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Prominence of Hyperarousal Symptoms Explains Variability of Sleep Disruption in Posttraumatic Stress Disorder.

Prominence of Hyperarousal Symptoms Explains Variability of Sleep Disruption in Posttraumatic Stress Disorder.

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Prominence of Hyperarousal Symptoms Explains Variability of Sleep Disruption in Posttraumatic Stress Disorder.

Psychol Trauma. 2016 Apr 11;

Authors: van Wyk M, Thomas KG, Solms M, Lipinska G

Abstract

OBJECTIVE: Disrupted sleep is a central feature of posttraumatic stress disorder (PTSD). The precise nature of that disruption is not agreed upon, however, and there is no explanation for why sleep disruptions are detected in some PTSD-diagnosed individuals but not in others. We tested the novel proposition that PTSD-diagnosed individuals with prominent hyperarousal symptoms will have more disrupted sleep than those without such symptoms.

METHOD: We assigned each of 57 female volunteers to 1 of 4 groups: PTSD + Hyperarousal (PTSD + HYP; n = 14), PTSD – Hyperarousal (n = 13), depression (n = 14), or healthy control (n = 16). Each experienced 1 night of polysomnographic recording in a sleep laboratory.

RESULTS: General linear modeling confirmed that group status (i.e., being in the PTSD + HYP group rather than the other groups) predicted disrupted sleep quality most strongly. PTSD patients with prominent hyperarousal symptoms, relative to those without such symptoms, experienced reduced sleep efficiency, spent more time awake after sleep onset, and self-reported poorer sleep quality.

CONCLUSION: These preliminary findings, although requiring replication in larger samples, suggest an important association between hyperarousal symptoms and sleep quality in PTSD, and may help explain why some PTSD-diagnosed individuals experience markedly disrupted sleep whereas others do not. (PsycINFO Database Record

PMID: 27065065 [PubMed – as supplied by publisher]

Consistency of Reporting for Stressful Life Events Among Nondeployed Soldiers.

Consistency of Reporting for Stressful Life Events Among Nondeployed Soldiers.

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Consistency of Reporting for Stressful Life Events Among Nondeployed Soldiers.

J Clin Psychol. 2016 Apr 8;

Authors: Pless Kaiser A, Proctor SP, Vasterling JJ

Abstract

OBJECTIVES: Measurement of stress exposure is central to understanding military mental health outcomes. Although temporal stability of combat event reporting has been examined, less is known about the stability of reporting for noncombat events in military samples. Objectives are to examine consistency in reporting stressful life events in nondeployed U.S. Army soldiers and its association with posttraumatic stress disorder (PTSD) symptomatology.

METHOD: Examined reporting consistency over approximately 8 months among 466 soldiers. Regression models examined factors associated with decreased, increased, and stable reporting.

RESULTS: Stability of the number of events endorsed over time was high. However, item-level agreement was slight to moderate (kappas: .13-.54), with inconsistencies due primarily to decreased reporting. After adjusting for covariates and initial PTSD, second assessment PTSD was associated with increased and stable reporting.

CONCLUSIONS: Inconsistent reporting extends beyond combat events to other stressful life events in military personnel and is associated with PTSD.

PMID: 27062505 [PubMed – as supplied by publisher]

The burden of alcohol use disorders in U.S. Military veterans: results from the national health and resilience in veterans study.

The burden of alcohol use disorders in U.S. Military veterans: results from the national health and resilience in veterans study.

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The burden of alcohol use disorders in U.S. Military veterans: results from the national health and resilience in veterans study.

Addiction. 2016 Apr 9;

Authors: Fuehrlein BS, Mota N, Arias AJ, Trevisan LA, Kachadourian LK, Krystal JH, Southwick SM, Pietrzak RH

Abstract

AIMS: To analyze data from a large, contemporary, nationally representative sample of U.S. veterans to evaluate: (1) the prevalence of lifetime alcohol use disorder (AUD), and past-year AUD; (2) common psychiatric comorbidities associated with lifetime AUD; and (3) correlates of lifetime and past-year probable AUD.

DESIGN: Data were analyzed from the National Health and Resilience in Veterans Study (NHRVS), a web-based survey of a random probability sample of a contemporary, nationally representative sample of U.S. military veterans.

SETTING: USA.

PARTICIPANTS: Nationally representative sample of 3,157 U.S. veterans aged 21 years and older.

MEASUREMENTS: Lifetime alcohol abuse and dependence were assessed according to DSM-IV diagnostic criteria using the Mini International Neuropsychiatric Interview, and combined into a single variable: AUD. Past-year probable AUD was assessed using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C). Correlates of AUD, including psychiatric comorbidities, suicidality, and demographic characteristics, were also assessed.

