UNIFORMED
UNIVERSITY
13th Annual
Amygdala, StressSERVICES
and PTSD Conference:
The Sequela of Trauma
CENTER FOR THE STUDY OF TRAUMATIC STRESSPROGRAM
13th Annual Amygdala, Stress and PTSD
Conference: The Sequela of Trauma
APRIL 17, 2018

Joachim Böttger, Ralph Schurade Max Planck Institute for Human Cognitive and Brain Sciences

Sanford Auditorium & Lobby, Building B
Uniformed Services University, Bethesda, MD

www.AmygdalaPTSDconference.org
The Amgydala, Stress and PTSD Conference at the Uniformed Services University brings together scientists andclinicians working towards solving the biological basis of stress, fear, and posttraumatic stress disorder.

SPONSORED BY:
The Center for the Study of Traumatic Stress (USU), Department of Psychiatry (USU),
Neuroscience Program (USU), Department of Family Medicine (USU), andDepartment of Psychiatry(WRNMMC)1

13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

213th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

UNIFORMED SERVICES UNIVERSITYCENTER FOR THE STUDY OF TRAUMATIC STRESS

13th Annual Amygdala, Stress and PTSD
Conference: The Sequela of Trauma
APRIL 17, 2018
Sanford Auditorium & Lobby, Building B
Uniformed Services University
Bethesda, MD

www.AmygdalaPTSDconference.org
SPONSORED BY:
The Center for the Study of Traumatic Stress (USU), Department of Psychiatry (USU),
Neuroscience Program (USU), Department of Family Medicine (USU), andDepartment of Psychiatry (WRNMMC)

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13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Background
The Center for the Study of Traumatic Stress (CSTS) of the Uniformed Services University (USU) in collaboration with the USU Department of Psychiatry, USU Neuroscience
Program, USU Department of Family Medicine, and the Walter Reed National Military
Medical Center (WRNMMC), Department of Psychiatry, is pleased to present the 13th
Annual Amygdala, Stress and PTSD Conference: The Sequelae of Trauma.
The Amygdala, Stress and PTSD Conference at the Uniformed Services University brings
together scientists and clinicians working towards solving the biological basis of stress,
fear, and posttraumatic stress disorder.

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13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Table of Contents
Agenda............................................................................................................................. 3
Conference Speakers...................................................................................................... 4Moderators...................................................................................................................... 7
Conference Leadership.................................................................................................. 8
Conference Committee............................................................................................... 10
Conference Posters....................................................................................................... 11
Continuing Education Credit..................................................................................... 33

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13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

213th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

AGENDA
0800-0900

Registration and Poster Review

0900-0905

Conference Announcements — Gary H. Wynn, MD

0905-0915

Welcome and Introduction — Robert J. Ursano, MD

0915-1000

When Threat is Near Overcoming Brain Stem Driven Defensive 					Responses to PTSD — Ruth Lanius, MD, PhD

1000-1045

Trauma and Sociocultural Context Exposure, Illness, and Recovery			

		— Roberto Lewis-Fernández, MD
1045-1115

Coffee Break and Poster Review in Lobby

1115-1145

Discussion Panel 1 — Moderator, LTC Vincent Capaldi

1145-1245

Lunch

1245-1330

Can the Neuroscience of Resilient Coping Provide Clues for PTSD and 				Addiction Prevention? — Rajita Sinha, PhD
1330-1415

Targeted Rescue Of Stress-Related Prefrontal Circuit Dysfunction by 					Antidepressant-Induced Synaptogenesis — Conor Liston, MD, PhD
1415-1445

Coffee Break and Poster Review in Lobby

1445-1530

Complicated Grief and its Treatment — M. Katherine Shear, MD

1530-1600

Discussion Panel 2 — Moderator, Derrick Hamaoka, MD

1600-1615

Closing Remarks and Presentation of Travel Award — Robert J. Ursano, MD313th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Conference Speakers
Ruth Lanius, MD, PhD

Roberto Lewis-Fernandez, MD

Ruth Lanius, MD, PhD, Professor of Psychiatry is the director of the posttraumatic stressdisorder (PTSD) research unit
at the University of Western
Ontario. She established theTraumatic Stress Service andthe Traumatic Stress Service
Workplace Program, services
that specialize in the treatment
and research of Posttraumatic Stress Disorder (PTSD)
and related comorbid disorders. She currently holds theHarris-Woodman Chair in Mind-Body Medicine at the
Schulich School of Medicine & Dentistry at the University of Western Ontario. Her research interests focus
on studying the neurobiology of PTSD and treatment
outcome research examining various pharmacologicaland psychotherapeutic methods. She has authored morethan 100 published papers and chapters in the field oftraumatic stress and is currently funded by several federal funding agencies. She regularly lectures on the topic
of PTSD nationally and internationally. She has recently
published a book ‘Healing the traumatized self: consciousness, neuroscience, treatment’ with Paul Frewen.

