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Post-Traumatic Stress Disorders: HELP
Articles by Eric Vermetten
Based on 67 articles published since 2010
(Why 67 articles?)
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Between 2010 and 2020, E. Vermetten wrote the following 67 articles about Stress Disorders, Post-Traumatic.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Editorial New findings from prospective studies. 2015

Vermetten, Eric / Baker, Dewleen / Yehuda, Rachel. ·Department of Psychiatry, University of Leiden, Leiden, The Netherlands; Military Mental Health - Research, Department of Defense, Leiden, The Netherlands; Arq Psychotrauma Expert Group, Diemen, The Netherlands. Electronic address: e.vermetten@lumc.nl. · Department of Psychiatry, University of California at San Diego, La Jolla, CA, USA; VA Center of Excellence for Stress and Mental Health (CESAMH), VA San Diego Healthcare System, San Diego, CA, USA. · James J. Peters Veterans Affairs Medical Center, Bronx, New York, NY, USA; Traumatic Stress Studies Division, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA. ·Psychoneuroendocrinology · Pubmed #25496647.

ABSTRACT: -- No abstract --

2 Review The study of service dogs for veterans with Post-Traumatic Stress Disorder: a scoping literature review. 2018

van Houtert, Emmy A E / Endenburg, Nienke / Wijnker, Joris J / Rodenburg, Bas / Vermetten, Eric. ·Department of Animal in Science and Society, Utrecht University, Utrecht, The Netherlands. · Department of IRAS Division EEPI & VPH, Utrecht University, Utrecht, The Netherlands. · Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands. · Arq Psychotrauma Expert Groep, Diemen, The Netherlands. · Department of MGGZ, Ministry of Defence, Utrecht, The Netherlands. ·Eur J Psychotraumatol · Pubmed #31798814.

ABSTRACT: The therapeutic application of human-animal interaction has gained interest recently. One form this interest takes is the use of service dogs as complementary treatment for veterans with Post-Traumatic Stress Disorder (PTSD). Many reports on the positive effect of PTSD Service Dogs (PSDs) on veterans exist, though most are indirect, anecdotal, or based on self-perceived welfare by veterans. They therefore only give a partial insight into PSD effect. To gain a more complete understanding of whether PSDs can be considered an effective complementary treatment for PTSD, a scoping literature review was performed on available studies of PSDs. The key search words were 'dog', 'canine', 'veteran', and 'PTSD'. This yielded 126 articles, of which 19 matched the inclusion criteria (six empirical studies). Recurrent themes in included articles were identified for discussion of methodology and/or results. It was found that results from most included studies were either applicable to human-animal interaction in general or other types of service animals. They therefore did not represent PSDs specifically. Studies which did discuss PSDs specifically only studied welfare experience in veterans, but used different methodologies. This lead us to conclude there is currently no undisputed empirical evidence that PSDs are an effective complementary treatment for veterans with PTSD other than reports on positive welfare experience. Additionally, the lack of development standardization and knowledge regarding welfare of PSDs creates risks for both human and animal welfare. It is therefore recommended that a study on the effect of PSDs be expanded to include evaluation methods besides self-perceived welfare of assisted humans. Future studies could include evaluations regarding human stress response and functioning, ideally conducted according to validated scientific methodologies using objective measurement techniques to identify the added value and mechanisms of using PSDs to assist treatment of PTSD in humans.

3 Review A Review of the Neurobiological Basis of Trauma-Related Dissociation and Its Relation to Cannabinoid- and Opioid-Mediated Stress Response: a Transdiagnostic, Translational Approach. 2018

Lanius, Ruth A / Boyd, Jenna E / McKinnon, Margaret C / Nicholson, Andrew A / Frewen, Paul / Vermetten, Eric / Jetly, Rakesh / Spiegel, David. ·Department of Neuroscience, Western University, London, ON, Canada. Ruth.lanius@lhsc.on.ca. · Department of Psychiatry, Western University, London, ON, Canada. Ruth.lanius@lhsc.on.ca. · Lawson Health Research Institute, London, ON, Canada. Ruth.lanius@lhsc.on.ca. · Homewood Research Institute, Guelph, ON, Canada. Ruth.lanius@lhsc.on.ca. · Homewood Research Institute, Guelph, ON, Canada. · Mood Disorders Program, St. Joseph's Healthcare, Hamilton, ON, Canada. · Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, ON, Canada. · Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, ON, Canada. · Department of Neuroscience, Western University, London, ON, Canada. · Department of Psychiatry, Western University, London, ON, Canada. · Lawson Health Research Institute, London, ON, Canada. · Department of Psychology, Western University, London, ON, Canada. · Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands. · Military Mental Health Research, Ministry of Defense, Utrecht, Netherlands. · Canadian Forces, Health Services, Ottawa, ON, Canada. · Stanford University School of Medicine, Stanford, CA, USA. ·Curr Psychiatry Rep · Pubmed #30402683.

