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。     

Exacerbated Headache-Related Pain in the Single Prolonged Stress Preclinical Model of Post-traumatic Stress Disorder

Chronic headache pain is one of the most commonly reported comorbid pain conditions with post-traumatic stress disorder (PTSD) patients and resistant to effective treatment, yet no combined preclinical model of the two disorders has been reported. Here, we used a modified chronic headache pain model to investigate the contribution of single prolonged stress (SPS) model of PTSD with sodium nitroprusside (SNP)-induced hyperalgesia. Injection of SNP (2 mg/kg, i.p.) occurred every other day from day 7 to day 15 after initiation of SPS in rats. Paw withdrawal threshold (PWT) to von Frey stimuli and tail flick latencies (TFL) dramatically decreased as early as 7 days after SPS and lasted until at least day 21. Basal PWT and TFL also significantly decreased during the SNP treatment period. The lower nociceptive thresholds recovered in 6 days following the final SNP injection in SNP group, but not in SPS?+?SNP group. Elevated nociceptin/OFQ (N/OFQ) levels observed in cerebrospinal fluid of SPS rats were even higher in SPS?+?SNP group. Glial fibrillary acidic protein (GFAP) and N/OFQ peptide (NOP) receptor mRNA expression increased in dorsal root ganglia (DRG) 21 days after SPS exposure; mRNA increases in the SPS/SNP group was more pronounced than SPS or SNP alone. GFAP protein expression was upregulated in trigeminal ganglia by SPS. Our results indicate that traumatic stress exaggerated chronic SNP-induced nociceptive hypersensitivity, and that N/OFQ and activated satellite glia cells may play an important role in the interaction between both conditions.

     

Effect of the Interplay between Trauma Severity and Trait Neuroticism on Posttraumatic Stress Disorder Symptoms among Adolescents Exposed to a Pipeline Explosion

Background

While numerous studies have explored relevant factors of posttraumatic stress disorder (PTSD) symptoms, there have been few joint investigations of trauma severity and trait neuroticism on the development of PTSD symptoms. This study aims to assess the involvement and interrelationship of trauma severity and neuroticism in the expression of PTSD symptoms among adolescents exposed to an accidental explosion.

Methods

Six hundred and sixty-two adolescents were recruited from a junior middle school closest to the 2013 pipeline explosion site in China and were assessed using the Explosion Exposure Questionnaire, the NEO Five Factor Inventory-Neuroticism Subscale (FFI-N), and the PTSD Checklist-Civilian (PCL-C). A battery of hierarchical multiple regression analyses and two-way ANOVAs were performed to examine the effect of trauma severity and trait neuroticism on adolescent PTSD symptoms.

Results

Eighty-seven adolescents (13.1%) showed PTSD symptoms after the pipeline explosion. Correlation analysis showed that all the factors of explosion exposure and trait neuroticism were positively associated with adolescent PTSD symptoms. Being male and younger was linked to lower risk for PTSD symptoms. The regression models identified explosion exposure and neuroticism as independent risk factors for PTSD symptoms, and the interactions between trait neuroticism and trauma exposure (personal casualty, degree of influence, total traumatic severity) were related to PTSD symptoms.

Conclusions

The results highlight the role of trauma exposure and trait neuroticism as risk factors for PTSD symptoms. Therefore, the combination of these two factors should be investigated in clinical settings due to an augmented risk for more severe PTSD symptoms.     

Posttraumatic Stress Disorder Increases Sensitivity to Long Term Losses among Patients with Major Depressive Disorder

Background

Decisions under risk and with outcomes that are delayed in time are ubiquitous in real life and can have a significant impact on the health and wealth of the decision-maker. Despite its potential relevance for real-world choices, the degree of aberrant risky and intertemporal decision-making in patients suffering from major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) has received little attention to date.

Method

We used a case-control design to compare decision-making in healthy control subjects (N=16) versus untreated depressed subjects in a current major depressive episode (N=20). In order to examine how major depressive disorder (MDD) may impact decision-making, subjects made decisions over (1) risky outcomes and (2) delayed outcomes in the domain of gains and losses using choice paradigms from neuroeconomics. In a pre-planned analysis, depressed subjects were subdivided into those with primary PTSD along with comorbid MDD (MDD+PTSD) versus those with primary MDD without PTSD (MDD-only). Choice behavior was modeled via a standard econometric model of intertemporal choice, a quasi-hyperbolic temporal discounting function, which was estimated for each subject group separately.