Roberto Lewis-Fernández, MD
is a Professor of Clinical Psychiatry at Columbia University
and the Director of the New
York State Center of Excellence for Cultural Competence
and the Hispanic Treatment
Program, and the Co-Directorof the Anxiety Disorder Clinic,
at New York State Psychiatric Institute. His research
focuses on developing culturally valid interventions andinstruments to enhance patient engagement, reduce
misdiagnosis, and help overcome disparities in the careof underserved cultural groups, especially Latinos. He
also studies the way culture affects individuals’ experience of mental disorder and their help-seeking expectations, including how to explore this cultural variation
during the psychiatric evaluation. He led the development of the DSM-5 Cultural Formulation Interview, astandardized method for cultural assessment for use inmental health practice, and was the Principal Investigator of its international field trial. He is Chair of the
Cultural Committee of the Group for the Advancementof Psychiatry, President of the Society for the Study ofPsychiatry and Culture, President-Elect of the World
Association of Cultural Psychiatry, and Past Presidentof the American Society of Hispanic Psychiatry. He
was a member of the NIMH National Advisory Mental
Health Council and Chair of the Cross-Cultural Issues
Subgroup of DSM-5. Currently, he is Co-Chair of the
ICD-11 Working Group on Culture-Related Issues anda member of the Working Group on Somatic Distressand Dissociative Disorders. He is also Chair of the DSM
Review Committee for Internalizing Disorders. His
awards include the 2014 Simón Bolívar Award and the2018 Health Services Senior Scholar Research Award of
the American Psychiatric Association, the 2014 Creative Scholarship Award of the Society for the Studyof Psychiatry and Culture, and the 2015 Multicultural
Excellence Award of the New York State Chapter of the
National Alliance on Mental Illness.

413th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Rajita Sinha, PhD

Conor Liston, MD, PhD

Dr. Rajita Sinha, is the Foundations Fund Endowed Professor
in Psychiatry, Neuroscience
and Child Study at the Yale
University School of Medicine. She is also the Chief of
the Psychology Section in
Psychiatry and Co-Director of
Education for the Yale Centerfor Clinical Investigation. Her
PhD was in Biological Psychology and she then retrained in Clinical Psychology and is a licensed ClinicalPsychologist with expertise in mood, trauma, anxiety
and addictive disorders. She is the founding director of
the Yale Interdisciplinary Stress Center that focuses onunderstanding the sex-specific neurobiology of stress,
trauma and resilient versus vulnerable coping mechanisms that promote neuropsychiatric diseases suchas alcoholism, other substance abuse, PTSD and otherchronic diseases. Her lab also develops and tests novel
treatments to address these processes to prevent relapse
and risk of stress-related chronic diseases. Her researchhas been supported by a series of NIH funded research
projects continuously for over 20 years and she has
published over 250 scientific peer reviewed publicationsin these areas. She currently serves on the NIH/NIAAA
Advisory Council and also on the Expert Scientific
Panel for the NIH Common Fund’s Science of Behavior
Change program. She has served on many other NIH
special emphasis panels, review committees and workshops, presented at numerous national and international
conferences, and her work is widely cited. She has beenfeatured as an expert on stress and trauma and its effects
on memory, cognition, emotion and health behaviors
for numerous news outlets including the Dr. OZ Show,
NBC Nightly News, CNN Health, Wall Street Journal and USA Today to name a few. She also conducts
workshops, lectures and retreats on stress management,
self-care for the stressed professional and for senior
executives, and on ways to reduce stress to enrich andenhance work, family and life.

Conor Liston, MD, PhD is
an Assistant Professor of
Neuroscience and Psychiatry in the Brain and Mind
Research Institute andDepartment of Psychiatryat Weill Cornell Medicine.
His laboratory operates at
the interface between basic
circuit neurobiology and biological psychiatry. The
long-term goals of his research program are 1) to define mechanisms by which neuronal subtypes in theprefrontal cortex (PFC) interact to support learning,memory, and motivated approach and avoidance
behaviors, and 2) to understand how these processes
are disrupted in chronic stress states and in stress-related neuropsychiatric disorders. To this end, hislaboratory employs an approach that integrates
optogenetic tools and genetically encoded calcium
indicators with two-photon imaging and functional
MRI, and they are actively developing new methods for quantifying cortex-wide circuit dynamics in
topologically defined neuronal subtypes. His work
has been recognized with awards from the Brainand Behavior Research Foundation, the Whitehall
Foundation, the Klingenstein-Simons Foundation,and the Rita Allen Foundation, among others. Prior
to starting his lab at Weill Cornell, he completed
his undergraduate training at Harvard College; his
PhD, MD, and residency training at the Rockefeller
University and Weill Cornell; and a postdoctoral
fellowship in the Stanford University laboratory of
Dr. Karl Deisseroth.