ABSTRACT: Dissociative experiences have been associated with increased disease severity, chronicity, and, in some cases, reduced treatment response across trauma-related and other psychiatric disorders. A better understanding of the neurobiological mechanisms through which dissociative experiences occur may assist in identifying novel pharmacological and non-pharmacological treatment approaches. Here, we review emerging work on the dissociative subtype of posttraumatic stress disorder (PTSD), and other trauma-related disorders providing evidence for two related overarching neurobiological models of dissociation, the defense cascade model of dissociation and Mobb's threat detection model. In particular, we review neuroimaging studies highlighting alterations in functional connectivity of key brain regions associated with these models, including connectivity between the prefrontal cortex, the amygdala and its complexes, the insula, and the periaqueductal gray. Work implicating the kappa-opioid and endocannabinoid systems in trauma-related dissociative experiences is also reviewed. Finally, we hypothesize mechanisms by which pharmacological modulation of these neurochemical systems may serve as promising transdiagnostic treatment modalities for individuals experiencing clinically significant levels of dissociation. Specifically, whereas kappa-opioid receptor antagonists may serve as a pharmacological vehicle for the selective targeting of dissociative symptoms and associated emotion overmodulation in the dissociative subtype of posttraumatic stress disorder and transdiagnostically, modulation of the endocannabinoid system may reduce symptoms associated with emotional undermodulation of the fight or flight components of the defense cascade model.

4 Review The Dissociative Subtype of Post-traumatic Stress Disorder: Research Update on Clinical and Neurobiological Features. 2018

van Huijstee, Jytte / Vermetten, Eric. ·Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, The Netherlands. · Department Psychiatry, Leiden University Medical Center Utrecht, Albinusdreef 2, Leiden, 2333 ZA, The Netherlands. e.vermetten@lumc.nl. · Arq Psychotrauma Research Group, Diemen, 1112 XE, The Netherlands. e.vermetten@lumc.nl. ·Curr Top Behav Neurosci · Pubmed #29063485.

ABSTRACT: Recently, a dissociative subtype of post-traumatic stress disorder (PTSD) has been included in the DSM-5. This review focuses on the clinical and neurobiological features that distinguish the dissociative subtype of PTSD from non-dissociative PTSD. Clinically, the dissociative subtype of PTSD is associated with high PTSD severity, predominance of derealization and depersonalization symptoms, a more significant history of early life trauma, and higher levels of comorbid psychiatric disorders. Furthermore, PTSD patients with dissociative symptoms exhibit different psychophysiological and neural responses to the recall of traumatic memories. While individuals with non-dissociative PTSD exhibit an increased heart rate, decreased activation of prefrontal regions, and increased activation of the amygdala in response to traumatic reminders, individuals with the dissociative subtype of PTSD show an opposite pattern. It has been proposed that dissociation is a regulatory strategy to restrain extreme arousal in PTSD through hyperinhibition of limbic regions. In this research update, promises and pitfalls in current research studies on the dissociative subtype of PTSD are listed. Inclusion of the dissociative subtype of PTSD in the DSM-5 stimulates research on the prevalence, symptomatology, and neurobiology of the dissociative subtype of PTSD and poses a challenge to improve treatment outcome in PTSD patients with dissociative symptoms.

5 Review MicroRNAs in Post-traumatic Stress Disorder. 2018

Snijders, Clara / de Nijs, Laurence / Baker, Dewleen G / Hauger, Richard L / van den Hove, Daniel / Kenis, Gunter / Nievergelt, Caroline M / Boks, Marco P / Vermetten, Eric / Gage, Fred H / Rutten, Bart P F. ·Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Faculty of Health, Medicine and Life Sciences, Maastricht University, European Graduate School of Neuroscience, (EURON), Maastricht, 6200 MD, The Netherlands. · Department of Psychiatry, University of California, San Diego, La Jolla, CA, 92037, USA. · VA Center of Excellence for Stress and Mental Health, San Diego, La Jolla, CA, 92037, USA. · VA San Diego Healthcare System, San Diego, La Jolla, CA, 92037, USA. · Laboratory of Translational Neuroscience, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, 97080, Germany. · Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, 3584 CG, The Netherlands. · Military Mental Health Research Center, Ministry of Defense, P.O. Box 90000, Utrecht, 3509 AA, The Netherlands. · Department of Psychiatry, Leiden University Medical Center, Leiden, 2333 ZA, The Netherlands. · Arq Psychotrauma Research Group, Diemen, 1112 XE, The Netherlands. · Laboratory of Genetics, The Salk Institute for Biological Studies, La Jolla, CA, 92037, USA. · Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Faculty of Health, Medicine and Life Sciences, Maastricht University, European Graduate School of Neuroscience, (EURON), Maastricht, 6200 MD, The Netherlands. b.rutten@maastrichtuniversity.nl. ·Curr Top Behav Neurosci · Pubmed #29063484.

ABSTRACT: Post-traumatic stress disorder (PTSD) is a psychiatric disorder that can develop following exposure to or witnessing of a (potentially) threatening event. A critical issue is to pinpoint the (neuro)biological mechanisms underlying the susceptibility to stress-related disorder such as PTSD, which develops in the minority of ~15% of individuals exposed to trauma. Over the last few years, a first wave of epigenetic studies has been performed in an attempt to identify the molecular underpinnings of the long-lasting behavioral and mental effects of trauma exposure. The potential roles of non-coding RNAs (ncRNAs) such as microRNAs (miRNAs) in moderating or mediating the impact of severe stress and trauma are increasingly gaining attention. To date, most studies focusing on the roles of miRNAs in PTSD have, however, been completed in animals, using cross-sectional study designs and focusing almost exclusively on subjects with susceptible phenotypes. Therefore, there is a strong need for new research comprising translational and cross-species approaches that use longitudinal designs for studying trajectories of change contrasting susceptible and resilient subjects. The present review offers a comprehensive overview of available studies of miRNAs in PTSD and discusses the current challenges, pitfalls, and future perspectives of this field.

