The impact of acceptance of disability and psychological resilience on post-traumatic stress disorders in burn patients

Objective:To investigate the impact of acceptance of disability and psychological resilience on post-traumatic stress disorders(PTSD)in patients with burns.Methods:A total of 127 patients with burns were asked to complete PTSD Checklist-Civilian Version,Acceptance of Disability Scale and ConnoreDavidson Resilience Scale questionnaires.Results were evaluated using correlational and regression analyses.Results:The incidence of PTSD in burn patients was 37.80%(48/127),with an overall average checklist score of 45.78±15.29 points.PTSD was negatively correlated with the level of disability acceptance and psychological resilience(p<0.05).Multiple regression analysis showed that the depth of burn,marital status,degree of subordination,self-value and selfimprovement were factors influencing the incidence PTSD.Conclusion:Nurses should screen and identify patients with PTSD as early as possible and provide proper psychological interventions to help them accept the reality of disability and improve the level of psychological resilience。

MicroRNAs as potential biomarkers for diagnosis of post-traumatic stress disorder

Post-traumatic stress disorder is a mental disorder caused by exposure to severe traumatic life events.Currently,there are no validated biomarkers or laboratory tests that can distinguish between trauma survivors with and without post-traumatic stress disorder.In addition,the heterogeneity of clinical presentations of post-traumatic stress disorder and the overlap of symptoms with other conditions can lead to misdiagnosis and inappropriate treatment.Evidence suggests that this condition is a multisystem disorder that affects many biological systems,raising the possibility that peripheral markers of disease may be used to diagnose post-traumatic stress disorder.We performed a PubMed search for microRNAs(miRNAs)in post-traumatic stress disorder(PTSD)that could serve as diagnostic biomarkers and found 18 original research articles on studies performed with human patients and published January 2012 to December 2023.These included four studies with whole blood,seven with peripheral blood mononuclear cells,four with plasma extracellular vesicles/exosomes,and one with serum exosomes.One of these studies had also used whole plasma.Two studies were excluded as they did not involve microRNA biomarkers.Most of the studies had collected samples from adult male Veterans who had returned from deployment and been exposed to combat,and only two were from recently traumatized adult subjects.In measuring miRNA expression levels,many of the studies had used microarray miRNA analysis,miRNA Seq analysis,or NanoString panels.Only six studies had used real time polymerase chain reaction assay to determine/validate miRNA expression in PTSD subjects compared to controls.The miRNAs that were found/validated in these studies may be considered as potential candidate biomarkers for PTSD and include miR-3130-5p in whole blood;miR-193a-5p,-7113-5p,-125a,-181c,and-671-5p in peripheral blood mononuclear cells;miR-10b-5p,-203a-3p,-4488,-502-3p,-874-3p,-5100,and-7641 in plasma extracellular vesicles/exosomes;and miR-18a-3p and-7-1-5p in blood plasma.Several important limitations identified in the studies need to be taken into account in future studies.Further studies are warranted with war veterans and recently traumatized children,adolescents,and adults having PTSD and use of animal models subjected to various stressors and the effects of suppressing or overexpressing specific microRNAs.

Ginger oil-loaded transdermal adhesive patch treats post-traumatic stress disorder

Objective:To find a viable alternative to reduce the number of doses required for the patients with post-traumatic stress disorder(PTSD),and to improve efficacy and patient compliance.Methods: In this study,we used ginger oil,a phytochemical with potential therapeutic properties,to prepare ginger oil patches.High-performance liquid chromatography(HPLC)was used to quantify the main active component of ginger oil,6-gingerol.Transdermal absorption experiments were conducted to optimize the various pressure-sensitive adhesives and permeation enhancers,including their type and concentration.Subsequently,the ginger oil patches were optimized and subjected to content determination and property evaluations.A PTSD mouse model was established using the foot-shock method.The therapeutic effect of ginger oil patches on PTSD was assessed through pathological sections,behavioral tests,and the evaluation of biomarkers such as tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),brain-derived neurotrophic factor(BDNF),and melatonin(MT).Results: The results demonstrated that ginger oil patches exerted therapeutic effects against PTSD by inhibiting inflammatory responses and modulating MT and BDNF levels.Pharmacokinetic experiments revealed that ginger oil patches maintained a stable blood drug concentration for at least one day,addressing the rapid metabolism drawback of 6-gingerol and enhancing its therapeutic efficacy.Conclusions: Ginger oil can be prepared as a transdermal drug patch that meets these requirements,and the bioavailability of the prepared patch is better than that of oral administration.It can improve PTSD with good patient compliance and ease of administration.Therefore,it is a promising therapeutic formulation for the treatment of PTSD.