513th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

M. Katherine Shear, MD
Dr. M. Katherine Shear is
the Marion E. Kenworthy
Professor of Psychiatry andthe founding Director of theCenter for Complicated Grief
at Columbia School of Social
Work. Dr. Shear is a clinicalresearcher who first worked
in anxiety, depression. For the last two decades she has
focused on understanding and treating people who
experience persistent intense grief. She developed andtested complicated grief treatment (CGT) a short-termtargeted intervention and confirmed its efficacy in threelarge NIMH-funded studies. CGT is strength-based
and focused on fostering adaptation to loss. Dr. Shearis widely recognized for her work in bereavement,
including both research and clinical awards from the
Association for Death Education and Counseling andinvited authorship of articles for Uptodate and the New
England Journal of Medicine.

613th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Moderators
Derrick Hamaoka, MD

LTC Vincent F. Capaldi

Col (Dr.) Derrick Hamaoka
serves as the Assistant Chair,
Medical Education, for the
Uniformed Services University of the Health Sciences
Department of Psychiatry. Col
Hamaoka is a graduate of the
Uniformed Services Universityof the Health Sciences Schoolof Medicine (1999) and the
University of Texas Health Science Center Psychiatry Residency Program (2003). Prior to serving in his
current position, he was the Associate Program Director, University of Texas Health San Antonio Psychiatry
Residency Program, leading one of the largest programsin the nation and responsible for the majority of theactive duty Air Force psychiatry pipeline. He holds the
Air Force Medical Corps Academic Grand Master (ME)Special Experience Identifier (SEI). He also serves as the
Defense Institute for Medical Operations director andsubject matter expert for the Mental Health Services After Disasters & Combat course, providing support/education for recent missions to Iraq, Sierra Leone, Tunisia,
Colombia, Mexico, and Slovakia.

LTC Vincent F. Capaldi, II,
MC, USA, is the Chief of the
Department of Behavioral
Biology, Center for Military
Psychiatry and Neuroscience
Research, at the Walter Reed
Army Institute of Research in
Silver Spring, MD. He currently serves as an associate
professor in the departmentsof Internal Medicine and Psychiatry at the Uniformed
Services University of the Health Sciences in Bethesda,
MD. He is also the program director of the National
Capital Consortium combined Internal Medicine andPsychiatry residency training program and chair of the
Biomedical Ethics Committee at Walter Reed National
Military Medical Center
LTC Capaldi completed dual residency training
in Internal Medicine and Psychiatry and fellowship in
Sleep Medicine at Walter Reed National Military Medical Center. LTC Capaldi holds board certifications fromthe American Board of Psychiatry and Neurology andthe American Board of Internal Medicine to practiceGeneral Psychiatry, Internal Medicine, and Sleep Medicine. In 2013, LTC Capaldi was elected as a Fellow of
the American Psychiatric Association and the American
College of Physicians and currently serves at the president of the Society of Uniformed Services Psychiatrists.
In January, 2013, LTC Capaldi was appointed as
officer in charge (OIC) of the Restoration Program at
Bagram Air Field, Afghanistan. As OIC, LTC Capaldi was responsible for the comprehensive behavioral
health restoration program, all clinical operations, andprevention activities for over 45,000 NATO troops stationed across Afghanistan.
LTC Capaldi has published over 30 peer reviewed
scientific articles and book chapters on various topics
such as sleep disorders, traumatic brain injury, and post
stroke depression that have appeared in several medical
journals. He serves as the Psychiatry & Clinical Psychology Disorders Capabilities Manager and Steering Committee Chair for Physiological Health and Performancein the Military Operational Research Program, MRMC.