6 Review Integrating NIMH Research Domain Criteria (RDoC) into PTSD Research. 2018

Schmidt, Ulrike / Vermetten, Eric. ·Trauma Outpatient Unit and RG Molecular Psychotraumatology, Clinical Department, Max Planck Institute of Psychiatry, Kraepelinstrasse 10, Munich, 80804, Germany. · Department Psychiatry, Leiden University Medical Center Utrecht, Albinusdreef 2, Leiden, 2333 ZA, The Netherlands. e.vermetten@lumc.nl. · Arq Psychotruama Research Group, Diemen, The Netherlands. e.vermetten@lumc.nl. ·Curr Top Behav Neurosci · Pubmed #28341942.

ABSTRACT: Three and a half decades of research on posttraumatic stress disorder (PTSD) has produced substantial knowledge on the pathobiology of this frequent and debilitating disease. However, despite all research efforts, so far no drug that has specifically targeted PTSD core symptoms progressed to clinical use. Instead, although not overly efficient, serotonin re-uptake inhibitors continue to be considered the gold standard of PTSD pharmacotherapy. The psychotherapeutic treatment and symptom-oriented drug therapy options available for PTSD treatment today show some efficacy, although not in all PTSD patients, in particular not in a substantial percent of those suffering from the detrimental sequelae of repeated childhood trauma or in veterans with combat related PTSD. PTSD has this in common with other psychiatric disorders - in particular effective treatment for incapacitating conditions such as resistant major depression, chronic schizophrenia, and frequently relapsing obsessive-compulsive disorder as well as dementia has not yet been developed through modern neuropsychiatric research.In response to this conundrum, the National Institute of Mental Health launched the Research Domain Criteria (RDoC) framework which aims to leave diagnosis-oriented psychiatric research behind and to move on to the use of research domains overarching the traditional diagnosis systems. To the best of our knowledge, the paper at hand is the first that has systematically assessed the utility of the RDoC system for PTSD research. Here, we review core findings in neurobiological PTSD research and match them to the RDoC research domains and units of analysis. Our synthesis reveals that several core findings in PTSD such as amygdala overactivity have been linked to all RDoC domains without further specification of their distinct role in the pathophysiological pathways associated with these domains. This circumstance indicates that the elucidation of the cellular and molecular processes ultimately decisive for regulation of psychic processes and for the expression of psychopathological symptoms is still grossly incomplete. All in all, we find the RDoC research domains to be useful but not sufficient for PTSD research. Hence, we suggest adding two novel domains, namely stress and emotional regulation and maintenance of consciousness. As both of these domains play a role in various if not in all psychiatric diseases, we judge them to be useful not only for PTSD research but also for psychiatric research in general.

7 Review Odor-induced recall of emotional memories in PTSD-Review and new paradigm for research. 2016

Daniels, Judith K / Vermetten, Eric. ·Department of Psychology, Division of Clinical Psychology and Experimental Psychopathology, University of Groningen, The Netherlands; Psychologische Hochschule Berlin, Berlin, Germany. · Department Psychiatry, Leiden University Medical Center Utrecht, The Netherlands; Military Mental Health Research, Defense, The Netherlands; Arq Psychotrauma Research Group, Diemen, The Netherlands. Electronic address: e.vermetten@lumc.nl. ·Exp Neurol · Pubmed #27511295.

ABSTRACT: It is clinically well known that olfactory intrusions in PTSD can be a disabling phenomena due to the involuntary recall of odor memories. Odorants can trigger involuntary recall of emotional memories as well have the potential to help diminishing emotional arousal as grounding stimuli. Despite major advances in our understanding of the function of olfactory system, the study of the relation of olfaction and emotional memory is still relatively scarce. Odor memory is long thought to be different than other types of memories such as verbal or visual memories, being more strongly engraved and more closely related to strong emotions. Brain areas mediating smell memory including orbitofrontal cortex and other parts of medial prefrontal cortex, hippocampus and amygdala, have been implicated in learning and memory and are part of a neural circuitry that is involved in PTSD. The olfactory cortex itself also plays an important role in emotional processing. Clinical observations support the notion that odor-evoked memories can play a role in the symptomatology of PTSD. This paper reviews a re-emerging body of science linking odor processing to emotional processing in PTSD using the calming and grounding effect of odors as well as the use of odors in augmented exposure therapy. This results in converging evidence that olfaction is an excellent model for studying many questions germane to the field of human emotional memory processing.

8 Review [Efficacy of HRV-biofeedback as additional treatment of depression and PTSD]. 2016

Blase, K L / van Dijke, A / Cluitmans, P J M / Vermetten, E. · ·Tijdschr Psychiatr · Pubmed #27075221.

