Diagnostic Utility of the Impact of Event Scale–Revised in Two Samples of Survivors of War

The study aimed at examining the diagnostic utility of the Impact of Event Scale-Revised (IES-R) as a screening tool for post-traumatic stress disorder (PTSD) in survivors of war. The IES-R was completed by two independent samples that had survived the war in the Balkans: a sample of randomly selected people who had stayed in the area of former conflict (n = 3,313) and a sample of refugees to Western European countries (n = 854). PTSD was diagnosed using the MINI International Neuropsychiatric Interview. Prevalence of PTSD was 20.1% in the Balkan sample and 33.1% in the refugee sample. Results revealed that when considering a minimum value of specificity of 0.80, the optimally sensitive cut-off score for screening for PTSD in the Balkan sample was 34. In both the Balkan sample and the refugee sample, this cut-off score provided good values on sensitivity (0.86 and 0.89, respectively) and overall efficiency (0.81 and 0.79, respectively). Further, the kappa coefficients for sensitivity for the cut-off of 34 were 0.80 in both samples. Findings of this study support the clinical utility of the IES-R as a screening tool for PTSD in large-scale research studies and intervention studies if structured diagnostic interviews are regarded as too labor-intensive and too costly.     

Diagnosis and classification of disorders specifically associated with stress: proposals for ICD‐11

The diagnostic concepts of post‐traumatic stress disorder (PTSD) and other disorders specifically associated with stress have been intensively discussed among neuro‐ and social scientists, clinicians, epidemiologists, public health planners and humanitarian aid workers around the world. PTSD and adjustment disorder are among the most widely used diagnoses in mental health care worldwide. This paper describes proposals that aim to maximize clinical utility for the classification and grouping of disorders specifically associated with stress in the forthcoming 11th revision of the International Classification of Diseases (ICD‐11). Proposals include a narrower concept for PTSD that does not allow the diagnosis to be made based entirely on non‐specific symptoms; a new complex PTSD category that comprises three clusters of intra‐ and interpersonal symptoms in addition to core PTSD symptoms; a new diagnosis of prolonged grief disorder, used to describe patients that undergo an intensely painful, disabling, and abnormally persistent response to bereavement; a major revision of “adjustment disorder” involving increased specification of symptoms; and a conceptualization of “acute stress reaction” as a normal phenomenon that still may require clinical intervention. These proposals were developed with specific considerations given to clinical utility and global applicability in both low‐ and high‐income countries.     

Comparing Screening Instruments to Predict Posttraumatic Stress Disorder

Background

Following traumatic exposure, a proportion of trauma victims develops posttraumatic stress disorder (PTSD). Early PTSD risk screening requires sensitive instruments to identify everyone at risk for developing PTSD in need of diagnostic follow-up.

Aims

This study compares the accuracy of the 4-item SPAN, 10-item Trauma Screening Questionnaire (TSQ) and 22-item Impact of Event Scale-Revised (IES-R) in predicting chronic PTSD at a minimum sensitivity of 80%.

Method

Injury patients admitted to a level-I trauma centre (N = 311) completed the instruments at a median of 23 days and were clinically assessed for PTSD at 6 months. Areas under the curve and specificities at 80% sensitivity were compared between instruments.

Results

Areas under the curve in all instruments were adequate (SPAN: 0.83; TSQ: 0.82; IES-R: 0.83) with no significant differences. At 80% sensitivity, specificities were 64% for SPAN, 59% for TSQ and 72% for IES-R.

Conclusion

The SPAN, TSQ and IES-R show similar accuracy in early detection of individuals at risk for PTSD, despite differences in number of items. The modest specificities and low positive predictive values found for all instruments could lead to relatively many false positive cases, when applied in clinical practice.     

灾后消防救援人员创伤后应激障碍分析

目的:对地震后消防救援人员创伤后应激障碍(PTSD)的发生率及心理健康状况进行分析。方法:选用创伤后应激评定量表(PCL-C)和中文版事件影响量表(IES-R),对灾后三个月内消防员310人进行评估。结果:灾后三个月内PTSD症状的总发生率为35.3%;地震救援组和基层消防组IES-R得分显著高于一般院校组,但地震救援组和基层消防组得分无显著差异,PCL-C得分结果与之类似;恐惧、创伤经历和救援失败等是PTSD症状的影响因素。结论:消防员是职业心理创伤的高危人群,地震后消防救援人员PTSD症状发生率较高,应给予及时心理干预。     