Results

Under conditions of potential gain, depressed subjects demonstrated greater discounting for gains across all time frames compared to controls. In the realm of losses, both subgroups of depressed subjects discounted more steeply than controls for short time frames. However, for delayed losses ranging from >1-10 years, MDD+PTSD subjects showed shallower discounting rates relative to MDD-only subjects, who continued to discount future losses steeply. Risk attitudes did not contribute to differences in intertemporal choice.

Conclusions

Depressed patients make choices that minimize current pain and maximize current reward, despite severe later consequences or lost opportunities. Anxiety associated with PTSD may serve as a partially protective factor in decision-making about long-term potential losses compared to MDD patients without PTSD.     

Experimental Post-traumatic Stress Disorder Decreases Astrocyte Density and Changes Astrocytic Polarity in the CA1 Hippocampus of Male Rats

Post-traumatic stress disorder (PTSD) is a psychiatric condition resulting from exposure to a traumatic event. It is characterized by several debilitating symptoms including re-experiencing the past trauma, avoidance behavior, increased fear, and hyperarousal. Key roles in the neuropathology of PTSD and its symptomatology have been attributed to the hippocampus and amygdala. These regions are involved in explicit memory processes and context encoding during fear conditioning. The aim of our study was to investigate whether PTSD is capable of altering the morphology, density and expression of glial fibrillary acidic protein (GFAP) in astrocytes from the CA1 region of the hippocampus and the medial amygdala and correlate the data obtained with the orientation index of the polarity of astrocytes. Thirty male rats were divided in two groups: control (n = 15) and PTSD (n = 15). The inescapable shock protocol, in which the animals are exposed to a single episode of footshock, was used to induce PTSD. Our results show that, in the hippocampus, PTSD is capable of decreasing the density of GFAP+ astrocytes as well as altering astrocytic morphology, as shown by the reductions observed in the total number of primary processes, in the number of primary processes in the lateral quadrants, and the degree of branching in the lateral quadrants. The analysis of the orientation index indicates that PTSD alters the polarity of hippocampal astrocytes. No alterations were observed in the amygdala astrocytes. Therefore, this study demonstrates notable changes in hippocampal astrocytes, supporting the concept that these cells play an important role in PTSD symptomatology.

     

Follicle Selection in Cattle: Relationships among Growth Rate, Diameter Ranking, and Capacity for Dominance

Follicles of wave 1 were designated F1, F2, and so forth, according to descending diameter at the expected (F1, > or =8.2 mm) or observed beginning of deviation (Hour 0), as indicated by a reduction in growth rate of F2. During Hours -24 to 0 (experiment 1; n = 34 waves) and Hours -16 to 0 (experiment 2; n = 21), F1 and F2 grew in parallel (no significant differences). During Hours -16 to 0, growth rate was greater (P < 0.05) for F1 (1.4 +/- 0.1 mm/16 h) and F2 (1.0 +/- 0.1) than for F3 (0.6 +/- 0.1) and F4 (0.5 +/- 0.1). During Hours 0 to 16, growth rate was greater (P < 0.05) for F1 (1.4 +/- 0.2 mm/16 h) than for F2 (0.1 +/- 0.1), F3 (0.1 +/- 0.1), and F4 (0.1 +/- 0.2). In experiment 1, zero, one, two, or three largest follicles were ablated by aspiration of contents at Hour 0 (n = 7/group). For heifers with a single dominant follicle, the dominant follicle formed from the largest retained follicle more often when it was >7.0 mm (14 of 15) than when it was <7.0 mm (0 of 10). When the retained follicles were <7.0 mm, the first follicle to reach 7.0 mm became dominant in seven of eight heifers. Mean hour of observed deviation (occurring after Hour 0 in the ablation groups) increased progressively in groups with increasing number of ablated follicles. Plasma concentrations of FSH for groups with one, two, or three ablated follicles increased to a similar extent between Hours 0 and 12. Results supported the following: 1) during the 24 h before the beginning of deviation, small follicles grew more slowly than large follicles and the largest follicles grew in parallel; 2) after ablation of large follicles, the small retained follicles did not deviate until one reached a diameter characteristic of the beginning of deviation; 3) the potential for dominance at the expected beginning of deviation was greatest for the largest follicle and decreased progressively for the smaller follicles but only when the retained follicles were >7.0 mm; and 4) the three largest subordinate follicles began to deviate simultaneously.     