ABSTRACT: BACKGROUND: Heartrate variability biofeedback (HRVB) is a non-invasive treatment in which patients are assumed to self-regulate a physiological dysregulated vagal nerve. Although the therapeutic approach of HRVB is promising in various stress-related disorders, it has only been offered on a regular basis in a few mental health treatment settings. AIM: To analyse the efficacy of HRV biofeedback as an additional psychophysiological treatment for depression and PTSD. METHOD: Systematic review with search terms HRV, biofeedback, PTSD, depression, panic disorder and anxiety disorder. RESULTS: Our search of the literature yielded 789 studies. After critical appraisal using the GRADE method, we selected 6 randomised controlled trials (RCTs) and 4 relevant studies. The RCTs with control groups 'treatment as usual' and muscle relaxation training revealed significant clinical efficacy and better results than control conditions after 4 to 8 weeks training. CONCLUSION: Although this systematic review shows the popularity of HRV in literature, it does not indicate that HRVB really has been reviewed systematically. Significant outcomes of this limited number of randomised studies indicate there may be a clinical improvement when HRVB training is integrated into treatment of PTSD and depression, particularly when this integration procedure is combined with psychotherapy. More research needs to be done with larger groups and further efforts are needed to integrate HRVB into treatment of stress-related disorders in psychiatry. Future research also needs to focus on the psychophysiological mechanisms involved.

9 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.

10 Review Pharmacotherapy in the aftermath of trauma; opportunities in the 'golden hours'. 2014

Vermetten, Eric / Zhohar, Joseph / Krugers, Harm J. ·Department Psychiatry, Leiden University Medical Center Utrecht, Einthovenweg 20, 2333 ZC, Leiden, The Netherlands, e.vermetten@lumc.nl. ·Curr Psychiatry Rep · Pubmed #24890991.

ABSTRACT: Several lines of research have demonstrated that memories for fearful events become transiently labile upon re-exposure. Activation of molecular mechanisms is required in order to maintain retrieved information. This process is called reconsolidation. Targeting reconsolidation - as in exposure-based psychotherapy - offers therefore a potentially interesting tool to manipulate fear memories, and subsequently to treat disorders such as post-traumatic stress disorder (PTSD). In this paper we discuss the evidence for reconsolidation in rodents and humans and highlight recent studies in which clinical research on normal and abnormal fear extinction reduction of the expression of fear was obtained by targeting the process of reconsolidation. We conclude that reconsolidation presents an interesting opportunity to modify or alter fear and fear-related memories. More clinical research on normal and abnormal fear extinction is required.

11 Review Trauma and dissociation: implications for borderline personality disorder. 2014

Vermetten, Eric / Spiegel, David. ·Department Psychiatry, Leiden University Medical Center, Utrecht, The Netherlands, e.vermetten@lumc.nl. ·Curr Psychiatry Rep · Pubmed #24442670.

ABSTRACT: Psychological trauma can have devastating consequences on emotion regulatory capacities and lead to dissociative processes that provide subjective detachment from overwhelming emotional experience during and in the aftermath of trauma. Dissociation is a complex phenomenon that comprises a host of symptoms and factors, including depersonalization, derealization, time distortion, dissociative flashbacks, and alterations in the perception of the self. Dissociation occurs in up to two thirds of patients with borderline personality disorder (BPD). The neurobiology of traumatic dissociation has demonstrated a heterogeneity in posttraumatic stress symptoms that, over time, can result in different types of dysregulated emotional states. This review links the concepts of trauma and dissociation to BPD by illustrating different forms of emotional dysregulation and their clinical relevance to patients with BPD.

12 Review Biological and clinical framework for posttraumatic stress disorder. 2012

Vermetten, Eric / Lanius, Ruth A. ·Department of Psychiatry, Rudolf Magnus Institute of Neurosciences, Utrecht, The Netherlands. e.vermetten@umcutrecht.nl ·Handb Clin Neurol · Pubmed #22608629.

ABSTRACT: -- No abstract --

13 Review The dissociative subtype of posttraumatic stress disorder: rationale, clinical and neurobiological evidence, and implications. 2012

Lanius, Ruth A / Brand, Bethany / Vermetten, Eric / Frewen, Paul A / Spiegel, David. ·The University of Western Ontario, London, Ontario, Canada. ·Depress Anxiety · Pubmed #22431063.

ABSTRACT: BACKGROUND: Clinical and neurobiological evidence for a dissociative subtype of posttraumatic stress disorder (PTSD) has recently been documented. A dissociative subtype of PTSD is being considered for inclusion in the forthcoming Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) to address the symptoms of depersonalization and derealization found among a subset of patients with PTSD. This article reviews research related to the dissociative subtype including antecedent, concurrent, and predictive validators as well as the rationale for recommending the dissociative subtype. METHODS: The relevant literature pertaining to the dissociative subtype of PTSD was reviewed. RESULTS: Latent class analyses point toward a specific subtype of PTSD consisting of symptoms of depersonalization and derealization in both veteran and civilian samples of PTSD. Compared to individuals with PTSD, those with the dissociative subtype of PTSD also exhibit a different pattern of neurobiological response to symptom provocation as well as a differential response to current cognitive behavioral treatment designed for PTSD. CONCLUSIONS: We recommend that consideration be given to adding a dissociative subtype of PTSD in the revision of the DSM. This facilitates more accurate analysis of different phenotypes of PTSD, assist in treatment planning that is informed by considering the degree of patients' dissociativity, will improve treatment outcome, and will lead to much-needed research about the prevalence, symptomatology, neurobiology, and treatment of individuals with the dissociative subtype of PTSD.

14 Review Emotion modulation in PTSD: Clinical and neurobiological evidence for a dissociative subtype. 2010

Lanius, Ruth A / Vermetten, Eric / Loewenstein, Richard J / Brand, Bethany / Schmahl, Christian / Bremner, J Douglas / Spiegel, David. ·Department of Psychiatry, The University of Western Ontario, London, Canada. ·Am J Psychiatry · Pubmed #20360318.