Correlation Study of Neurotransmitter and Immune Levels in Pre-Hospital Emergency Nurses with Post-Traumatic Stress Disorder

Objective: To investigate the occurrence of PTSD in pre-hospital emergency nurses and its related factors, and to compare the differences of neurotransmitter and immune-related factors between pre-hospital emergency nurses who experienced traumatic events and those who did not develop PTSD and healthy people. How: Post-traumatic Stress Disorder Self-Rating Scale (PCL-C) tests were performed on pre-hospital emergency nurses in PTSD group, non-PTSD group and healthy control group, and the plasma monoamine neurotransmitters and serum cytokines were determined by double-antibody sandwich ABC-ELISA assay using enzyme-linked adsorption kit provided by Shanghai Xitang Biotechnology Co., Ltd. Results: 1) There were statistically significant differences in PCL-C scores between PTSD group, non-PTSD group and healthy group (p α between PTSD group, non-PTSD group and healthy group (p Conclusion: Pre-hospital emergency nurses should have early psychological intervention and guidance to reduce the occurrence of PTSD in emergency and emergency nurses.

Effects of Pearl Yangxin Anshen Decoction on HAMD and PTSD-SS Scores, Cytokines and Related Metabolites in Patients with Post-Traumatic Stress Disorder

Objective: This paper aims to observe the Pearl Yangxin Anshen Decoction to influence the score of HAMD and PTSD-SS, the changes of the cytokines and the related metabolic product in patients with PTSD. Methods: From June 2015 to May 2016, in the traditional Chinese medicine clinics of Hainan Province People’s Hospital, there were 50 patients with PTSD, the age were from 30 to 60, they were randomly divided into treatment group (25 cases) and control group (25 cases), then compared the scores of HAMD and PTSD-SS between the two groups, searched the changes of cytokines and the related metabolic product. Results: In the treatment group: before and after treatment the scores of PTSD-SS were 65.64 ± 7.02, 28.32 ± 4.18, and the scores of HAMD were 29.28 ± 1.97, 11.72 ± 2.13;In the control group: before and after treatment the scores of PTSD-SS were 63.24 ± 6.16, 31.40 ± 4.29, the scores of HAMD were 30.24 ± 2.05, 13.08 ± 2.30. After 3 months patients in treatment group the scores of PTSD-SS and HAMD were lower than the control group (t = 2.570, P = 0.013, t = -2.1640, P = 0.035). In the control group: before and after 3 months treatment the IL-2 levels respectively were 79.84 ± 26.46 pg/ml, 56.18 ± 22.67 pg/ml, the IL-6 levels respectively were 110.83 ± 47.65 pg/ml, 59.67 ± 44.68 pg/ml, the IL-8 levels respectively were 73.11 ± 78.51 pg/ml, 55.83 ± 81.94 pg/ml, the NE levels respectively were 420.04 ± 674.75 pg/ml, 185.31 ± 417.91 pg/ml, the MDA levels respectively were 112.35 ± 62.87 ng/ml, 60.42.33 ± 53.64 ng/ml, the NO levels were 126.6 ± 47.4 μmol/L, 78.6 ± 45.7 μmol/L, the VIP levels were 396.6 ± 144.4 pg/ml, 122.4 ± 111.5 pg/ml. In the treatment group: before and after 3 months treatment the IL-2 levels respectively were 86.00 ± 32.29 pg/ml, 53.84 ± 27.01 pg/ml, the IL-6 levels respectively were 108.21 ± 44.60 pg/ml, 42.46 ± 42.16 pg/ml, the IL-8 levels respectively were 81.48 ± 94.19 pg/ml, 54.07 ± 84.15 pg/ml, the NE levels respectively were 392.93 ± 592.84 pg/ml, 243.85 ± 588.45 pg/ml, the MDA levels respectively were 117.58 ± 63.37 ng/ml, 45.91 ± 38.94 ng/ml, the NO levels respectively were 135.9 ± 46.4 μmol/L, 72.6 ± 46.6 μmol/L, the VIP levels respectively were 414.0 ± 140.1 pg/ml, 185.8 ± 105.3 pg/ml. In the two groups as the extension of treatment time, the content of IL-2, IL-8, IL-6, NE, MDA, NO, and VIP were gradually reduced, and the level of reduction of the treatment group patients was higher than the control group, the change of ACTH and SOD levels just the opposite. Conclusion: The Pearl Yangxin Anshen Decoction could improve the symptoms of psychological anxiety, depression and other psychological problems in patients with PTSD, and influence the change of cytokines and related metabolites product.