PTSD症状与人格特征的关联及性别差异

目的:探究在中国人群中使用气质性格问卷(TCI)评测出的人格特质和PTSD的症状之间的关联,并在此基础上验证两者之间的关联是否也存在性别差异.方法:应用气质性格问卷中文版(TCI-144)及事件影响量表(IES-R)评估个体的人格和PTSD症状,以303名经历过5·12地震的大学生为调查对象,通过对两个调查量表的得分进行PTSD和人格的相关性分析.结果:①被调查者中有13.2％为PTSD可疑者,其中女性为35人(占女生总数的15.8％)男性为5人(占男生总数的7.8％).②在女性样本中,除了合作性因子与回避症状两者之间无关联外,性格维度的三因子与PTSD三症状均有相关;对于气质维度,追求刺激因子显示出了与闯入或过度警觉两个症状间有正相关;而回避损害和坚持性因子都只显示出了与过度警觉症状有正相关.③在男性样本中,除了性格维度的自我超越因子与PTSD三症状都显示了正相关之外,只有气质维度上的坚持性因子与回避症状之间存在正相关.结论:人格特质与PTSD存在显著关联,但是男女两性表现的是各自不同的相关关系.     

Psychometric Properties of the Child PTSD Checklist in a Community Sample of South African Children and Adolescents

Objective

The current study assessed the basic psychometric properties of the Child PTSD Checklist and examined the structure of symptoms of posttraumatic stress disorder (PTSD) in a large sample of South African youth.

Methodology

The checklist was completed by 1025 (540 male; 485 female) South African youth (aged between 10 and 19 years). The factor structure of the scale was assessed with a combination of confirmatory and exploratory techniques. Internal consistencies for the full scale and all subscales were evaluated with Cronbach’s alpha and McDonald’s omega. Validity was assessed by comparing PTSD scores obtained by children who had and had not experienced a traumatic event, and by examining associations between total PTSD scores and known correlates of PTSD.

Results

Scores on the Child PTSD Checklist clearly discriminated between youth who had experienced a traumatic event and those who had not. Internal consistencies for the full scale (and all subscales) were acceptable to good and hypothesized correlations between PTSD, depression, anxiety, somatic symptoms, and age were observed. Two of the reported fit statistics for the tripartite DSM-IV-TR model of PTSD did not meet traditional criteria and further exploratory analyses revealed a four-factor structure (broadly consistent with Simms and colleagues’ Dysphoria Model of PTSD symptoms) which provided a better fit to the observed data.

Conclusion

Given the continued use of the Child PTSD Checklist in South Africa, findings offer an important first step in establishing the reliability and validity of the checklist for use with South African youth. However, further evaluation of the checklist in South African samples is clearly required before conclusions regarding its use as diagnostic tool in this context can be made.     

Subjective Distress Associated with Adult ADHD: evaluation of a new self-report

The current study aims at documenting the psychometric properties of the Subjective Distress Associated with Adult ADHD-Self-Report (SDAAA-SR), a newly developed instrument for the assessment of psychological suffering in ADHD adults. The SDAAA-SR was administered to 247 students and 142 ADHD adults. Factor structure, internal consistency, test–retest reliability, convergent validity and discriminant validity were assessed. Sensitivity to change was examined in a subsample of 25 ADHD patients who participated in a 1-year therapy. The initial pool of 62 items was reduced to 33 items distributed in a three-component structure. Internal consistency was excellent for the “distress due to inattention/disorganization” subscale and good for the “distress due to hyperactivity/impulsivity” and “distress due to self-esteem deficit” subscales. Test–retest reliability in a subsample of 98 students was substantial for all three subscales. ADHD patients scored significantly higher than students on distress due to “inattention/disorganization” and “hyperactivity/impulsivity,” but no difference was observed for “self-esteem deficit.” The components “inattention/disorganization” and “hyperactivity/impulsivity” displayed moderate to large correlations with the corresponding dimensions of the Adult Self-Report Scale for ADHD (ASRS-V1.1). Distress due to “inattention/disorganization” and “self-esteem deficit” was significantly associated with lower satisfaction with social behaviors (QFS, social functioning questionnaire) and quality of life (WHOQOL-BREF). Distress due to “inattention/disorganization” and “self-esteem deficit” significantly decreased after a 1-year therapy. The SDAAA-SR represents a reliable and valid measure of adult ADHD-associated distress, an important but often undocumented parameter in the clinical setting. Its use as an outcome variable in psychological interventions deserves further investigation.     

