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Article ; Online: The associations between repetitive negative thinking, insomnia symptoms, and sleep quality in adults with a history of trauma.

Arditte Hall, Kimberly A / McGrory, Christopher M / Snelson, Alana M / Pineles, Suzanne L

2024 Volume 37, Issue 3, Page(s) 394–405

Abstract: Background: Posttraumatic stress disorder (PTSD) and sleep disturbance are highly comorbid and repetitive negative thinking (RNT) is associated with both sleep disturbance and PTSD. However, few studies have examined the association between RNT and ... ...

Abstract	Background: Posttraumatic stress disorder (PTSD) and sleep disturbance are highly comorbid and repetitive negative thinking (RNT) is associated with both sleep disturbance and PTSD. However, few studies have examined the association between RNT and sleep disturbance in individuals exposed to trauma, with and without PTSD. Method: Associations between trait-level and trauma-related RNT, insomnia, and sleep quality were investigated in a trauma-exposed MTurk ( Results: Trait-level RNT predicted poorer sleep quality and greater insomnia, regardless of PTSD severity. Trauma-related RNT was also associated with greater insomnia, though the effect was moderated by PTSD severity such that it was significant for participants with low and moderate, but not severe, PTSD. Both trait- and trauma-related RNT were associated with several specific aspects of sleep quality, including: sleep disturbances, daytime dysfunction, use of sleep medications, sleep onset latency, and subjective sleep quality. Conclusions: This study demonstrates significant associations linking RNT with insomnia and sleep disturbance in trauma-exposed individuals. Clinically, results suggest that it may be helpful to target both general and trauma-related RNT in sleep interventions for trauma-exposed individuals with insomnia.
MeSH term(s)	Adult ; Humans ; Sleep Initiation and Maintenance Disorders/complications ; Sleep Quality ; Pessimism ; Stress Disorders, Post-Traumatic/epidemiology ; Comorbidity
Language	English
Publishing date	2024-02-29
Publishing country	England
Document type	Journal Article
ZDB-ID	1115932-7
ISSN	1477-2205 ; 1061-5806
ISSN (online)	1477-2205
ISSN	1061-5806
DOI	10.1080/10615806.2024.2324266
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Zs.A 2778: Show issues

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Article ; Online: Heart rate reactivity during trauma recall as a predictor of treatment outcome in cognitive processing therapy for PTSD.

Carpenter, Joseph K / Pineles, Suzanne L / Griffin, Michael G / Pandey, Shivani / Werner, Kimberly / Kecala, Natalia M / Resick, Patricia A / Galovski, Tara E

Behaviour research and therapy

2024 Volume 176, Page(s) 104519

Abstract: Emotional engagement when recollecting a trauma memory is considered a key element of effective trauma-focused therapy. Research has shown that reduced physiological reactivity during trauma recall is associated with worse treatment outcomes for ... ...

Abstract	Emotional engagement when recollecting a trauma memory is considered a key element of effective trauma-focused therapy. Research has shown that reduced physiological reactivity during trauma recall is associated with worse treatment outcomes for posttraumatic stress disorder (PTSD), but this has yet to be examined in a cognitively oriented treatment. This study examined whether pretreatment heart rate (HR) reactivity during trauma recall predicts PTSD symptom improvement and treatment dropout during Cognitive Processing Therapy (CPT) for PTSD. Participants were 142 women with PTSD secondary to interpersonal violence enrolled in one of two clinicals trials. HR reactivity reflected the mean increase in HR after listening to two 30-s scripts of the trauma memory prior to treatment. Linear mixed-effects models showed the effect of HR reactivity on change in total PTSD symptoms was not significant, but lower HR reactivity predicted less improvement in reexperiencing and avoidance and was associated with increased dropout. Findings suggest pretreatment physiological reactivity to the trauma memory may be a prognostic indicator of some elements of treatment response in CPT. Results tentatively support the importance of emotional activation during trauma recall in cognitive treatment of PTSD, though more research is needed to clarify how low HR reactivity impacts treatment.
MeSH term(s)	Humans ; Female ; Stress Disorders, Post-Traumatic/psychology ; Heart Rate/physiology ; Treatment Outcome ; Psychotherapy/methods ; Cognitive Behavioral Therapy/methods
Language	English
Publishing date	2024-03-11
Publishing country	England
Document type	Journal Article
ZDB-ID	211997-3
ISSN	1873-622X ; 0005-7967
ISSN (online)	1873-622X
ISSN	0005-7967
DOI	10.1016/j.brat.2024.104519
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Zs.A 162: Show issues

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Article ; Online: Effect of PTSD treatment on cardiovascular reactivity during trauma memory recall and correspondence with symptom improvement.