Risk factors for post-traumatic stress disorder among young and middle-aged cancer patients in the intensive care unit:A casecontrol study

BACKGROUND Young and middle-aged cancer patients in intensive care unit(ICU)often suffer from stress and pressure,causing huge physical and mental damage.Currently,there is few research on post-traumatic stress disorder(PTSD)among young and middle-aged cancer patients in ICU in China,and the psychological status of patients who have experienced both cancer development and ICU stay is still unclear.AIM To explore the risk factors for PTSD in young and middle-aged patients with cancer in ICU.METHODS Using convenient sampling method,we enrolled 150 young and middle-aged patients with cancer who were admitted to the ICU of our center during the period from July to December 2020.The general data of the patients and PTSDrelated indicators were collected.The Impact of Event Scale-Revised(IES-R)was used for assessing PTSD one month after the discharge from the ICU.Binary Logistic regression analysis was performed to assess the independent risk factors for PTSD in these patients.RESULTS Among these 150 patients,32(21.33%)were found to be with PTSD.Binary Logistic regression analysis revealed that factors significantly associated with PTSD among young and middle-aged patients with cancer in ICU included monthly income(OR=0.24,P=0.02),planned transfers(OR=0.208,P=0.019),and Acute Physiology and Chronic Health Evaluation(APACHE II)score(OR=1.171,P=0.003).CONCLUSION The low monthly income,unplanned transfers,and increased APACHE II score are the risk factors for PTSD in young and middle-aged patients with cancer in ICU.

Research progress on the biological effects of BDNF and proBDNFs in post-traumatic stress disorder

Many people were affected psycho-logically and even traumatized by the outbreak of new coronavirus pneumonia in 2020,which has the potential to lead to post-traumatic stress disorder.Many neuropsy-chiatric illnesses are aided by brain-derived neurotrophic factor and its predecessors.Brain-derived neurotrophic factor precursors have the biological impact of triggering neuronal apoptosis and hindering neural regeneration,and brain-derived neurotrophic factor itself can help increase the growth,survival,and differentiation of central and peripheral nerve cells.This article provides an in-depth study of their biological impacts in post-traumatic stress disorder in an attempt to understand the biological effects of brain-derived neurotrophic factor and its precursor proteins.

A Case Report on Sandplay Therapy for a 3-Year-11-Month-Old Child with Post-Traumatic Stress Disorder

This report presents a case study of sandplay therapy for a 3-year-11-month-old child with post-traumatic stress disorder. The child had experienced a distressing traumatic event and exhibited symptoms of anxiety, fear, and traumatic reenactment. Sandplay therapy, as a therapeutic modality, was utilized to provide a safe environment for the child to express and process their inner experiences. The case report provides a detailed account of the child’s presentation, treatment goals, therapeutic strategies, and treatment outcomes. Through sandplay therapy, the child achieved emotional release, resolution of internal conflicts, and a reframing of the traumatic event. Ultimately, a significant reduction in symptoms of post-traumatic stress disorder was observed, along with improved functioning and psychological well-being.