High Prevalence of Post-Traumatic Stress Symptoms in Relation to Social Factors in Affected Population One Year after the Fukushima Nuclear Disaster

Objective

This study investigated post-traumatic stress symptoms in relation to the population affected by the Fukushima Nuclear Disaster, one year after the disaster. Additionally, we investigated social factors, such as forced displacement, which we hypothesize contributed to the high prevalence of post-traumatic stress. Finally, we report of written narratives that were collected from the impacted population.

Design and Settings

Using the Impact of Event Scale-Revised (IES-R), questionnaires were sent to 2,011 households of those displaced from Fukushima prefecture living temporarily in Saitama prefecture. Of the 490 replies; 350 met the criteria for inclusion in the study. Multiple logistic regression analysis was performed to examine several characteristics and variables of social factors as predictors of probable post-traumatic stress disorder, PTSD.

Results

The mean score of IES-R was 36.15±21.55, with 59.4% having scores of 30 or higher, thus indicating a probable PTSD. No significant differences in percentages of high-risk subjects were found among sex, age, evacuation area, housing damages, tsunami affected, family split-up, and acquaintance support. By the result of multiple logistic regression analysis, the significant predictors of probable PTSD were chronic physical diseases (OR = 1.97), chronic mental diseases (OR = 6.25), worries about livelihood (OR = 2.27), lost jobs (OR = 1.71), lost social ties (OR = 2.27), and concerns about compensation (OR = 3.74).

Conclusion

Although there are limitations in assuming a diagnosis of PTSD based on self-report IES-R, our findings indicate that there was a high-risk of PTSD strongly related to the nuclear disaster and its consequent evacuation and displacement. Therefore, recovery efforts must focus not only on medical and psychological treatment alone, but also on social and economic issues related to the displacement, as well.     

灾后消防救援人员创伤后应激障碍分析

目的：对地震后消防救援人员创伤后应激障碍（PTSD）的发生率及心理健康状况进行分析。方法：选用创伤后应激评定量表（PCL-C）和中文版事件影响量表（IES-R）,对灾后三个月内消防员310人进行评估。结果：灾后三个月内PTSD症状的总发生率为35.3%;地震救援组和基层消防组IES-R得分显著高于一般院校组,但地震救援组和基层消防组得分无显著差异,PCL-C得分结果与之类似;恐惧、创伤经历和救援失败等是PTSD症状的影响因素。结论：消防员是职业心理创伤的高危人群,地震后消防救援人员PTSD症状发生率较高,应给予及时心理干预。     

“Nudging Them Back to Reality”: Toward a Growing Public Acceptance of the Role Dogs Fulfill in Ameliorating Contemporary Veterans' PTSD Symptoms

ABSTRACT

There is a long history of service dog usage to assist people with physical disabilities (e. g., dogs for the blind, deaf, and disabled). In comparison, however, relatively little empirical research has been conducted into the use of service or emotional support dogs for people with psychiatric disabilities (e. g., PTSD, bipolar disorder, anxiety disorder and schizophrenia). Given this research shortfall, the present study sought to provide insights into the post-war dog ownership experiences of contemporary veterans from the Iraq and Afghanistan fields of engagement, particularly in relation to the differences adopted dogs have made to the veterans' readjustment back into society. In this regard, reporters' media accounts of the experiences of veterans with PTSD and the general public's social media response comments were subjected to a triangulated three-phase content analysis to explore the role dogs seemingly play in helping contemporary veterans to readjust to civilian life. The core theme to emerge from the study was one of: “‘Nudging them back to reality’: Toward a growing public acceptance of the role dogs fulfill in ameliorating contemporary veterans' PTSD symptoms.” In light of the difficulties of interpreting the accounts of veterans through the filter of media coverage and social commentary, this core finding may prove to provide insights into how contemporary veterans diagnosed with PTSD utilize the assistance of dogs to help deal with their fundamental human needs for safety, affiliation, and succourance. Finally, the difficulties associated with dogs as therapeutic agents are discussed.     