Carpenter, Joseph K / Pineles, Suzanne L / Griffin, Michael G / Werner, Kimberly / Resick, Patricia A / Galovski, Tara E

European journal of psychotraumatology

2024 Volume 15, Issue 1, Page(s) 2335865

Abstract: ... ...

Abstract	ABSTRACT
MeSH term(s)	Humans ; Female ; Stress Disorders, Post-Traumatic/psychology ; Mental Recall ; Imagery, Psychotherapy ; Life Change Events ; Violence/psychology
Language	English
Publishing date	2024-04-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2586642-4
ISSN	2000-8066 ; 2000-8066
ISSN (online)	2000-8066
ISSN	2000-8066
DOI	10.1080/20008066.2024.2335865
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Article ; Online: Conditioned physiological reactivity and PTSD symptoms across the menstrual cycle: Anxiety sensitivity as a moderator.

Carpenter, Joseph K / Bragdon, Laura / Pineles, Suzanne L

Psychological trauma : theory, research, practice and policy

2021 Volume 14, Issue 3, Page(s) 453–461

Abstract: Objective: Posttraumatic stress disorder (PTSD) is often associated with heightened physiological reactivity during fear conditioning procedures, but results vary across studies. This study examined whether anxiety sensitivity (AS), or the fear of ... ...

Abstract	Objective: Posttraumatic stress disorder (PTSD) is often associated with heightened physiological reactivity during fear conditioning procedures, but results vary across studies. This study examined whether anxiety sensitivity (AS), or the fear of arousal-related sensations, strengthens the relationship between PTSD symptoms and skin conductance responses (SCR) during fear conditioning and extinction. Because gonadal hormones implicated in fear learning fluctuate across the menstrual cycle, the stability of these relationships in women was examined in 2 distinct menstrual cycle phases. Method: Thirty-two trauma-exposed women, half of whom had PTSD, completed the Clinician-Administered PTSD Scale, Anxiety Sensitivity Inventory, and a fear conditioning and extinction paradigm during the midluteal (mLP) and early-follicular (eFP) menstrual cycle phases. Results: In the mLP, stronger SCR to stimuli paired with shock (CS +) during fear acquisition significantly predicted greater PTSD symptoms only when AS was high and after removing an outlier. This appeared driven by effects on Numbing and Hyperarousal symptom clusters. Other hypothesized interactions between AS and CS responses were not significant. However, in the eFP, differential SCR between the CS + and CS- during extinction predicted significantly greater PTSD symptoms, and there was a trend for this effect being stronger as AS increased. Conclusions: Results offer preliminary evidence that high AS contributes to a stronger relationship between SCR during fear acquisition and PTSD symptoms, at least among women in the mLP. Further research investigating the impact of individual differences in traits such as AS on the relationship between conditioned fear responses and PTSD symptoms is warranted. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
MeSH term(s)	Anxiety ; Conditioning, Classical/physiology ; Extinction, Psychological/physiology ; Female ; Humans ; Menstrual Cycle ; Stress Disorders, Post-Traumatic
Language	English
Publishing date	2021-10-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2497028-1
ISSN	1942-969X ; 1942-9681
ISSN (online)	1942-969X
ISSN	1942-9681
DOI	10.1037/tra0001129
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Article ; Online: Neurotransmitter, Peptide, and Steroid Hormone Abnormalities in PTSD: Biological Endophenotypes Relevant to Treatment.

Rasmusson, Ann M / Pineles, Suzanne L

Current psychiatry reports

2018 Volume 20, Issue 7, Page(s) 52

Abstract: Purpose of review: This review summarizes neurotransmitter, peptide, and other neurohormone abnormalities associated with posttraumatic stress disorder (PTSD) and relevant to development of precision medicine therapeutics for PTSD.: Recent findings: ... ...