The Roots of Psychological Trauma and Post-TraumaticStress Reaction/Disorders and the Intervention

Psychological trauma refers to the catastrophic or traumatic events harmful to individuals＇ inner world. Strong emotional and psychological reaction caused by traumatic factors will form psychological shadows, and the improper coping of these events will lead to a post-traumatic stress disorder. In this paper, the author makes an exploration on the roots of psychological trauma and of post-traumatic stress reaction or disorders, which were caused by natural traumatic event, such as floods, snowstorms, earthquakes and other man-made factors such as wars, accidents from a psychological point of view. Finally, some suggestions of intervention are provided for the relevant departments to make relevant rebuilding policies.

Promoting Post-Traumatic Growth in Colorectal Cancer Patients:Exploring the Role of Social Support through a Chain Mediation Model

Colorectal cancer(CRC)poses significant physical and psychological challenges that necessitate an exploration of factors influencing post-traumatic growth(PTG)for patient well-being.This study aims to investigate the effects of positive psychological capital(PsyCap)and perceived stress on mediating the social support-PTG relation among 673 CRC patients.Social support,positive PsyCap,perceived stress,and PTG were assessed through questionnaires.The results indicated a direct prediction effect of social support on PTG(LICI=0.481,ULCI=0.644),with the direct effect being 59.5%.Both positive PsyCap and perceived stress exerted a mediating role in the correlation between social support and PTG,with the mediating effects occupying 29.4%(LICI=0.217,ULCI=0.343)and 5.7%(LICI=0.030,ULCI=0.082),respectively.Positive PsyCap further had a chain mediating effect on perceived stress(LICI=0.031,ULCI=0.074),with the chain effect accounting for 5.4%.The total impact of social support on PTG was 100%(LICI=0.882,ULCI=1.008).This model underscores the pivotal role of social support in promoting PTG in CRC patients.Positive PsyCap serves as a crucial mediator in the social support-PTG link,with perceived stress playing a sequential mediating role.Thesefindings suggest that strengthening social support networks and cultivating positive PsyCap may reduce perceived stress and promote the development of PTG in CRC patients.Consequently,intervention programs are recommended to improve the psychosocial well-being of CRC patients.

Effects of therapeutic horseback riding on post-traumatic stress disorder in military veterans

Background:Large numbers of post-deployment U.S.veterans are diagnosed with post-traumatic stress disorder(PTSD)and/or traumatic brain injury(TBI),leading to an urgent need for effective interventions to reduce symptoms and increase veterans’coping.PTSD includes anxiety,flashbacks,and emotional numbing.The symptoms increase health care costs for stress-related illnesses and can make veterans’civilian life difficult.Methods:We used a randomized wait-list controlled design with repeated measures of U.S.military veterans to address our specific aim to test the efficacy of a 6-week therapeutic horseback riding(THR)program for decreasing PTSD symptoms and increasing coping self-efficacy,emotion regulation,social and emotional loneliness.Fiftyseven participants were recruited and 29 enrolled in the randomized trial.They were randomly assigned to either the horse riding group(n=15)or a wait-list control group(n=14).The wait-list control group experienced a 6-week waiting period,while the horse riding group began THR.The wait-list control group began riding after 6 weeks of participating in the control group.Demographic and health history information was obtained from all the participants.PTSD symptoms were measured using the standardized PTSD Checklist-Military Version(PCL-M).The PCL-M as well as other instruments including,The Coping Self Efficacy Scale(CSES),The Difficulties in Emotion Regulation Scale(DERS)and The Social and Emotional Loneliness Scale for Adults-short version(SELSA)were used to access different aspects of individual well-being and the PTSD symptoms.Results:Participants had a statistically significant decrease in PTSD scores after 3 weeks of THR(P≤0.01)as well as a statistically and clinically significant decrease after 6 weeks of THR(P≤0.01).Logistic regression showed that participants had a 66.7%likelihood of having lower PTSD scores at 3 weeks and 87.5%likelihood at 6 weeks.Under the generalized linear model(GLM),our ANOVA findings for the coping self-efficacy,emotion regulation,and social and emotional loneliness did not reach statistical significance.The results for coping self-efficacy and emotion regulation trended in the predicted direction.Results for emotional loneliness were opposite the predicted direction.Logistic regression provided validation that outcome effects were caused by riding longer.Conclusion:The findings suggest that THR may be a clinically effective intervention for alleviating PTSD symptoms in military veterans.