Relationships among microarthropods,fungi, and their environment

Temporal and spatial relationships in a maple-forest soil among mycophagous microarthropods, total hyphal length, vesicular-arbuscular mycorrhizal (VAM) fungus spores, microfungus diversity, root biomass and some abiotic variables (temperature, water content, pH, organic matter content) were investigated. Samples were obtained from spring 1991 to winter 1992 at four soil depths. Canonical correspondence analysis was used to analyze the data. Four species of sporulating VAM fungi were identified, along with 23 species of mites and springtails, 9 of which were common. Hyphal length, VAM fungus spores, and soil animals peaked in spring and autumn. Canonical correspondence analysis suggests that animal abundance and success in the soil is dependent on a number of environmental variables. The most important variables that influence microarthropod community structure are: (i) temperature, (ii) water content, (iii) pH, (iv) total length of fungal hyphae, and (v) diversity of darkly-pigmented fungi. However, the relative importance of these variables changes with increasing soil depth. We have also shown a relationship between arthropod populations and their food supply under field conditions, a phenomenon that has been demonstrated previously under controlled laboratory conditions.     

Relationships among ontogenetic,static, and evolutionary allometry

The relationship between ontogenetic, static, and evolutionary levels of allometry is investigated. Extrapolation from relative size relationships in adults to relative growth in ontogeny depends on the variability of slopes and intercepts of ontogenetic vectors relative to variability in length of the vector. If variability in slopes and intercepts is low relative to variability in length, ontogenetic and static allometries will be similar. The similarity of ontogenetic and static allometries was tested by comparing the first principal component, or size vector, for correlations among 48 cranial traits in a cross-sectional ontogenetic sample of rhesus macaques from Cayo Santiago with a static sample from which all age- and sex-related variation had been removed. The vector correlation between the components is high but significantly less than one while two of three allometric patterns apparent in the ontogenetic component are not discernable in the static component. This indicates that there are important differences in size and shape relationships among adults and within ontogenies. Extrapolation from intra- or interspecific phenotypic allometry to evolutionary allometry is shown to depend on the similarity of genetic and phenotypic allometry patterns. Similarity of patterns was tested by comparing the first principal components of the phenotypic, genetic, and environmental correlation matrices calculated using standard quantitative genetic methods. The patterns of phenotypic, genetic, and environmental allometry are dissimilar; only the environmental allometries show ontogenetic allometric patterns. This indicates that phenotypic allometry may not be an accurate guide to patterns of evolutionary change in size and shape.     

Adjustment Disorders as a Stress-Related Disorder: A Longitudinal Study of the Associations among Stress,Resources, and Mental Health

Objective

Adjustment disorders are re-conceptualized in the DSM-5 as a stress-related disorder; however, besides the impact of an identifiable stressor, the specification of a stress concept, remains unclear. This study is the first to examine an existing stress-model from the general population, in patients diagnosed with adjustment disorders, using a longitudinal design.

Methods

The study sample consisted of 108 patients consecutively admitted for adjustment disorders. Associations of stress perception, emotional distress, resources, and mental health were measured at three time points: the outpatients’ presentation, admission for inpatient treatment, and discharge from the hospital. To evaluate a longitudinal stress model of ADs, we examined whether stress at admission predicted mental health at each of the three time points using multiple linear regressions and structural equation modeling. A series of repeated-measures one-way analyses of variance (rANOVAs) was performed to assess change over time.

Results

Significant within-participant changes from baseline were observed between hospital admission and discharge with regard to mental health, stress perception, and emotional distress (p<0.001). Stress perception explained nearly half of the total variance (44%) of mental health at baseline; the adjusted R² increased (0.48), taking emotional distress (i.e., depressive symptoms) into account. The best predictor of mental health at discharge was the level of emotional distress (i.e., anxiety level) at baseline (β = −0.23, R² _corr = 0.56, p<0.001). With a CFI of 0.86 and an NFI of 0.86, the fit indices did not allow for acceptance of the stress-model (C_min/df = 15.26; RMSEA = 0.21).

Conclusions

Stress perception is an important predictor in adjustment disorders, and mental health-related treatment goals are dependent on and significantly impacted by stress perception and emotional distress.     

Relationship among Medical Student Resilience,Educational Environment and Quality of Life

Context

Resilience is a capacity to face and overcome adversities, with personal transformation and growth. In medical education, it is critical to understand the determinants of a positive, developmental reaction in the face of stressful, emotionally demanding situations. We studied the association among resilience, quality of life (QoL) and educational environment perceptions in medical students.

Methods

We evaluated data from a random sample of 1,350 medical students from 22 Brazilian medical schools. Information from participants included the Wagnild and Young’s resilience scale (RS-14), the Dundee Ready Educational Environment Measure (DREEM), the World Health Organization Quality of Life questionnaire – short form (WHOQOL-BREF), the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI).