Abstract	Purpose of review: This review summarizes neurotransmitter, peptide, and other neurohormone abnormalities associated with posttraumatic stress disorder (PTSD) and relevant to development of precision medicine therapeutics for PTSD. Recent findings: As the number of molecular abnormalities associated with PTSD across a variety of subpopulations continues to grow, it becomes clear that no single abnormality characterizes all individuals with PTSD. Instead, individually variable points of molecular dysfunction occur within several different stress-responsive systems that interact to produce the clinical PTSD phenotype. Future work should focus on critical interactions among the systems that influence PTSD risk, severity, chronicity, comorbidity, and response to treatment. Effort also should be directed toward development of clinical procedures by which points of molecular dysfunction within these systems can be identified in individual patients. Some molecular abnormalities are more common than others and may serve as subpopulation biological endophenotypes for targeting of currently available and novel treatments.
MeSH term(s)	Comorbidity ; Endophenotypes ; Hormones/metabolism ; Humans ; Neuropeptides/metabolism ; Neurotransmitter Agents/metabolism ; Steroids/metabolism ; Stress Disorders, Post-Traumatic/metabolism ; Stress Disorders, Post-Traumatic/physiopathology ; Stress Disorders, Post-Traumatic/therapy
Chemical Substances	Hormones ; Neuropeptides ; Neurotransmitter Agents ; Steroids
Language	English
Publishing date	2018-07-17
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2055376-6
ISSN	1535-1645 ; 1523-3812
ISSN (online)	1535-1645
ISSN	1523-3812
DOI	10.1007/s11920-018-0908-9
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 5520: Show issues

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Article ; Online: The Impact of the Menstrual Cycle and Underlying Hormones in Anxiety and PTSD: What Do We Know and Where Do We Go From Here?

Nillni, Yael I / Rasmusson, Ann M / Paul, Emilie L / Pineles, Suzanne L

Current psychiatry reports

2021 Volume 23, Issue 2, Page(s) 8

Abstract: Purpose of review: This paper reviews the recent literature on menstrual cycle phase effects on outcomes relevant to anxiety and PTSD, discusses potential neurobiological mechanisms underlying these effects, and highlights methodological limitations ... ...

Abstract	Purpose of review: This paper reviews the recent literature on menstrual cycle phase effects on outcomes relevant to anxiety and PTSD, discusses potential neurobiological mechanisms underlying these effects, and highlights methodological limitations impeding scientific advancement. Recent findings: The menstrual cycle and its underlying hormones impact symptom expression among women with anxiety and PTSD, as well as psychophysiological and biological processes relevant to anxiety and PTSD. The most consistent findings are retrospective self-report of premenstrual exacerbation of anxiety symptoms and the protective effect of estradiol on recall of extinction learning among healthy women. Lack of rigorous methodology for assessing menstrual cycle phase and inconsistent menstrual cycle phase definitions likely contribute to other conflicting results. Further investigations that address these limitations and integrate complex interactions between menstrual cycle phase-related hormones, genetics, and psychological vulnerabilities are needed to inform personalized prevention and intervention efforts for women.
MeSH term(s)	Anxiety ; Fear ; Female ; Humans ; Menstrual Cycle ; Retrospective Studies ; Stress Disorders, Post-Traumatic/genetics
Language	English
Publishing date	2021-01-06
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2055376-6
ISSN	1535-1645 ; 1523-3812
ISSN (online)	1535-1645
ISSN	1523-3812
DOI	10.1007/s11920-020-01221-9
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Article ; Online: A role for deficits in GABAergic neurosteroids and their metabolites with NMDA receptor antagonist activity in the pathophysiology of posttraumatic stress disorder.

Rasmusson, Ann M / Pineles, Suzanne L / Brown, Kayla D / Pinna, Graziano

Journal of neuroendocrinology

2021 Volume 34, Issue 2, Page(s) e13062

Abstract: Trauma-focused psychotherapies show general efficacy in post-traumatic stress disorder (PTSD), although outcomes vary substantially among individuals with PTSD and many patients do not achieve clinically meaningful symptom improvement. Several factors ... ...