Association of post-traumatic stress disorder and work performance: A survey from an emergency medical service, Karachi, Pakistan

BACKGROUND: The purpose of the study was to explore the association between posttraumatic stress disorder(PTSD) and work performance of emergency medical services personnel in Karachi, Pakistan.METHODS: Emergency medical service personnel were screened for potential PTSD using Impact of Event Scale-Revised(IES-R). Work performance was assessed on the basis of fi ve variables: number of late arrivals to work, number of days absent, number of days sick, adherence to protocol, and patient satisfaction over a period of 3 months. In order to model outcomes like the number of late arrivals to work, days absent and days late, negative binomial regression was applied, whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores.RESULTS: Mean scores of PTSD were 24.0±12.2. No association was found between PTSD and work performance measures: number of late arrivals to work(RRadj 0.99; 0.98–1.00), days absent(RRadj 0.98; 0.96–0.99), days sick(RRadj 0.99; 0.98–1.00), adherence to protocol(ORadj 1.01; 0.99–1.04) and patient satisfaction(β 0.001%–0.03%) after adjusting for years of formal schooling, living status, coping mechanism, social support, working hours, years of experience and anxiety or depression.CONCLUSION: No statistically significant association was found between PTSD and work performance amongst EMS personnel in Karachi, Pakistan.

Prevalence of post-traumatic stress disorder after earthquakes among the elderly in China: A meta-analysis

BACKGROUND: The study aims to investigate the occurrence of post-traumatic stress disorder(PTSD) after earthquakes among the elderly. METHODS: Data from cross-sectional studies focusing on the prevalence of PTSD after earthquakes among the elderly were collected from Pub Med, EMBASE, Cochrane Library, and China National Knowledge Infrastructure in December 2019. The search terms included post-traumatic stress disorder, earthquake, and elderly. This study used Review Manager 5.0 to evaluate the impact of the results. In addition, forest plots, sensitivity analysis, and bias analysis were carried out on the included articles. The combined estimate of the risk ratio and the standard deviation of the 95% confidence interval(95% CI) were measurements of the size of the effect.RESULTS: There were 4,834 patients included from 10 eligible studies. The sample sizes of PTSD group and non-PTSD group were 1,277 and 3,557, respectively. The meta-analysis showed that the overall occurrence of PTSD after earthquakes among the elderly was 0.25;the occurrence in females was higher than that in males, and the occurrence in the same province indicated little difference(Wenchuan city 0.25 and Ya'an city 0.24).CONCLUSIONS: After earthquakes, the occurrence of PTSD is higher among the elderly than among other age groups, and higher among the females than among the males, while there is little difference among different areas within the same province. This indicated that prioritized specific psychological interventions should be provided to the aged and the females.

Correlation of gut microbiota and neurotransmitters in a rat model of post-traumatic stress disorder

Objective:To determine the effect of gut microbiota on a rat model of post-traumatic stress disorder(PTSD)and explore the correlation of gut microbiota with behavior and neurotransmitters.Methods:We established a single prolonged stress(SPS)model to examine the pathogenesis of PTSD on rat behavior,gut microbiota,and neurotransmitter levels.Rats were separated into control and model groups,and neurotransmitter levels were measured using enzyme linked immunosorbent assay.Then,16 S rRNA sequencing was used to compare the gut microbiota between the control and model groups.Results:Compared with those in the control group,freezing time significantly increased,while number of standing upright,crossing frequency,time spent in the central arena,and total distance traveled were significantly reduced in the model group after exposure to SPS(all P<.05).Meanwhile,serotonin,or 5-hydroxytryptamine,levels in the brain in the model group were significantly lower than those the control group(P紏.0332).In addition,changes were observed in the gut microbiota diversity and relative abundances of bacterial phyla,orders,families,and genera in the model group.Especially,changes in Firmicutes,Bacteroidetes,Cyanobacteria,and Proteobacteria levels were most pronounced after SPS exposure.Correlation analysis showed that the strongest positive correlation was found between Bacteroidaceae and 5-HT(P?.0009).Moreover,RF32 abundance was the most negatively related to 5-HT(P?.0009),crossing frequency(P?.0007),and total distance(P?.0003).Conclusion:Our results suggest that SPS model rats showed differences in behavior,neurotransmitter levels,and gut microbiota with control rats.Moreover,Firmicutes,Bacteroidetes,Cyanobacteria,and Proteobacteria were most relevant to the exhibited fear-like and anxiety-like behaviors and significant serotonin content reduction in SPS model rats.