ABSTRACT: In this article, the authors present evidence regarding a dissociative subtype of PTSD, with clinical and neurobiological features that can be distinguished from nondissociative PTSD. The dissociative subtype is characterized by overmodulation of affect, while the more common undermodulated type involves the predominance of reexperiencing and hyperarousal symptoms. This article focuses on the neural manifestations of the dissociative subtype in PTSD and compares it to those underlying the reexperiencing/hyperaroused subtype. A model that includes these two types of emotion dysregulation in PTSD is described. In this model, reexperiencing/hyperarousal reactivity is viewed as a form of emotion dysregulation that involves emotional undermodulation, mediated by failure of prefrontal inhibition of limbic regions. In contrast, the dissociative subtype of PTSD is described as a form of emotion dysregulation that involves emotional overmodulation mediated by midline prefrontal inhibition of the same limbic regions. Both types of modulation are involved in a dynamic interplay and lead to alternating symptom profiles in PTSD. These findings have important implications for treatment of PTSD, including the need to assess patients with PTSD for dissociative symptoms and to incorporate the treatment of dissociative symptoms into stage-oriented trauma treatment.

15 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.

16 Clinical Trial Decreased nocturnal growth hormone secretion and sleep fragmentation in combat-related posttraumatic stress disorder; potential predictors of impaired memory consolidation. 2011

van Liempt, Saskia / Vermetten, Eric / Lentjes, Eef / Arends, Johan / Westenberg, Herman. ·Research Centre Military Mental Healthcare, Utrecht, The Netherlands. S.vanliempt@umcutrecht.nl ·Psychoneuroendocrinology · Pubmed #21489700.

ABSTRACT: BACKGROUND: Healthy sleep facilitates the consolidation of newly acquired memories. Although patients with posttraumatic stress disorder (PTSD) often complain of sleep disturbances and memory deficits, the interrelatedness of these symptoms is not well understood. Sleep may be disturbed in PTSD by increased awakenings during sleep, which has been associated with decreased growth hormone (GH) secretion. We conducted a controlled study in which we assessed sleep fragmentation, nocturnal secretion of GH, and memory consolidation in patients with PTSD. METHODS: While sleep EEG was being monitored, 13 veterans with PTSD, 15 trauma controls (TC) and 15 healthy controls (HC) slept with an iv catheter, through which blood was collected every 20 min from 23:00 h to 08:00 h. Declarative memory encoding was assessed with the 15 word task before sleep, and consolidation was assessed the next morning by a free recall. RESULTS: Sleep was more fragmented in patients with PTSD, with more awakenings in the first half of the night (p<0.05). Plasma levels of GH during the night were significantly decreased in PTSD compared with HC (p<0.05). Furthermore, GH secretion and awakenings were independent predictors for delayed recall, which was lower in PTSD compared to HC (p<0.05). CONCLUSIONS: These data show that PTSD is associated with increased awakenings during sleep and decreased nocturnal GH secretion. Furthermore, decreased GH secretion may be related to sleep fragmentation and both variables may exert a negative effect on sleep dependent memory consolidation.

17 Article Reviewing the Potential of Psychedelics for the Treatment of PTSD. 2020

Krediet, Erwin / Bostoen, Tijmen / Breeksema, Joost / van Schagen, Annette / Passie, Torsten / Vermetten, Eric. ·Department of Psychiatry, Leiden University Medical Center, The Netherlands. · ARQ National Psychotrauma Center, Diemen, The Netherlands. · Department of Psychiatry, University Medical Center Groningen, The Netherlands. · Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany. · Dr. Senckenberg Institute for the History and Ethics in Medicine, Goethe University Frankfurt/Main, Germany. · Military Mental Health Care, Utrecht, The Netherlands. ·Int J Neuropsychopharmacol · Pubmed #32170326.

ABSTRACT: There are few medications with demonstrated efficacy for the treatment of posttraumatic stress disorder (PTSD). Treatment guidelines have unequivocally designated psychotherapy as a first line treatment for PTSD. Yet, even after psychotherapy, PTSD often remains a chronic illness, with high rates of psychiatric and medical comorbidity. Meanwhile, the search and development of drugs with new mechanisms of action has stalled. Therefore, there is an urgent need to explore not just novel compounds, but novel approaches for the treatment of PTSD. A promising new approach involves the use of psychedelic drugs. Within the past few years, two psychedelics have received breakthrough designations for psychiatric indications from the US Food and Drug Administration, and several psychedelics are currently being investigated for the treatment of PTSD. This review discusses four types of compounds: 3,4-methylenedioxymethamphetamine (MDMA), ketamine, classical psychedelics (e.g. psilocybin and LSD) and cannabinoids. We describe the therapeutic rationale, the setting in which they are being administered, and their current state of evidence in the treatment of PTSD. Each compound provides unique qualities for the treatment of PTSD, from their use to rapidly target symptoms, to their use as adjuncts to facilitate psychotherapeutic treatments. Several questions are formulated that outline an agenda for future research.