FINDINGS: The prevalence of lifetime AUD and past-year probable AUD was 42.2% (95% confidence interval [CI] = 40.5%-43.9%), and 14.8% (95%CI = 13.6%-16.0%), respectively. Compared with veterans without AUD, those with lifetime AUD had substantially elevated rates of lifetime and current mood and anxiety disorders (odds ratios [ORs] = 2.6-4.1), drug use disorder (OR = 10.7), lifetime suicide attempt (OR = 4.1) and current suicidal ideation (OR = 2.1). Younger age, male sex, lower education, lower annual household income, and greater number of lifetime traumatic events were independently associated with lifetime AUD. Younger age, male sex, unpartnered marital status, and a lifetime diagnosis of major depressive disorder were independently associated with past-year probable AUD.

CONCLUSIONS: More than 40% of U.S. military veterans have a lifetime history of alcohol use disorder (AUD). Veterans with a lifetime history of AUD have substantial comorbid psychiatric burden, including elevated rates of suicidal ideation and attempts. Certain sociodemographic (e.g., younger age, male sex, lower education) and clinical (e.g., trauma burden, history of depression) characteristics are associated with increased risk of AUD.

PMID: 27061707 [PubMed – as supplied by publisher]

US media representation of post-traumatic stress disorder: a comparative study of regional newspapers and national newspapers.

US media representation of post-traumatic stress disorder: a comparative study of regional newspapers and national newspapers.

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US media representation of post-traumatic stress disorder: a comparative study of regional newspapers and national newspapers.

J Ment Health. 2016 Apr 7;:1-7

Authors: Wu L

Abstract

BACKGROUND: News media play an important role in introducing and defining PTSD-related issues to the general public as well as framing their social importance and analyzing solutions for policymakers.

AIMS: Compare how coverage of PTSD by larger papers serving general audiences differed from smaller papers catering to communities likely to be affected by the issue.

METHOD: A content analysis of frames and subtopics about PTSD in all newspaper articles published by selected national newspapers and regional newspapers between the year of 2003 and 2014 (N = 426).

RESULTS: National newspapers engaged in higher-level policy discussion with greater frequency than regional newspapers, while regional newspapers were more likely to publish stories highlighting the impact of PTSD on individuals and local communities. Furthermore, coverage by regional newspapers used significantly more episodic frames than thematic frames.

CONCLUSION: Both national and regional newspapers increased the amount of coverage on PTSD significantly after the beginning of the Iraq War in 2003. National newspapers and regional newspapers shared similarities in recognizing dominant issues with PTSD but varied in the way of presenting the topics to the public.

PMID: 27053417 [PubMed – as supplied by publisher]

Prescription opioid use: Patient characteristics and misuse in community pharmacy.

Prescription opioid use: Patient characteristics and misuse in community pharmacy.

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Prescription opioid use: Patient characteristics and misuse in community pharmacy.

J Am Pharm Assoc (2003). 2016 Mar 24;

Authors: Cochran G, Bacci JL, Ylioja T, Hruschak V, Miller S, Seybert AL, Tarter R

Abstract

OBJECTIVES: Opioid pain medication misuse is a major concern for US public health. The purpose of this article is to: 1) describe the demographic and physical, behavioral, and mental health characteristics of patients who fill opioid medications in community pharmacy settings; and 2) describe the extent of opioid medication misuse behaviors among these patients.

DESIGN: We recruited and screened a convenience sample of patients with the use of a tablet computer-based assessment protocol that examined behavioral, mental, and physical health. Descriptive and inferential statistics were calculated to describe respondents and their opioid medication misuse and health characteristics.

SETTING: Patients were screened in two urban and two rural community pharmacies in southwestern Pennsylvania.

PARTICIPANTS: Survey participants were adult patients filling opioid pain medications who were not currently receiving treatment for a cancer diagnosis.

INTERVENTION: None.

MAIN OUTCOME MEASURES: Validated screening measures included the: Prescription Opioid Misuse Index, Alcohol Use Disorders Identification Test C, Short Form 12, Drug Abuse Screening Test 10, Primary Care Post-traumatic Stress Disorder (PTSD) screen, and the Patient Health Questionnaire 2.

RESULTS: A total of 333 patients were screened (71.2% response rate). Nearly the entire population reported pain above and general health below national norms. Hydrocodone (19.2%) and morphine (20.8%) were found to be the medications with the highest rates of misuse-with hydrocodone having more than four times higher odds of misuse compared with other medications (adjusted odds ratio [AOR] 4.48, 95% confidence interval [CI] 1.1-17.4). Patients with positive screens for illicit drug use (AOR 8.07, 95% CI 2.7-24.0), PTSD (AOR 5.88, 95% CI 2.3-14.7), and depression (AOR 2.44, 95% CI 1.0-5.9) also had significantly higher odds for misuse compared with those with negative screening results.

CONCLUSION: These findings provide important foundational data that suggest implementation of regular opioid misuse screening protocols within community pharmacies. Such screening activities could foster a culture of prevention and overall reduction for misuse among patients filling opioid medications in community pharmacies.

PMID: 27053277 [PubMed – as supplied by publisher]