Clinical application of repetitive transcranial magnetic stimulation for post-traumatic stress disorder:A literature review

The efficacy of traditional treatment for post-traumatic stress disorder(PTSD)is still unsatisfactory.Repetitive transcranial magnetic stimulation(rTMS)has been widely used in the treatment of various types of mental disorders,including PTSD.Although rTMS has been demonstrated to be effective in many cases,there are still arguments regarding its mechanism and protocol.This review aims to summarize the origin,development,principle,and future direction of rTMS and introduce this neuro-stimulation therapy to relevant clinicians.

Double-blind randomized controlled study of the efficacy, safety and tolerability of eszopiclone vs placebo for the treatment of patients with post-traumatic stress disorder and insomnia

BACKGROUND Sleep disturbance is a core feature of post-traumatic stress disorder(PTSD).Given the relationship between sleep disturbance and PTSD,there has been a relative paucity of studies examining the potential therapeutic impact of using pharmacotherapy to target sleep disturbance in patients with PTSD.Eszopiclone(ESZ)is a non-benzodiazepine y-aminobutyric acid-A receptor agonist indicated for the treatment of sleep and may affect sleep in patients with PTSD.AIM To evaluate the efficacy of ESZ vs placebo(PBO)for patients with PTSD and insomnia.METHODS The study was a 12-wk,double blind,randomized controlled trial with 3 mg of ESZ(n=13)or PBO(n=12).RESULTS Patients in both arms experienced significant improvement in PTSD symptoms as assessed by the Clinician-Administered PTSD Scale for DSM-IV(CAPS):ESZ(t11=-3.12,P=0.005)and PBO(t11=-3.5,P=0.002)and by self-report with the Short PTSD Rating Interview(ESZ t11=-3.38,P=0.003 and PBO t11=-4.48,P=0.0005).There were no significant differences between treatments on the CAPS(t22=-0.13,P=0.70)or the Short PTSD Rating Interview(t22=-0.58,P=0.56).Similarly,both treated groups improved on sleep measures as assessed by the Pittsburgh Sleep Quality Index with PTSD Addendum(PSQI)and on total sleep time(TST)and sleep latency assessed by actigraphy with no significant differences between groups(PSQI t22=-0.24,P=0.81;total sleep time t10=0.13,P=0.90 and sleep latency t10=0.68,P=0.50).There was a significant correlation between improvement in sleep and overall improvement in PTSD as measured by change scores on the PSQI and CAPS,r(8)=0.79,P=0.01 for ESZ treated subjects,but not for those treated with PBO r(9)=0.16,P=0.69.Adverse events of ESZ were consistent with the known profile of the medication including dysgeusia(30%,mild),sedation(20%,mild)and headache(20%,moderate to severe).CONCLUSION Results do not support the hypothesis of a specific positive effect of ESZ compared to PBO for measures of PTSD and associated sleep disturbance.

Drawing soldiers out of post-traumatic stress disorder

Art therapies are a broad suite of treatments including drawing, painting and music that can facilitate non-verbal communication through artistic expression. They have been used as adjunctive therapies for a range of mental health conditions. Significant numbers of returning military personnel experience post-traumatic stress disorder(PTSD), and discontinuation of care is a concern. Using drawing-based art therapy as an adjuvant to classical therapies may provide a benefit for such military patients.

Brain structure in post-traumatic stress disorder A voxel-based morphometry analysis