18 Article Longitudinal epigenome-wide association studies of three male military cohorts reveal multiple CpG sites associated with post-traumatic stress disorder. 2020

Snijders, Clara / Maihofer, Adam X / Ratanatharathorn, Andrew / Baker, Dewleen G / Boks, Marco P / Geuze, Elbert / Jain, Sonia / Kessler, Ronald C / Pishva, Ehsan / Risbrough, Victoria B / Stein, Murray B / Ursano, Robert J / Vermetten, Eric / Vinkers, Christiaan H / Anonymous611057 / Smith, Alicia K / Uddin, Monica / Rutten, Bart P F / Nievergelt, Caroline M. ·Department of Psychiatry and Neuropsychology, School for Mental health and Neuroscience, Maastricht University, Maastricht, Limburg, Netherlands. · Department of Psychiatry, University of California San Diego, La Jolla, CA, USA. · Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA. · Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA. · Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. · Psychiatry Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA. · Department of Psychiatry, UMC Utrecht Brain Center, Utrecht, Utrecht, Netherlands. · Brain Research & Innovation Centre, Netherlands Ministry of Defense, Utrecht, Utrecht, Netherlands. · Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA. · Department of Health Care Policy, Harvard Medical School, Boston, MA, USA. · College of Medicine and Health, University of Exeter Medical School, Exeter, UK. · Million Veteran Program, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA. · Department of Psychiatry, Uniformed Services University, Bethesda, MD, USA. · Arq, Psychotrauma Research Expert Group, Diemen, North Holland, Netherlands. · Department of Psychiatry, Leiden University Medical Center, Leiden, South Holland, Netherlands. · Military Mental Healthcare, Netherlands Ministry of Defense, Utrecht, Utrecht, Netherlands. · Department of Psychiatry, New York University School of Medicine, New York, NY, USA. · Department of Anatomy and Neurosciences, Amsterdam UMC (location VUmc), Amsterdam, Holland, Netherlands. · Department of Psychiatry, Amsterdam UMC (location VUmc), Amsterdam, Holland, Netherlands. · Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA. · Department of Gynecology and Obstetrics, Emory University, Atlanta, GA, USA. · Genomics Program, University of South Florida College of Public Health, Tampa, FL, USA. · Department of Psychiatry and Neuropsychology, School for Mental health and Neuroscience, Maastricht University, Maastricht, Limburg, Netherlands. cnievergelt@ucsd.edu. · Department of Psychiatry, University of California San Diego, La Jolla, CA, USA. cnievergelt@ucsd.edu. · Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA. cnievergelt@ucsd.edu. · Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA. cnievergelt@ucsd.edu. ·Clin Epigenetics · Pubmed #31931860.

ABSTRACT: BACKGROUND: Epigenetic mechanisms have been suggested to play a role in the development of post-traumatic stress disorder (PTSD). Here, blood-derived DNA methylation data (HumanMethylation450 BeadChip) collected prior to and following combat exposure in three cohorts of male military members were analyzed to assess whether DNA methylation profiles are associated with the development of PTSD. A total of 123 PTSD cases and 143 trauma-exposed controls were included in the analyses. The Psychiatric Genomics Consortium (PGC) PTSD EWAS QC pipeline was used on all cohorts, and results were combined using a sample size weighted meta-analysis in a two-stage design. In stage one, we jointly analyzed data of two new cohorts (N = 126 and 78) for gene discovery, and sought to replicate significant findings in a third, previously published cohort (N = 62) to assess the robustness of our results. In stage 2, we aimed at maximizing power for gene discovery by combining all three cohorts in a meta-analysis. RESULTS: Stage 1 analyses identified four CpG sites in which, conditional on pre-deployment DNA methylation, post-deployment DNA methylation was significantly associated with PTSD status after epigenome-wide adjustment for multiple comparisons. The most significant (intergenic) CpG cg05656210 (p = 1.0 × 10 CONCLUSIONS: This study suggests that the development of combat-related PTSD is associated with distinct methylation patterns in several genomic positions and regions. Our most prominent findings suggest the involvement of the immune system through the HLA region and HEXDC, and MAD1L1 which was previously associated with PTSD.

19 Article Circulating Serum MicroRNAs as Potential Diagnostic Biomarkers of Posttraumatic Stress Disorder: A Pilot Study. 2019

Snijders, Clara / Krauskopf, Julian / Pishva, Ehsan / Eijssen, Lars / Machiels, Barbie / Kleinjans, Jos / Kenis, Gunter / van den Hove, Daniel / Kim, Myeong Ok / Boks, Marco P M / Vinkers, Christiaan H / Vermetten, Eric / Geuze, Elbert / Rutten, Bart P F / de Nijs, Laurence. ·Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands. · Department of Toxicogenomics, Maastricht University, Maastricht, Netherlands. · College of Medicine and Health, University of Exeter Medical School, Exeter, United Kingdom. · Department of Bioinformatics (BiGCaT), NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands. · Division of Applied Life Science (BK 21), College of Natural Sciences, Gyeongsang National University, Jinju, South Korea. · UMC Utrecht Brain Center, Department of Psychiatry, Utrecht, Netherlands. · Amsterdam UMC (location VUmc), Department of Anatomy and Neurosciences, Amsterdam, Netherlands. · Amsterdam UMC (location VUmc), Department of Psychiatry, Amsterdam, Netherlands. · Arq, Psychotrauma Research Expert Group, Diemen, Netherlands. · Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands. · Military Mental Healthcare, Netherlands Ministry of Defense, Utrecht, Netherlands. · Department of Psychiatry, New York University School of Medicine, New York, United States. ·Front Genet · Pubmed #31824554.