Results

Full multiple linear regression models were adjusted for sex, age, year of medical course, presence of a BDI score ≥ 14 and STAI state or anxiety scores ≥ 50. Compared to those with very high resilience levels, individuals with very low resilience had worse QoL, measured by overall (β=-0.89; 95% confidence interval =-1.21 to -0.56) and medical-school related (β=-0.85; 95%CI=-1.25 to -0.45) QoL scores, environment (β=-6.48; 95%CI=-10.01 to -2.95), psychological (β=-22.89; 95%CI=-25.70 to -20.07), social relationships (β=-14.28; 95%CI=-19.07 to -9.49), and physical health (β=-10.74; 95%CI=-14.07 to -7.42) WHOQOL-BREF domain scores. They also had a worse educational environment perception, measured by global DREEM score (β=-31.42; 95%CI=-37.86 to -24.98), learning (β=-7.32; 95%CI=-9.23 to -5.41), teachers (β=-5.37; 95%CI=-7.16 to -3.58), academic self-perception (β=-7.33; 95%CI=-8.53 to -6.12), atmosphere (β=-8.29; 95%CI=-10.13 to -6.44) and social self-perception (β=-3.12; 95%CI=-4.11 to -2.12) DREEM domain scores. We also observed a dose-response pattern across resilience level groups for most measurements.

Conclusions

Medical students with higher resilience levels had a better quality of life and a better perception of educational environment. Developing resilience may become an important strategy to minimize emotional distress and enhance medical training.     

Investigating the Relationships among Stressors,Stress Level,and Mental Symptoms for Infertile Patients: A Structural Equation Modeling Approach

Objective

Patients with infertility are a high risk group in depression and anxiety. However, an existing theoretically and empirically validated model of stressors, stress, and mental symptoms specific for infertile patients is still a void. This study aimed to determine the related factors and their relational structures that affect the level of depressive and anxiety symptoms among infertile patients.

Methods

A cross-sectional sample of 400 infertility outpatients seeking reproduction treatments in three teaching hospitals across Taiwan participated in the structured questionnaire survey in 2011. The hypothesized model comprising 10 latent variables was tested by Structural Equation Modeling using AMOS 17.

Results

Goodness-of-fit indexes, including χ²/DF = 1.871, PGFI = 0.746, PNFI = 0.764, and others, confirmed the modified model fit the data well. Marital stressor, importance of children, guilt-and-blame, and social stressor showed a direct effect on perceived stress. Instead of being a factor of stress, social support was directly and positively related to self-esteem. Perceived stress and self-esteem were the two major mediators for the relationships between stressors and mental symptoms. Increase in social support and self-esteem led to decrease in mental symptoms among the infertile patients.

Conclusions

The relational structures were identified and named as the Stressors Stress Symptoms Model, clinically applied to predict anxiety and depression from various stressors. Assessing sources and level of infertility-related stress and implementing culturally-sensitive counseling with an emphasis on positive personal value may assist in preventing the severity of depression and anxiety.     

Relationships among Rhizosphere Oxygen Deficiency,Root Restriction,Photosynthesis, and Growth in Baldcypress (Taxodium Distichum L.) Seedlings

Seedlings of baldcypress (Taxodium distichum L.) grown in sealed containers containing nutrient solution were subjected to root-zone oxygen deficiency, physical restriction, and the combined stresses in a greenhouse. After six weeks of treatments (Phase I), half of the plants were harvested. The remaining half were allowed to continue (Phase II) under various treatments except plants that had restricted roots were freed thus allowing free expansion of roots into the nutrient solution. Oxygen deficiency and root physical restriction inhibited plant gas exchange parameters. Net photosynthetic rate (PN) was significantly higher in aerated unrestricted root (AUR) plants than in aerated root restricted (AR) plants and in anaerobic root unrestricted (FUR) plants than in anaerobic root restricted (FR) plants. After Phase I, FUR plants' shoot and root biomasses were 57.0 and 30.6 % lower than those of AUR plants, and AUR plants showed 3.3 and 3.8 times greater shoot and root biomasses than the AR plants, respectively. During Phase II, PN recovered rapidly in plants under aerated conditions, but not in plants under anaerobic conditions. The removal of physical root restriction under both aerated and anaerobic conditions resulted in rapid shoot and root growth in seedlings. Hence, root restriction or root-zone anaerobiosis, reductions in plant gas exchange, and biomass production in baldcypress were closely interrelated. In addition, root release from restriction was related to the regain of photosynthetic activity and biomass growth. The results support the previously proposed source-sink feed-back inhibition of photosynthesis in plants subjected to root-zone oxygen deficiency or physical restriction.     