This study compared the difference in brain structure in 12 mine disaster survivors with chronic post-traumatic stress disorder, 7 cases of improved post-traumatic stress disorder symptoms, and 14 controls who experienced the same mine disaster but did not suffer post-traumatic stress disorder, using the voxel-based morphometry method. The correlation between differences in brain structure and post-traumatic stress disorder symptoms was also investigated. Results showed that the gray matter volume was the highest in the trauma control group, followed by the symptoms-improved group, and the lowest in the chronic post-traumatic stress disorder group. Compared with the symptoms-improved group, the gray matter volume in the lingual gyrus of the right occipital lobe was reduced in the chronic post-traumatic stress disorder group. Compared with the trauma control group, the gray matter volume in the right middle occipital gyrus and left middle frontal gyrus was reduced in the symptoms-improved group. Compared with the trauma control group, the gray matter volume in the left superior parietal lo- bule and right superior frontal gyrus was reduced in the chronic post-traumatic stress disorder group. The gray matter volume in the left superior parietal Iobule was significantly positively correlated with the State-Trait Anxiety Inventory subscale score in the symptoms-improved group and chronic post-traumatic stress disorder group （r = 0.477, P = 0.039）. Our findings indicate that （1） chronic post-traumatic stress disorder patients have gray matter structural damage in the prefrontal lobe, oc- cipital lobe, and parietal lobe, （2） after post-traumatic stress, the disorder symptoms are improved and gray matter structural damage is reduced, but cannot recover to the trauma-control level, and （3） the superior parietal Iobule is possibly associated with chronic post-traumatic stress disorder. Post-traumatic stress disorder patients exhibit gray matter abnormalities.

The incorporation of emotion-regulation skills into couple-and family-based treatments for post-traumatic stress disorder

Post-traumatic stress disorder(PTSD) is a disabling, potentially chronic disorder that is characterized by re-experience and hyperarousal symptoms as well as the avoidance of trauma-related stimuli. The distress experienced by many veterans of the Vietnam War and their partners prompted a strong interest in developing conjoint interventions that could both alleviate the core symptoms of PTSD and strengthen family bonds. We review the evolution of and evidence base for conjoint PTSD treatments from the Vietnam era through the post-911 era. Our review is particularly focused on the use of treatment strategies that are designed to address the emotions that are generated by the core symptoms of the disorder to reduce their adverse impact on veterans, their partners and the relationship. We present a rationale and evidence to support the direct incorporation of emotion-regulation skills training into conjoint interventions for PTSD. We begin by reviewing emerging evidence suggesting that high levels of emotion dysregulation are characteristic of and predict the severity of both PTSD symptoms and the level of interpersonal/marital difficulties reported by veterans with PTSD and their family members. In doing so, we present a compelling rationale for the inclusion of formal skills training in emotional regulation in couple–/family-based PTSD treatments. We further argue that increased exposure to trauma-related memories and emotions in treatments based on learning theory requires veterans and their partners to learn to manage the uncomfortable emotions that they previously avoided. Conjoint treatments that were developed in the last 30 years all acknowledge the importance of emotions in PTSD but vary widely in their relative emphasis on helping participants to acquire strategies to modulate them compared to other therapeutic tasks such as learning about the disorder or disclosing the trauma to a loved one. We conclude our review by describing two recent innovative treatments for PTSD that incorporate a special emphasis on emotion-regulation skills training in the dyadic context: structured approach therapy(SAT) and multi-family group for military couples(MFG-MC). Although the incorporation of emotion-regulation skills into conjoint PTSD therapies appears promising, replication and comparison to cognitive-behavioral approaches is needed to refine our understanding of which symptoms and veterans might be more responsive to one approach versus others.

The Relationship between Post-Traumatic Stress Disorder and Self-Esteem along with the Importance of Support for Children

Post-Traumatic Stress Disorder (PTSD) is widely known in our society. The symptoms of PTSD are particularly believed to occur predominantly in children. We believe that Yogo teachers, who play a role in maintaining and promoting the health of children, are expected to provide appropriate support for children with a tendency for PTSD. In this study, we investigated the tendency for PTSD in students at University, as well as self-esteem related to depression and anxiety. Furthermore, we clarified the relationship between PTSD and self-esteem and examined the support provided by Yogo teachers. As a result, it was found that the higher the tendency for PTSD, the lower the self-esteem. We believe that the onset of PTSD causes a decline in memory ability and attentional function, which interferes with one’s life and leads to self-denial, resulting in a decline in self-esteem among those with a high tendency for PTSD. These results suggest that Yogo teachers should provide support to prevent the onset of PTSD in child students due to accidents, incidents, natural disasters, etc., as well as support to prevent the decline in self-esteem associated with the onset of PTSD.