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13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Conference Leadership
Gary H. Wynn, MD
LTC, MC, USA
Dr. Wynn is Associate Professor of Psyc12hiatry and
Neuroscience and Assistant
Chair of the Department of
Psychiatry at the Uniformed
Services University of the
Health Sciences. He is a
Scientist at the Center for the
Study of Traumatic Stress. He is also a Distinguished
Fellow of the American Psychiatric Association and on
the editorial boards of Psychosomatics and the Journal of Neuroscience Research. Dr. Wynn received his
education at the United States Military Academy at West
Point and Uniformed Services University of the Health
Sciences. He completed a dual residency in psychiatry
and internal medicine at the Walter Reed Army Medical
Center in Washington, DC. During his military career
Dr. Wynn has served as a Division Psychiatrist (2nd
Infantry Division, Korea), Assistant Chief of Inpatient
Services (Walter Reed), and as a Research Psychiatrist(Walter Reed Army Institute of Research) prior to transitioning to the Uniformed Services University of the
Health Sciences.
Dr. Wynn has served as a frequent member of DoD
level committees and working groups on the topics of
PTSD and suicide. He currently serves as the Chair for
the DoD’s Joint Program Committee working group on
Diagnosis and Treatment of PTSD. Dr. Wynn has served
as a member of VA Merit Review Boards, as a memberof a National Institutes of Mental Health Data Safety
and Monitoring Board, and as US Representative to theNATO Human Factors in Medicine panel on technology in military mental health. He is the recipient of the
AMEDD “A” Proficiency Designator, the Rundell Award,
the Artiss Award, and three Meritorious Service Medals
as well as a member of the Order of Military Medical
Merit. Dr. Wynn is Chair for the Amygdala, Stress, and
PTSD conference currently in its 13th year and past
President of the Society of Uniformed Services Psychiatrists. In addition, Dr. Wynn has over 60 publications
including being co-author and editor of three books.
8

Robert J. Ursano, MD
Dr. Ursano is Professor of
Psychiatry and Neuroscience
and Chairman of the Department of Psychiatry at the
Uniformed Services Universityof the Health Sciences, Bethesda, Maryland. He is founding
Director of the Center for the
Study of Traumatic Stress. In
addition, Dr. Ursano is Editorof Psychiatry, the distinguished journal of interpersonal and biological processes, founded by Harry Stack
Sullivan. Dr Ursano completed twenty years service in
USAF medical corps and retired as Colonel in 1991. He
was educated at the University of Notre Dame and Yale
University School of Medicine and did his psychiatrictraining at Wilford Hall USAF Medical Center and Yale
University.
Dr. Ursano served as the Department of Defense
representative to the National Advisory Mental HealthCouncil of the National Institutes of Mental Health andis a past member of the Veterans Affairs Mental HealthStudy Section and the National Institute of Mental
Health Rapid Trauma and Disaster Grant Review Section. He is a Distinguished Life Fellow in the American
Psychiatric Association and a Fellow of the American
College of Psychiatrists. Dr. Ursano was the first Chairman of the American Psychiatric Association’s Committee on Psychiatric Dimensions of Disaster. This work
greatly aided the integration of psychiatry and publichealth in times of disaster and terrorism. Dr. Ursano
was an invited participant to the White House Mental
Health Conference in 1999. He has received the Department of Defense Humanitarian Service Award andthe highest award of the International Traumatic StressSociety, The Lifetime Achievement Award, for “outstanding and fundamental contributions to understanding
traumatic stress.” He is the recipient of the William C.
Porter Award from the Association of Military SurgeonsContinued on page 9

13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Robert J. Ursano, MD, Continuedof the United States, the William Menninger Awardof the American College of Physicians and the James
Leonard Award of the Uniformed Services University.
He is a frequent advisor on issues surrounding psychological response to trauma to the highest levels of the
US Government and specifically to the Department of
Defense leadership..
Dr. Ursano has served as a frequent member of
the National Academies of Science, Institute of Medicine Committees and working groups including theCommittee on Psychological Responses to Terrorism,
Committee on PTSD, the Committee on Compensation
for PTSD in Veterans and the Committee on Nuclear
Preparedness; and the National Institute of Mental
Health Task Force on Mental Health Surveillance After
Terrorist Attack. In addition, he has served as a memberof scientific advisory boards to the Secretary of Healthand Human Services for disaster mental health andthe Centers for Disease Control for preparedness andterrorism. Dr. Ursano is co-principal investigator of thelargest NIMH grant ever given for the study of Suicidein the U.S. Army. In collaboration with his co-principal
investigators at Harvard University, the University ofMichigan and Columbia University the Army- STARRS
grant will be the Framingham Study of suicidal behavior, and address a national as well as DoD mental healthneed. In 2014, Dr. Ursano and Dr. Matthew Friedmanof the VA National Center for PTSD co-founded theFriedman-Leahy Brain Bank supported through Senator
Patrick Leahy (D-VT). It is the first human brain bankdedicated to PTSD. This joint effort of many people wasa 12 year project developing concepts, pilot data andsupport. Dr. Ursano has over 300 publications. He is
co-author or editor of eight books.