Translationally relevant modeling of PTSD in rodents

Post-traumatic stress disorder (PTSD) is clinically defined in DSM-4 by exposure to a significantly threatening and/or horrifying event and the presence of a certain number of symptoms from each of three symptom clusters at least one month after the event. Since humans clearly do not respond homogeneously to a potentially traumatic experience, the heterogeneity in animal responses might be regarded as confirming the validity of animal studies, rather than as representing a problem. A model of diagnostic criteria for psychiatric disorders could therefore be applied to animal responses to augment the validity of study data, providing that the criteria for classification are clearly defined, reliably reproducible and yield results that conform to findings in human subjects. The method described herein was developed in an attempt to model diagnostic criteria in terms of individual patterns of response by using behavioral measures and determining cut-off scores to distinguish between extremes of response or non-response, leaving a sizeable proportion of subjects in a middle group, outside each set of cut-off criteria. The cumulative results of our studies indicate that the contribution of animal models can be further enhanced by classifying individual animal study subjects according to their response patterns. The animal model also enables the researcher to go one step further and correlate specific anatomic, bio-molecular and physiological parameters with the degree and pattern of the individual behavioral response and introduces “prevalence rates” as a parameter. The translational value of the classification method and future directions are discussed.     

Interpretation of elevated serum VEGF concentrations in patients with myocardial infarction

Our aim was to examine the relationship between the level of the inflammatory markers, C-reactive protein (CRP) and interleukin-6 (IL-6), and posttraumatic stress disorder (PTSD) symptomology in a random sample of 115 police officers. CRP was measured in citrated plasma using a particle enhanced immunonepholometric assay and IL-6 was measured in serum with a solid-phase quantitative sandwich ELISA. The presence of high PTSD symptomology was defined as having an Impact of Event Scale score (IES) of ≥ 26 compared to<26 (low PTSD symptomology). 28% of the officers had high PTSD symptomology. Mean levels of CRP and IL-6 did not differ significantly between officers with high PTSD symptomology and those with low symptomology (CRP: 0.76 mg/l vs. 0.97 mg/l; IL-6: 2.03 pg/ml vs. 1.74 pg/ml). We found no association of CRP and IL-6 levels with PTSD symptomology. This study was limited by sample size and its cross-sectional study design. A lack of association may occur if either CRP or IL-6 is elevated only at the onset of PTSD symptomology, or if inflammation is related to specific key components that define PTSD. Further research examining these relationships in a larger population may be worthwhile.     

An earliest Givetian “Lilliput Effect” in the Paraná Basin,and the collapse of the Malvinokaffric shelly fauna

An earliest Givetian “Lilliput Effect” at Sítio Wolff and São Bento in the Paraná Basin occurred after an extinction event, possibly related to the latest Eifelian KA?ÁK Event. The Malvinokaffric fauna was reduced from 65 genera before the extinction event to eight genera after the event. However, the abundance of the individual taxa is high. The size reduction of the surviving taxa was up to 90%. The palynomorphs during the extinction and post-extinction (“Lilliput Effect”) events are scarce. Normal palynomorph abundance and diversity is restored later in the early Givetian immediately after the post-extinction event. The relictual fauna in the beds with the “Lilliput Effect” at Sítio Wolff and São Bento constitute the last survivors of the classical Malvinokaffric shelly fauna in the Paraná Basin, and are at these sites mixed with immigrants and alien elements (e.g. orthoconic nautiloids).     

Emotional Disorders in Pairs of Patients and Their Family Members during and after ICU Stay

Introduction

Patients and family members undergo different experiences of suffering from emotional disorders during ICU stay and after ICU discharge. The purpose of this study was to compare the incidence of anxiety, depression and post-traumatic stress disorder (PTSD) symptoms in pairs (patient and respective family member), during stay at an open visit ICU and at 30 and 90-days post-ICU discharge. We hypothesized that there was a positive correlation with the severity of symptoms among pairs and different patterns of suffering over time.

Methods

A prospective study was conducted in a 22-bed adult general ICU including patients with >48 hours stay. The Hospital Anxiety and Depression Scale (HADS) was completed by the pairs (patients/respective family member). Interviews were made by phone at 30 and 90-days post-ICU discharge using the Impact of Event Scale (IES) and the HADS. Multivariate models were constructed to predict IES score at 30 days for patients and family members.