ABSTRACT: Posttraumatic stress disorder (PTSD) is a psychiatric disorder that can develop upon exposure to a traumatic event. While most people are able to recover promptly, others are at increased risk of developing PTSD. However, the exact underlying biological mechanisms of differential susceptibility are unknown. Identifying biomarkers of PTSD could assist in its diagnosis and facilitate treatment planning. Here, we identified serum microRNAs (miRNAs) of subjects that underwent a traumatic event and aimed to assess their potential to serve as diagnostic biomarkers of PTSD. Next-generation sequencing was performed to examine circulating miRNA profiles of 24 members belonging to the Dutch military cohort Prospective Research in Stress-Related Military Operations (PRISMO). Three groups were selected: "susceptible" subjects who developed PTSD after combat exposure, "resilient" subjects without PTSD, and nonexposed control subjects (

20 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.

21 Article Exposure to combat and deployment; reviewing the military context in The Netherlands. 2019

Vermetten, Eric / Ambaum, Jan. ·a Military Mental Health - Research Center , Utrecht , The Netherlands. · b Department of Psychiatry , Leiden University Medical Center , Leiden , The Netherlands. · c Arq Psychotrauma Expert Group , Diemen , The Netherlands. ·Int Rev Psychiatry · Pubmed #31184276.

ABSTRACT: This paper reviews the military context of exposure to combat and deployment in Dutch soldiers. It does so by reviewing war victims and military psychiatry after WWII in the Netherlands, and describes Dutch deployments from the late 1970s to the present. 'Who is the Dutch soldier' is asked to articulate the mental load on the individual soldier before, during, and after deployment. The narrative review of this paper allows one to review how the armed forces personnel is challenged in relation to their specific assignment and in what respect the psychological dimensions are addressed and met in the face of risk and adversity. Finally, some critical considerations for future veterans care programmes are raised.

22 Article The Dissociative Subtype of PTSD Interview (DSP-I): Development and Psychometric Properties. 2019

Eidhof, Marloes B / Ter Heide, F Jackie June / van Der Aa, Niels / Schreckenbach, Monika / Schmidt, Ulrike / Brand, Bethany L / Lanius, Ruth A / Loewenstein, Richard J / Spiegel, David / Vermetten, Eric. ·Psychotraumacentrum Zuid Nederland, Reinier van Arkel , 's Hertogenbosch , The Netherlands. · Psychotrauma Expert Group, Arq , Diemen , The Netherlands. · Max Planck Institute of Psychiatry , München , Germany. · Clinic of Psychiatry and Psychotherapy, Psychotrauma Unit & RG Stress Modulation of Neurodegeneration, University Medical Center Göttingen (UMG) , Göttingen , Germany. · Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center , Maastricht , The Netherlands. · Department of Psychology, Towson University , Towson , MD , USA. · Department of Psychiatry, University of Western Ontario , London , Ontario , Canada. · Sheppard Pratt Health System , Baltimore , MD , USA. · Department of Psychiatry, University of Maryland School of Medicine , Baltimore , MD , USA. · Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine , Stanford , CA , USA. · Department of Psychiatry, Leiden University Medical Center , Leiden , The Netherlands. · Military Mental Health Care - Research, Ministry of Defense , Utrecht , The Netherlands. ·J Trauma Dissociation · Pubmed #31132959.

ABSTRACT: The inclusion of the dissociative subtype of post-traumatic stress disorder (PTSD-DS) in the fifth edition of the

23 Article The effect of genetic vulnerability and military deployment on the development of post-traumatic stress disorder and depressive symptoms. 2019

Schür, Remmelt R / Schijven, Dick / Boks, Marco P / Rutten, Bart P F / Stein, Murray B / Veldink, Jan H / Joëls, Marian / Geuze, Elbert / Vermetten, Eric / Luykx, Jurjen J / Vinkers, Christiaan H. ·Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht (UMCU), Utrecht University Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands. Electronic address: rschur4@umcutrecht.nl. · Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht (UMCU), Utrecht University Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, the Netherlands; Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, the Netherlands. · Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht (UMCU), Utrecht University Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands. · School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands. · Department of Psychiatry, University of California San Diego (UCSD), CA, USA. · Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, the Netherlands. · Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, the Netherlands; University of Groningen, University Medical Center Groningen (UMCG), Groningen, the Netherlands. · Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht (UMCU), Utrecht University Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; Research Centre-Military Mental Healthcare, Ministry of Defense, Utrecht, the Netherlands. · Research Centre-Military Mental Healthcare, Ministry of Defense, Utrecht, the Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands. · Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht (UMCU), Utrecht University Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center Utrecht (UMCU), Utrecht University, Utrecht, the Netherlands; Department of Psychiatry, ZNA Hospitals, Antwerp, Belgium. · Department of Psychiatry, Amsterdam UMC (location VUmc), Amsterdam, the Netherlands; Department of Anatomy and Neurosciences, Amsterdam UMC (location VUmc), Amsterdam, the Netherlands. ·Eur Neuropsychopharmacol · Pubmed #30773389.