913th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Conference Committee
Gary H. Wynn, MD, 2018 Chairman
LTC, MC, USA
Assistant Chair and Associate Professor
Department of Psychiatry
Scientist
Center for the Study of Traumatic Stress
Uniformed Services University of the Health Sciences

Eric Meyer, MD
Maj, MC, USAF
Assistant Professor
Department of Psychiatry
Scientist
Center for the Study of Traumatic Stress
Uniformed Services University of the Health Sciences

David Mears, PhD, 2018 Co-Chairman
Associate Professor
Department of Anatomy, Physiology, and Genetics
Uniformed Services University of the Health Sciences

John Chaves, MD
Resident, PGY-3
NCC Psychiatry Residency Program
Walter Reed National Military Medical Center

Derrick Hamaoka, MD
Col, MC, USAF
Assistant Chair and Associate Professor
Department of Psychiatry
Scientist
Center for the Study of Traumatic Stress
Uniformed Services University of the Health Sciences

Jorge M. Hastings, Tsgt, USAFNCOIC, Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University of the Health Sciences
Nicole CaulfieldResearch AssistantCenter for the Study of Traumatic Stress
Uniformed Services University of the Health Sciences

Kwang Choi, PhD
Assistant Professor
Department of Psychiatry
Scientist
Center for the Study of Traumatic Stress
Uniformed Services University of the Health Sciences

Alison Neuwirth
Research AssistantCenter for the Study of Traumatic Stress
Uniformed Services University of the Health Sciences
Sydney Destefano
Research AssistantCenter for the Study of Traumatic Stress
Uniformed Services University of the Health Sciences

Kelly L. Cozza, MD
Associate Professor
Department of Psychiatry
Scientist
Center for the Study of Traumatic Stress
Uniformed Services University of the Health Sciences

We extend special thanks to:
Robyn Hulvey, CMP, CGMP
Assistant Director of Meetings
Office of Education & Meetings
Henry Jackson Foundation for the Advancement ofMilitary Medicine
1013th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Conference Posters
Presented in the Lobby
Chronic Mild Traumatic Brain Injury Altered Serum MicroRNAs and their
Association with Fear Behavior of Posttraumatic Stress Disorder........................... 13
Riluzole for PTSD: Efficacy of a Glutamatergic Modulator as Augmentation
Treatment for Combat-Related Posttraumatic Stress Disorder................................ 14
Changes in State Anxiety Over 62 hours of Sleep Deprivation and
Subsequent Recovery...................................................................................................... 15
Daily Variation in Post Traumatic Stress Symptoms (PTSS) in Individuals With andWithout Post Traumatic Stress Disorder...................................................................... 16
Recent Stressful Experiences and Resilience Among US Army Soldiers At Risk for
Suicide: Results from the Army Study to Assess Risk and Resilience among
Servicemembers (Army STARRS)................................................................................ 17
Profiles of Complicated Grief Symptoms and Depression Differentiate Types of
Cognitive Failures in Bereaved Family Members....................................................... 18
Clinical Response Profiles in Bereaved Family Members Fourteen Years after the
September 11th Terrorist Attacks.................................................................................. 19
Effect of Stress and Polytrauma in a Rat Model.................................................................. 20
Prevalence of Mental Health Conditions in Bereaved Military Service Widows: A
Longitudinal Case-Controlled Study ........................................................................... 21
Gene Expression Based Measures of Chronic Stress Exposure......................................... 22
Poor Responses to Intravenous Morphine Analgesia Predict Opioid Addiction
Vulnerability in Sprague-Dawley Rats.......................................................................... 23
Fear Learning Deficits and Myelin-Related Structural Changes in a Blast
Model of Mild Traumatic Brain Injury (mTBI).......................................................... 24
Family Risk Factors for Child Neglect Types....................................................................... 25
Post-Traumatic Stress Disorder in Female Service Members and Veterans.................... 26
Sub-Anesthetic Intravenous Ketamine Infusion Enhances Fear Memory and Brain
Glucose Metabolism (18f-Fdg Pet) in Sprague-Dawley Rats.................................... 27
Self-Reported Insomnia Symptoms Prior to a Simulated Deployment Training
Operation Robustly Predicts Post-Training Posttraumatic Stress Symptoms
in the Warfighter.............................................................................................................. 28
Continued
1113th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Neurophysiology of Anger in PTSD..................................................................................... 29
Association of N-Acetylaspartate Concentration in Anterior Cingulate and Amygdalawith Treatment Response to Riluzole Augmentation for Posttraumatic Stress
Disorder............................................................................................................................ 30
Daily Influence of Sleep Duration on Post Traumatic Stress Symptoms in Individuals
with and without Post Traumatic Stress Disorder...................................................... 31
Genetic Association of FKBP5 with PTSD through Mitochondrial Dysfunction.......... 32
Association Between Leukocyte Telomere Length and Hostility in Soldiers Deployed
During the Iraq and Afghanistan Wars........................................................................ 33