Results

Four hundred and seventy one family members and 289 patients were interviewed in the ICU forming 184 pairs for analysis. Regarding HADS score, patients presented less symptoms than family members of patients who survived and who deceased at 30 and 90-days (p<0.001). However, family members of patients who deceased scored higher anxiety and depression symptoms (p = 0.048) at 90-days when compared with family members of patients who survived. Patients and family members at 30-days had a similar IES score, but it was higher in family members at 90-days (p = 0.019). For both family members and patients, age and symptoms of anxiety and depression during ICU were the major determinants for PTSD at 30-days.

Conclusions

Anxiety, depression and PTSD symptoms were higher in family members than in the patients. Furthermore, these symptoms in family members persisted at 3 months, while they decreased in patients.     

A study of quiet eye's phenomenon in the shooting section of “laser run” of modern pentathlon

The aim of the study was to evaluate the effects of the Quiet eye (QE) phenomenon on performances during the shooting section of “Laser Run” of Modern Pentathlon, in two samples of athletes (novices and experts). The “Laser Run” consists of running and shooting activities. The study involved 18 experienced athletes of the Italian National Team of Modern Pentathlon (i.e., “elite” group) and 18 young and nonexpert athletes of a local Pentathlon club (i.e., “novice” group). Participants performed, in ecological conditions, five trials of four series of shootings (as it occurs in the real competitions), for a total of 20 series. During the shooting trials, athletes wore a mobile Eye Tracking System to record eye movements (saccades, blinks, and fixations). Key measures of the study were QE parameters (QE Duration [QED], Relative QED [RQED], and QE Onset), as well as the performance (accuracy and time to perform the event). The results revealed that both groups of athletes had a longer QED, RQED, and an earlier onset during their best shots than during the worse ones. Furthermore, differences between the groups showed that elite athletes had an earlier onset and a shorter QED than the novice group of athletes. These results provide insightful information about different cognitive and perceptual processes involved in Modern Pentathlon's athletes' performances at both the elite and non-elite level.     

On the interpretation of the hazard ratio in Cox regression

We argue that the term “relative risk” should not be used as a synonym for “hazard ratio” and encourage to use the probabilistic index as an alternative effect measure for Cox regression. The probabilistic index is the probability that the event time of an exposed or treated subject exceeds the event time of an unexposed or untreated subject conditional on the other covariates. It arises as a well known and simple transformation of the hazard ratio and nicely reveals the interpretational limitations. We demonstrate how the probabilistic index can be obtained using the R-package Publish.     

Vulnerability to traumatic stress in fibromyalgia patients: 19 month follow-up after the great East Japan disaster

Introduction

The aim of this study was to investigate vulnerability and long-term influence of traumatic stress caused by the Great East Japan Disaster which occurred on March 11, 2011, in patients with fibromyalgia, which is a chronic pain syndrome probably involving central sensitization.

Methods

A total of 60 female patients with fibromyalgia were compared with female patients with rheumatoid arthritis (RA, n = 23) as another chronic pain disease, and with female healthy controls (HC, n = 26) in the observational study. To evaluate responses to traumatic stress, the scores of Impact of Event Scale-Revised (IES-R) were assessed one month after the disaster and every six months until 19 months after the disaster. We also evaluated levels of depression during the study period. To know the score of IES-R of patients with fibromyalgia during usual living, we assessed IES-R in another population of fibromyalgia patients without exposure to a great disaster.

Results

The mean score of IES-R one month after the disaster in the fibromyalgia group (24.6 [SD 18.9]) was significantly higher than that of RA group (13.4 [SD 14.5]) or HC group (9.1 [9.2]) (F = 9.96, p < 0.0001). However, the mean score of IES-R in fibromyalgia patients without exposure to a great disaster was (20.3 [SD 18.7]), which was almost the same value as the fibromyalgia group seven months after the disaster (20.2 [SD 19.5]). Repeated measures analysis of variance showed significant effect of time course in the depression-related symptoms (F = 6.68, P = 0.001), and a post-hoc test revealed that the number of depression-related symptoms one month before the disaster was significantly different from other time points until 19 months after the disaster, respectively.

Conclusions

Although response to acute stress induced by the great earthquake was likely to be settled within seven months after the disaster, depression-related symptoms have been increasing for more than one year after the disaster, despite exclusion of patients with major depression at baseline. This long-lasting worsening of depression-related symptoms may have been in response to chronic stress induced by the fear of radiation due to the nuclear power disaster. These findings suggest that patients with fibromyalgia are vulnerable to chronic stress rather than acute stress.     