Abstract	Trauma-focused psychotherapies show general efficacy in post-traumatic stress disorder (PTSD), although outcomes vary substantially among individuals with PTSD and many patients do not achieve clinically meaningful symptom improvement. Several factors may contribute to poor treatment response, including genetic or environmental (e.g., stress) effects on neurobiological factors involved in learning and memory processes critical to PTSD recovery. In this review, we discuss the relationship between deficient GABAergic neurosteroid metabolites of progesterone, allopregnanolone (Allo) and pregnanolone (PA), and PTSD symptoms in men and women or PTSD-like behavioral abnormalities observed in male rodent models of PTSD. We also review the role and molecular underpinnings of learning and memory processes relevant to PTSD recovery, including extinction, extinction retention, reconsolidation of reactivated aversive memories and episodic non-aversive memory. We then discuss preclinical and clinical research that supports a role in these learning and memory processes for GABAergic neurosteroids and sulfated metabolites of Allo and PA that allosterically antagonize NMDA receptor function. Studies supporting the possible therapeutic impact of appropriately timed, acutely administered Allo or Allo analogs to facilitate extinction retention and/or block reconsolidation of aversive memories are also reviewed. Finally, we discuss important future directions for research in this area. Examining the varied and composite effects in PTSD of these metabolites of progesterone, as well as neuroactive derivatives of other parent steroids produced in the brain and the periphery, will likely enable a broadening of targets for treatment development. Defining contributions of these neuroactive steroids to common PTSD-comorbid psychiatric and medical conditions, as well as subpopulation-specific underlying dysfunctional physiological processes such as hypothalamic-pituitary-adrenal axis and immune system dysregulation, may also enable development of more effective multisystem precision medicines to prevent and treat the broader, polymorbid sequelae of extreme and chronic stress.
MeSH term(s)	Female ; Humans ; Hypothalamo-Hypophyseal System/metabolism ; Male ; Neurosteroids ; Pituitary-Adrenal System/metabolism ; Pregnanolone/therapeutic use ; Progesterone/therapeutic use ; Receptors, N-Methyl-D-Aspartate/metabolism ; Receptors, N-Methyl-D-Aspartate/therapeutic use ; Stress Disorders, Post-Traumatic/drug therapy
Chemical Substances	Neurosteroids ; Receptors, N-Methyl-D-Aspartate ; Progesterone (4G7DS2Q64Y) ; Pregnanolone (BXO86P3XXW)
Language	English
Publishing date	2021-12-28
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	1007517-3
ISSN	1365-2826 ; 0953-8194
ISSN (online)	1365-2826
ISSN	0953-8194
DOI	10.1111/jne.13062
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Article ; Online: Pleiotropic endophenotypic and phenotype effects of GABAergic neurosteroid synthesis deficiency in posttraumatic stress disorder.

Rasmusson, Ann M / Novikov, Olga / Brown, Kayla D / Pinna, Graziano / Pineles, Suzanne L

Current opinion in endocrine and metabolic research

2022 Volume 25

Abstract: PTSD is associated with deficits in synthesis of progesterone metabolites such as allopregnanolone and pregnanolone that potently facilitate gamma-amino-butyric acid (GABA) effects at ... ...

Abstract	PTSD is associated with deficits in synthesis of progesterone metabolites such as allopregnanolone and pregnanolone that potently facilitate gamma-amino-butyric acid (GABA) effects at GABA
Language	English
Publishing date	2022-05-28
Publishing country	England
Document type	Journal Article
ISSN	2451-9650
ISSN (online)	2451-9650
DOI	10.1016/j.coemr.2022.100359
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Article ; Online: Associations between insomnia and reward learning in clinical depression.

Liverant, Gabrielle I / Arditte Hall, Kimberly A / Wieman, Sarah T / Pineles, Suzanne L / Pizzagalli, Diego A

Psychological medicine

2021 , Page(s) 1–10

Abstract: Background: Depression and insomnia commonly co-occur. Yet, little is known about the mechanisms through which insomnia influences depression. Recent research and theory highlight reward system dysfunction as a potential mediator of the relationship ... ...