1213th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Chronic Mild Traumatic Brain Injury Altered Serum MicroRNAs
and their Association with Fear Behavior of
Posttraumatic Stress Disorder
Authors

istered for 3 consecutive days, to create mild TBI.
Serum and amygdala samples were collected at the
sub-acute and chronic time points of post-BOP
animals; TaqMan based serum miRNA profiling
was performed. MiRNA data analysis was carriedout to identify the statistically significantly altered
miRNAs. Bioinformatic analyses were carried out toidentify the potential targets of PTSD-related traitsby the BOP chronic mTBI associated miRNAs.

Nagaraja S. Balakathiresan, PhD , Manish Bhomia,
PhD1, Anna E. Tschiffely, PhD2, Richard McCarron,
PhD2,3, Stephen T Ahlers, PhD2, and Barbara
Knollmann-Ritschel, MD1
1

Affiliations

1. Department of Pathology, Uniformed Services
University of the Health Sciences, Bethesda, MD
2. Neurotrauma Department, Naval Medical
Research Center, Silver Spring, MD
3. Department of Surgery, Uniformed Services
University of the Health Sciences, Bethesda, MD

Results: Serum miRNA profiling data analysis
showed 2 miRNAs at 2 weeks, and 30 miRNAs at 5-6
months post-BOP were upregulated from samples
collected comparison to sham controls. Comparison of BOP chronic miRNAs with a panel of ninestress-responsive miRNAs using the tail shock PTSD
rat model from an earlier study, showed five BOP
chronic miRNAs (miR142-5p, -19b, -1928, -421, and-674*) could be potential PTSD miRNA biomarkers.
Bioinformatic approach indicated that BOP chronic
TBI miRNAs might play a potential role in the regulation of fear behavior associated genes.

ABSTRACT

Background: Blast-related traumatic brain injury(TBI) has been a major cause of injury in military
personnel and combat veterans. A striking featureof combat-acquired mild TBI (mTBI) is the co-existence of post-traumatic stress disorder (PTSD).
However, the molecular mechanisms underlying
the association of mTBI and PTSD are virtually
unknown. MicroRNAs (miRNAs) are posttranscriptional gene regulators of diverse biological processes. In this study, we sought to identify miRNAs inblast-related mTBI in the absence of psychologicalstressors that may induce PTSD-related traits.

Conclusions: This study suggests that the BOP
chronic TBI miRNAs may play a potential role in theregulation of genes associated with the developmentof PTSD.

Methods: Anesthetized adult male rats were exposed to repetitive low-intensity blast overpressure(BOP), one exposure (11 psi) per day was admin-

1313th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Riluzole for PTSD: Efficacy of a Glutamatergic Modulator as
Augmentation Treatment for Combat-Related
Posttraumatic Stress Disorder
Authors

Affairs Medical Center in an 8-week randomized,
double-blind, placebo-controlled trial. Participants
met criteria for PTSD as determined by a score ≥40
on the Clinician-Administered PTSD Scale (CAPSIV). Participants were randomized (1:1) to treatment
with riluzole or placebo and continued on theircurrent medications. Outcome variables included
PTSD, depression, and anxiety, which were assessedat baseline, mid-point, and post-treatment. Multivariate analyses controlled for covariates (gender, race,
age, marital status and pay grade).

David M. Benedek, MD1, Patricia T. Spangler, PhD1,James C. West, MD1, Catherine L. Dempsey PhD,
MPH1, Kyle Possemato, PhD2, Shannon McKenzie,
BA2, Andrea Gould, BA1, and Mark Jimerson, BA1

Author Affiliations

1. Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University of Health Sciences, Bethesda, MD
2. Syracuse VA Medical Center, Syracuse, NY

ABSTRACT

Results: ANOVA results suggested there were no
significant differences in PTSD (F (1, 59) = 2.75, p≤.103), depression (F =.04, p ≤. 833) and anxiety(F = 1.28, p ≤ .263) symptoms. However, there was asignificant difference in global functioning between
participants randomized to riluzole compared toplacebo (F = 6.62, p ≤.03).

