicts adult attachment security and post-traumatic stress disorder. 2017

Bryant, R A / Creamer, M / O'Donnell, M / Forbes, D / Felmingham, K L / Silove, D / Malhi, G / van Hoof, M / McFarlane, A C / Nickerson, A. ·School of Psychology,University of New South Wales,Sydney,NSW 2052,Australia. · Phoenix Institute,University of Melbourne,161 Barry Street,Carlton,VIC 3053,Australia. · Department of Psychology,University of Tasmania,Hobart,TAS 7000,Australia. · Department of Psychiatry,University of Sydney,St Leonards,NSW 2065,Australia. · Department of Psychiatry,University of Adelaide,Adelaide,SA 5000,Australia. ·Psychol Med · Pubmed #28535839.

ABSTRACT: BACKGROUND: Prolonged separation from parental support is a risk factor for psychopathology. This study assessed the impact of brief separation from parents during childhood trauma on adult attachment tendencies and post-traumatic stress. METHOD: Children (n = 806) exposed to a major Australian bushfire disaster in 1983 and matched controls (n = 725) were assessed in the aftermath of the fires (mean age 7-8 years) via parent reports of trauma exposure and separation from parents during the fires. Participants (n = 500) were subsequently assessed 28 years after initial assessment on the Experiences in Close Relationships scale to assess attachment security, and post-traumatic stress disorder (PTSD) was assessed using the PTSD checklist. RESULTS: Being separated from parents was significantly related to having an avoidant attachment style as an adult (B = -3.69, s.e. = 1.48, β = -0.23, p = 0.013). Avoidant attachment was associated with re-experiencing (B = 0.03, s.e. = 0.01, β = 0.31, p = 0.045), avoidance (B = 0.03, s.e. = 0.01, β = 0.30, p = 0.001) and numbing (B = 0.03, s.e. = 0.01, β = 0.30, p < 0.001) symptoms. Anxious attachment was associated with re-experiencing (B = 0.03, s.e. = 0.01, β = 0.18, p = 0.001), numbing (B = 0.03, β = 0.30, s.e. = 0.01, p < 0.001) and arousal (B = 0.04, s.e. = 0.01, β = 0.43, p < 0.001) symptoms. CONCLUSIONS: These findings demonstrate that brief separation from attachments during childhood trauma can have long-lasting effects on one's attachment security, and that this can be associated with adult post-traumatic psychopathology.

24 Article Is screening for the psychological effects of war useful? 2017

McFarlane, Alexander C. ·Centre for Traumatic Stress Studies, University of Adelaide, Adelaide, SA 5000, Australia. Electronic address: alexander.mcfarlane@adelaide.edu.au. ·Lancet · Pubmed #28215662.

ABSTRACT: -- No abstract --

25 Article The contribution of gender-based violence and network trauma to gender differences in Post-Traumatic Stress Disorder. 2017

Silove, Derrick / Baker, Jess R / Mohsin, Mohammed / Teesson, Maree / Creamer, Mark / O'Donnell, Meaghan / Forbes, David / Carragher, Natacha / Slade, Tim / Mills, Katherine / Bryant, Richard / McFarlane, Alexander / Steel, Zachary / Felmingham, Kim / Rees, Susan. ·Psychiatry Research and Teaching Unit, University of New South Wales, Sydney, Australia. · School of Psychiatry, University of New South Wales, Sydney, Australia. · Office of Medical Education, University of New South Wales, Sydney, Australia. · Department of Psychiatry, University of Melbourne, Melbourne, Australia. · School of Psychology, University of New South Wales, Sydney, Australia. · Centre for traumatic Stress Studies, University of Adelaide, Adelaide, Australia. ·PLoS One · Pubmed #28207775.

ABSTRACT: BACKGROUND: Posttraumatic stress disorder (PTSD) occurs twice as commonly amongst women as men. Two common domains of trauma, network trauma and gender based violence (GBV), may contribute to this gender difference in PTSD rates. We examined data from a nationally representative sample of the Australian population to clarify the characteristics of these two trauma domains in their contributions to PTSD rates in men and women. METHODS: We drew on data from the 2007 Australian National Survey of Mental Health and Well-being to assess gender differences across a comprehensive range of trauma domains, including (1) prevalence of lifetime exposure; (2) identification of an index trauma or DSM-IV Criterion A event; and (3) the likelihood of developing full DSM-IV PTSD symptoms once an index trauma was identified. RESULTS: Men reported more traumatic events (TEs) overall but women reported twice the prevalence of lifetime PTSD (women, 13.4%; men, 6.3%). Women reported a threefold higher level of exposure to GBV and were seven times more likely to nominate GBV as the index trauma as compared to men. Women were twice more likely than men to identify a network trauma as the index trauma and more likely to meet full PTSD symptoms in relation to that event (women, 20.6%; men, 14.6%). CONCLUSION: Women are more likely to identify GBV and network trauma as an index trauma. Women's far greater exposure to GBV contributes to their higher prevalence of PTSD. Women are markedly more likely to develop PTSD when network trauma is identified as the index trauma. Preventing exposure to GBV and providing timely interventions for acute psychological reactions following network trauma may assist in reducing PTSD rates amongst women.

Next