Abstract	Background: Depression and insomnia commonly co-occur. Yet, little is known about the mechanisms through which insomnia influences depression. Recent research and theory highlight reward system dysfunction as a potential mediator of the relationship between insomnia and depression. This study is the first to examine the impact of insomnia on reward learning, a key component of reward system functioning, in clinical depression. Methods: The sample consisted of 72 veterans with unipolar depression who endorsed sleep disturbance symptoms. Participants completed the Structured Clinical Interview for DSM-IV, self-report measures of insomnia, depression, and reward processing, and a previously validated signal detection task (Pizzagalli et al., 2005, Biological Psychiatry, 57(4), 319-327). Trial-by-trial response bias (RB) estimates calculated for each of the 200 task trials were examined using linear mixed-model analyses to investigate change in reward learning. Results: Findings demonstrated diminished rate and magnitude of reward learning in the Insomnia group relative to the Hypersomnia/Mixed Symptom group across the task. Within the Insomnia group, participants with more severe insomnia evidenced the lowest rates of reward learning, with increased RB across the task with decreasing insomnia severity. Conclusions: Among individuals with depression, insomnia is associated with decreased ability to learn associations between neutral stimuli and rewarding outcomes and/or modify behavior in response to differential receipt of reward. This attenuated reward learning may contribute to clinically meaningful decreases in motivation and increased withdrawal in this comorbid group. Results extend existing theory by highlighting impairments in reward learning specifically as a potential mediator of the association between insomnia and depression.
Language	English
Publishing date	2021-02-26
Publishing country	England
Document type	Journal Article
ZDB-ID	217420-0
ISSN	1469-8978 ; 0033-2917
ISSN (online)	1469-8978
ISSN	0033-2917
DOI	10.1017/S003329172100026X
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Zs.B 1003: Show issues

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Article ; Online: The transition to civilian life: Impact of comorbid PTSD, chronic pain, and sleep disturbance on veterans' social functioning and suicidal ideation.

Shor, Rachel / Borowski, Shelby / Zelkowitz, Rachel L / Pineles, Suzanne L / Copeland, Laurel A / Finley, Erin P / Perkins, Daniel F / Vogt, Dawne

Psychological trauma : theory, research, practice and policy

2022 Volume 15, Issue 8, Page(s) 1315–1323

Abstract: Objective: Trauma-exposed veterans may be more likely to experience posttraumatic stress disorder (PTSD), chronic pain, and sleep disturbance together rather than in isolation. Although these conditions are independently associated with distress and ... ...

Abstract	Objective: Trauma-exposed veterans may be more likely to experience posttraumatic stress disorder (PTSD), chronic pain, and sleep disturbance together rather than in isolation. Although these conditions are independently associated with distress and impairment, how they relate to social functioning and suicidal ideation (SI) when experienced comorbidly is not clear. Method: Using longitudinal data on 5,461 trauma-exposed U.S. veterans from The Veterans Metrics Initiative study and self-reported disorders, we assessed (a) the extent to which PTSD co-occurs with sleep disturbance and chronic pain (CP); (b) the relationship of PTSD in conjunction with sleep disturbance and chronic pain with later social functioning and SI; and (c) the extent to which social functioning mediates the impact of multimorbidity on SI. Results: At approximately 15 months postseparation, 90.5% of veterans with probable PTSD also reported sleep disturbance and/or CP. Relative to veterans without probable PTSD, veterans with all 3 conditions (n = 907) experienced the poorest social functioning ( Conclusions: Although these findings underscore the impact of PTSD on functioning and SI, they also highlight the complexity of multimorbidity and the importance of bolstering social functioning for veterans. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
MeSH term(s)	Humans ; Suicidal Ideation ; Veterans ; Stress Disorders, Post-Traumatic/epidemiology ; Stress Disorders, Post-Traumatic/complications ; Chronic Pain/epidemiology ; Chronic Pain/complications ; Social Interaction ; Sleep Wake Disorders/epidemiology ; Sleep Wake Disorders/complications ; Sleep
Language	English
Publishing date	2022-06-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2497028-1
ISSN	1942-969X ; 1942-9681
ISSN (online)	1942-969X
ISSN	1942-9681
DOI	10.1037/tra0001271
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