Background: Posttraumatic stress disorder (PTSD)
is a chronic and seriously debilitating anxiety disorder that develops in some individuals following
exposure to severe trauma. Current pharmacologicaltreatment for PTSD, and particularly combat-related PTSD, is suboptimal, thus there is a need todevelop novel treatments. Riluzole is a glutamatergic
modulator with demonstrated antidepressant andanxiolytic properties in human trials. This randomized controlled trial evaluated the efficacy of acuteriluzole augmentation treatment in veterans with
PTSD, with or without mild traumatic brain injury,
who were suboptimally responsive to standard pharmacologic treatments for PTSD.

Conclusions: The lack of significant effects of riluzole as augmentation treatment for PTSD in service
members may be explained by a therapeutic effect ofconducting serial psychological assessments and thismay have accounted for a significant placebo effect.
Further research is needed in a larger sample andacross multiple types of military treatment facilities
to ensure generalizable results.

Methods: Seventy OEF/OIF/OND veterans, aged
18 to 65 were enrolled from Walter Reed National
Military Medical Center and the Syracuse Veterans’

1413th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Changes in State Anxiety Over 62 hours of Sleep Deprivationand Subsequent Recovery
Authors

Results: There was a significant main effect of Sleep
Condition, F (3,192) = 15.94, p = 2.70 x 10-9. Posthoc tests revealed that anxiety was significantly increased after one night of TSD compared to baseline(p=0.009). Additionally, anxiety reported following
two nights of TSD was further increased compared
to one night of TSD (p=0.0008). This increase in
self-reported anxiety was reversed after one nightof recovery sleep (decreased compared to TSD2, p= 2.50 x 10-9; no difference compared to baseline,
p=0.37). There was no main effect of Time of Day
nor was there a significant interaction between Sleep
Condition x Time of Day.

Alexxa F. Bessey, MPS1, Nora E. Prindle, MPS1,
Meghan Powers Armstrong, BS1, Tina Burke, PhD1,
Vincent F. Capaldi, ScM, MD1, Thomas J. Balkin,
PhD1, Tracy Jill Doty, PhD1

Affiliations

1. Walter Reed Army Institute of Research, Silver
Spring, MD

ABSTRACT

Background: Previous work has indicated increases
in self-reported anxiety following one night of total
sleep deprivation (TSD). This study extends previous
work by assessing the effects of two nights of sleep
deprivation on state anxiety as well as the effect of asingle night of recovery sleep.

Conclusion: The present findings suggest that stateanxiety levels, as measured by the STAI-S, increase
across two nights of TSD and return to baseline
following a single night of recovery sleep. These
preliminary findings suggest that a single 12-hour
period of sleep is sufficient for restoring baseline levels of state anxiety — a finding that has implications
for determining appropriate ‘recycle rates’ (duration
between missions) for Soldiers and others involvedin continuous operations.

Methods: Seventeen healthy adults (7 females)
ranging from 18–33 years of age participated.
Self-reported state anxiety was assessed using theSpielberger State Trait Anxiety Inventory (STAI-S).
The STAI-S was administered at 10am, 1pm, and4pm under four sleep conditions 1) Baseline: day
following one night of 8 hours of time-in-bed (TIB),
2) TSD1: day following one night of TSD, 3) TSD2:
day following two nights of TSD 4) Recovery: day
following 12 hours TIB after 62 hours of TSD. The
data were analyzed with a 4 (Sleep Condition) x 3(Time of Day) mixed linear model.

1513th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Daily Variation in Post Traumatic Stress Symptoms (PTSS) in
Individuals With and Without Post Traumatic Stress Disorder
Authors

momentary assessment methodology, PTSS wereassessed four times daily by self-report for 15 days.
Linear mixed models were used to assess daily
variation in the PCL-5 total score and four subscalescores (intrusion, avoidance, negative cognition,
hyperarousal).

Affiliations

Results: The PCL-5 total score and all four subscalescores were higher on weekdays (Monday throughFriday) versus weekends (Saturday and Sunday)
in those with PTSD, but there were no weekday/
weekend differences among those without PTSD.
The PCL-5 total score and three subscales scores(intrusion, avoidance, hyperarousal) varied acrossthe seven days of the week among participants with
PTSD, but not among those without PTSD.