Post-traumatic Stress Disorder in children and adolescents: from Sigmund Freud's "trauma" to psychopathology and the (Dys)metabolic syndrome.

Post-traumatic Stress Disorder (PTSD) is an anxiety syndrome that develops after exposure to traumatic life events. Symptoms include re-experience of the initial trauma, avoidance of stimuli associated with the trauma and symptoms of excessive arousal. Neuroendocrine studies in adults with PTSD have demonstrated that basal cerebrospinal fluid (CSF) CRH levels are elevated and urinary cortisol levels are variable--low in the majority of cases--whereas other studies demonstrate no differences in urinary and plasma cortisol concentrations. Urinary catecholamine excretion is higher in PTSD patients than those of control subjects and other psychiatric disorders. Children may differ from adults in their psychologic and physiologic responses to severe stressors. Also, exposure to stress during critical periods of development may have irreversible effects on behavioral maturation and may affect specific vulnerable brain areas, altering CNS development. Similar to findings in adult studies, PTSD in children is characterized by increased sympathetic nervous system (SNS) activity, as indicated by elevated norepinephrine levels in the periphery. High cortisol levels in urine or saliva have been reported in most studies of childhood PTSD, while prospective longitudinal studies concerning the natural history of neuroendocrine changes in pediatric PTSD after an acute stressor are limited. The identification of neurobiologic changes in response to early adverse experiences is of major importance for the prognosis, prevention, management, and treatment of children and adolescents at risk for or suffering from PTSD.     

Relationships between Inflammation,Adiponectin, and Oxidative Stress in Metabolic Syndrome

Metabolic syndrome (MS) represents a cluster of physiological and anthropometric abnormalities. The purpose of this study was to investigate the relationships between the levels of inflammation, adiponectin, and oxidative stress in subjects with MS. The inclusion criteria for MS, according to the Taiwan Bureau of Health Promotion, Department of Health, were applied to the case group (n = 72). The control group (n = 105) comprised healthy individuals with normal blood biochemical values. The levels of inflammatory markers [high sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6), adiponectin, an oxidative stress marker (malondialdehyde), and antioxidant enzymes activities [catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx)] were measured. Subjects with MS had significantly higher concentrations of inflammatory markers and lower adiponectin level, and lower antioxidant enzymes activities than the control subjects. The levels of inflammatory markers and adiponectin were significantly correlated with the components of MS. The level of hs-CRP was significantly correlated with the oxidative stress marker. The IL-6 level was significantly correlated with the SOD and GPx activities, and the adiponectin level was significantly correlated with the GPx activity. A higher level of hs-CRP (≥1.00 mg/L), or IL-6 (≥1.50 pg/mL) or a lower level of adiponectin (<7.90 µg/mL) were associated with a significantly greater risk of MS. In conclusion, subjects suffering from MS may have a higher inflammation status and a higher level of oxidative stress. A higher inflammation status was significantly correlated with decreases in the levels of antioxidant enzymes and adiponectin and an increase in the risk of MS.     

Evolutionary Relationships among Actinophages and a Putative Adaptation for Growth in Streptomyces spp.

The genome sequences of eight Streptomyces phages are presented, four of which were isolated for this study. Phages R4, TG1, ϕHau3, and SV1 were isolated previously and have been exploited as tools for understanding and genetically manipulating Streptomyces spp. We also extracted five apparently intact prophages from recent Streptomyces spp. genome projects and, together with six phage genomes in the database, we analyzed all 19 Streptomyces phage genomes with a view to understanding their relationships to each other and to other actinophages, particularly the mycobacteriophages. Fifteen of the Streptomyces phages group into four clusters of related genomes. Although the R4-like phages do not share nucleotide sequence similarity with other phages, they clearly have common ancestry with cluster A mycobacteriophages, sharing many protein homologues, common gene syntenies, and similar repressor-stoperator regulatory systems. The R4-like phage ϕHau3 and the prophage StrepC.1 (from Streptomyces sp. strain C) appear to have hijacked a unique adaptation of the streptomycetes, i.e., use of the rare UUA codon, to control translation of the essential phage protein, the terminase. The Streptomyces venezuelae generalized transducing phage SV1 was used to predict the presence of other generalized transducing phages for different Streptomyces species.