ABSTRACT: Exposure to trauma strongly increases the risk to develop stress-related psychopathology, such as post-traumatic stress disorder (PTSD) or major depressive disorder (MDD). In addition, liability to develop these moderately heritable disorders is partly determined by common genetic variance, which is starting to be uncovered by genome-wide association studies (GWASs). However, it is currently unknown to what extent genetic vulnerability and trauma interact. We investigated whether genetic risk based on summary statistics of large GWASs for PTSD and MDD predisposed individuals to report an increase in MDD and PTSD symptoms in a prospective military cohort (N = 516) at five time points after deployment to Afghanistan: one month, six months and one, two and five years. Linear regression was used to analyze the contribution of polygenic risk scores (PRSs, at multiple p-value thresholds) and their interaction with deployment-related trauma to the development of PTSD- and depression-related symptoms. We found no main effects of PRSs nor evidence for interactions with trauma on the development of PTSD or depressive symptoms at any of the time points in the five years after military deployment. Our results based on a unique long-term follow-up of a deployed military cohort suggest limited validity of current PTSD and MDD polygenic risk scores, albeit in the presence of minimal severe psychopathology in the target cohort. Even though the predictive value of PRSs will likely benefit from larger sample sizes in discovery and target datasets, progress will probably also depend on (endo)phenotype refinement that in turn will reduce etiological heterogeneity.

24 Article An Innovative Framework for Delivering Psychotherapy to Patients With Treatment-Resistant Posttraumatic Stress Disorder: Rationale for Interactive Motion-Assisted Therapy. 2018

van Gelderen, Marieke J / Nijdam, Mirjam J / Vermetten, Eric. ·Foundation Centrum'45, Arq Psychotrauma Expert Groep, Diemen, Netherlands. · Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands. · Department of Psychiatry, Academic Medical Center at the University of Amsterdam, Amsterdam, Netherlands. · Military Mental Health-Research, Ministry of Defence, Utrecht, Netherlands. ·Front Psychiatry · Pubmed #29780334.

ABSTRACT: Despite an array of evidence-based psychological treatments for patients with a posttraumatic stress disorder (PTSD), a majority of patients do not fully benefit from the potential of these therapies. In veterans with PTSD, up to two-thirds retain their diagnosis after psychotherapy and often their disorder is treatment-resistant, which calls for improvement of therapeutic approaches for this population. One of the factors hypothesized to underlie low response in PTSD treatment is high behavioral and cognitive avoidance to traumatic reminders. In the current paper we explore if a combination of personalized virtual reality, multi-sensory input, and walking during exposure can enhance treatment engagement, overcome avoidance, and thereby optimize treatment effectiveness. Virtual reality holds potential to increase presence and in-session attention and to facilitate memory retrieval. Multi-sensory input such as pictures and music can personalize this experience. Evidence for the positive effect of physical activity on fear extinction and associative thinking, as well as embodied cognition theories, provide a rationale for decreased avoidance by literally approaching cues of the traumatic memories. A dual-attention task further facilitates new learning and reconsolidation. These strategies have been combined in an innovative framework for trauma-focused psychotherapy, named Multi-modular Motion-assisted Memory Desensitization and Reconsolidation (3MDR). In this innovative treatment the therapeutic setting is changed from the face-to-face sedentary position to a side-by-side activating context in which patients walk toward trauma-related images in a virtual environment. The framework of 3MDR has been designed as a boost for patients with treatment-resistant PTSD, which is illustrated by three case examples. The intervention is discussed in context of other advancements in treatment for treatment-resistant PTSD. Novel elements of this approach are activation, personalization and empowerment. While developed for veterans with PTSD who do not optimally respond to standardized treatments, this innovative framework holds potential to also be used for other patient populations and earlier stages of treatment for patients with PTSD.

25 Article Subanesthetic Dose Ketamine in Posttraumatic Stress Disorder: A Role for Reconsolidation During Trauma-Focused Psychotherapy? 2018

Veen, Cato / Jacobs, Gabriel / Philippens, Ingrid / Vermetten, Eric. ·Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands. c.veen@lumc.nl. · Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands. · Centre for Human Drug Research, Leiden, The Netherlands. · Biomedical Primate Research Centre, Rijswijk, The Netherlands. · Arq Psychotrauma Research Group, Diemen, The Netherlands. ·Curr Top Behav Neurosci · Pubmed #29637527.

ABSTRACT: Despite efforts to develop more effective therapies, PTSD remains a difficult disorder to treat. Insight into the dynamic nature of memory formation and its required molecular machinery can provide an opportunity to target pathological memories for emotionally arousing events. As memories become labile upon retrieval, novel information can update the strength and course of these consolidated memories. Targeting the process of reconsolidation may offer a relevant approach to attenuate fearful and traumatic memories. Specific molecular mechanisms that are required for reconsolidation of arousing information include an intact functioning of the glutamatergic signaling pathways and, more specifically, the integrity of NMDA receptors. Ketamine, a noncompetitive NMDA-receptor antagonist, is receiving increasing interest for a variety of psychiatric indications. This compound can also be an interesting candidate for targeting emotional memories. We explore whether single intravenous infusion of a subanesthetic dose of ketamine can be considered as a viable augmentation strategy for trauma-focused psychotherapy in patients with PTSD. As a consequence, a systematic approach is needed to assess the pharmacodynamic effects of ketamine in relation to both psychotherapy and its pharmacokinetics prior to its application in patient populations. By using a "question-based drug development plan," we can explore such aspects for novel drugs, and we formulated five additional topics that need to be addressed concerning the psychotherapeutic approach and phase orientation of pharmacological assisted psychotherapy.

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