Genetic-gonadal-genitals sex (3G-sex) and the misconception of brain and gender,or, why 3G-males and 3G-females have intersex brain and intersex gender

The categorization of individuals as “male” or “female” is based on chromosome complement and gonadal and genital phenotype. This combined genetic-gonadal-genitals sex, here referred to as 3G-sex, is internally consistent in ~99% of humans (i.e., one has either the “female” form at all levels, or the “male” form at all levels). About 1% of the human population is identified as “intersex” because of either having an intermediate form at one or more levels, or having the “male” form at some levels and the “female” form at other levels. These two types of “intersex” reflect the facts, respectively, that the different levels of 3G-sex are not completely dimorphic nor perfectly consistent. Using 3G-sex as a model to understand sex differences in other domains (e.g., brain, behavior) leads to the erroneous assumption that sex differences in these other domains are also highly dimorphic and highly consistent. But parallel lines of research have led to the conclusion that sex differences in the brain and in behavior, cognition, personality, and other gender characteristics are for the most part not dimorphic and not internally consistent (i.e., having one brain/gender characteristic with the “male” form is not a reliable predictor for the form of other brain/gender characteristics). Therefore although only ~1% percent of humans are 3G-“intersex”, when it comes to brain and gender, we all have an intersex gender (i.e., an array of masculine and feminine traits) and an intersex brain (a mosaic of “male” and “female” brain characteristics).     

Lignotubers and burls— their structure,function and ecological significance in Mediterranean ecosystems

Vegetative regeneration provides for immediate tissue replacement and reestablishment of the “parent” genotype, after the aerial canopy of a perennial plant is partially or wholly destroyed. If the frequency of destruction of above-ground biomass (e.g., by fire) is such that tissue replacement (production) is the predominant mode of growth, this regenerative capacity may preadapt the plant for reproduction via vegetative growth. In the perennial shrubs of the California chaparral, and in other similar Mediterranean-type ecosystems, one of the most significant modes of reproduction is characterized by sprouting after injury of new stem or root tissue from an ontogenetically produced swollen stem base/root crown known as a lignotuber (or “burl”). Lignotubers have been well described inEucalyptus (Myrtaceae) and observed in other families in the Mediterranean-type climate regions. “Burls” of shrubs in the family Ericaceae are morphologically similar to lignotubers. The term “burl” is vague in meaning, since it has been used to describe any anomalous or unusual woody structure with a swirled grain. The term lignotuber, which has a more restricted usage referring only to ontogenetically produced structures, should henceforth be used to describe these swollen “root crowns.” Investigations of lignotuber (burl) anatomy have revealed that the wood contains dormant buds, carbohydrates, and nutrients necessary for bud development. Reproductive strategies and tactics have evolved partially in response to the frequency and severity of disturbance (e.g., fire in shrublands of Mediterranean-type ecosystems). Reproductive strategies are defined by the timing and mode of production and reproduction. Reproductive tactics are the options of “reproductive effort” and energy allocation within each strategy. In the chaparral, fynbos, macchia, etc., one prevalent tactic in the sprouting strategy is the allocation of energy to the woody structure which has sprouting as its prime function—the lignotuber.     

Synthesis of a Smart Gold Nano‐vehicle for Liver Specific Drug Delivery

Targeting drug formulations to specific tissues and releasing the bioactive content in response to a certain stimuli remains a significant challenge in the field of biomedical science. We have developed a nanovehicle that can be used to deliver “drugs” to “specific” tissues. For this, we have simultaneously modified the surface of the nanovehicle with “drugs” and “tissue-specific ligands”. The “tissue-specific ligands” will target the nanovehicle to the correct tissue and release the “drug” of interest in response to specific stimuli. We have synthesised a “lactose surface-modified gold nanovehicle” to target liver cells and release the model fluorescent drug (coumarin derivative) in response to the differential glutathione concentration (between blood plasma and liver cells). Lactose is used as the liver-specific targeting ligand given the abundance of l-galactose receptors in hepatic cells. The coumarin derivative is used as a fluorescent tag as well as a linker for the attachment of various biologically relevant molecules. The model delivery system is compatible with a host of different ligands and hence could be used to target other tissues as well in future. The synthesised nanovehicle was found to be non-toxic to cultured human cell lines even at elevated non-physiological concentrations as high as 100 μg/mL. We discover that the synthesised gold-based nanovehicle shows considerable stability at low extracellular glutathione concentrations; however coumarin is selectively released at high hepatic glutathione concentration.