Quinn M. Biggs, PhD, MPH1, Robert J. Ursano, MD1,Jing Wang, PhD1, David S. Krantz, PhD1, Russell B.
Carr, MD2, Gary H. Wynn, MD1, Deborah Probe,
MA1, Nicole M. Dacuyan, BS1, and Carol S. Fullerton,
PhD1
1. Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University of the Health Sciences, Bethesda, MD
2. Walter Reed National Military Medical Center,
Bethesda, MD

ABSTRACT

Background: Little is known about the extent towhich post traumatic stress symptoms (PTSS) varyfrom day to day. This study examined the variationof the PCL-5 total score and subscale scores by the
day of the week, and whether day of week variationdiffers between individuals with and without PTSD.

Conclusions: These first preliminary results indicatethat among individuals with PTSD, post traumaticstress symptoms vary by the day of the week, withmore symptoms on weekdays compared to weekends. Determining the factors associated with daily
variation in PTSD symptoms may be important fortreatment of PTSD.

Methods: Subjects (N = 80) were assessed forprobable PTSD at enrollment. Using an ecological16

13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Recent Stressful Experiences and Resilience Among US Army Soldiers
At Risk for Suicide: Results from the Army Study to Assess Risk andResilience among Servicemembers (Army STARRS)
Authors

Results: NOK and SUP (retrospectively) reported
recent interpersonal stressful events and increased
risk of suicide: a spouse or partner left them (OR=7.8;
OR=14.0); serious ongoing arguments or break-up witha close friend or family member (OR=4.6; OR=11.8)
and some type of perceived failure or humiliation(OR=20.3; OR=16.4). Severity of occupational, legal andinterpersonal stressful experiences were reported: careeror job (OR = 4.6; OR = 3.2), social life (OR=2.4; OR= 13.4), love life (OR = 3.2; OR =7.8); family relations(OR = 6.0; OR = 4.2); and legal difficulties (OR = 3.7;
OR = 5.5). Third parties also reported poor adaptation
to change (OR=4.4; OR=3.8), difficulty managing stress(OR=3.3; OR=10.9) and inability to bounce back fromsetbacks (OR=6.5; OR=17.7).

Catherine L. Dempsey, PhD, MPH1, David M. Benedek,
MD1, Matthew K. Nock, PhD1, Tsz Hin Ng, MPH1,
Charlotte Riggs, MS1, Pablo Aliaga, MS1, Nicole
Caulfield, BA1, and Sydney DeStefano, BS1

Affiliations

1. Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University of Health Sciences, Bethesda, MD
2. Department of Psychology, Harvard University,
Boston, MA

ABSTRACT

Background: To identify the extent to which the presence, severity, and accumulation of stressful events(military/deployment-related and family/social-related) are risk factors for suicide.

Conclusions: This study identified several recent stressful experiences in the month prior to death associatedwith increased risk of suicide; specifically, relationshipproblems, career/job, legal difficulties and perceived failure or humiliation. Results suggest that ability to handle
stress and to adapt to change may be useful predictors ofsuicide.

Methods: Data are from the Army STARRS. Nextof kin (NOK) and first line supervisors (SUP) of 168
Soldiers who died by suicide and 389 similar living(control) soldiers provided data via structured interviews. Multivariate logistic regression accounting
for complex survey design was used to examine theassociation between recent stressors and suicide.

17

13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Profiles of Complicated Grief Symptoms and Depression
Differentiate Types of Cognitive Failures in
Bereaved Family Members
Authors

Method: Associations between types of cognitive
failures (memory, distractibility, blunders, memory
for names) and symptoms of CG (yearning, anger/
bitterness, shock/disbelief, estrangement from others, hallucinations of the deceased) in participants(n=447) from the National Military Family Bereavement Study were investigated using linear regression.
Depression scores were included as a covariate ineach of the regression models because depression
is often co-morbid with grief and can also lead tocognitive failures.

Joscelyn Fisher, PhD1, Jing Zhou, MS1, Alex Liu,
MPH1, Bilal Ali, BA1, and Stephen Cozza, MD1

Affiliations

1. Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University of the Health Sciences, Bethesda, MD

ABSTRACT

Background: Between 7-25% of bereaved individuals develop complicated grief (CG), characterized bypersistent sense of bitterness and loss of meaning inlife (Newson et al., 2001; Kersting et al., 2011; Prigerson et al., 1995). CG is also associated with memory
and attention difficulties.

Results: CG symptoms of anger, estrangement andshock and depression predicted distractibility. In
contrast, only shock and depression predicted both
memory and blunders. None of the CG symptoms
predicted memory for names, though depression
was a significant predictor.

Objective: To determine whether these difficulties
generalize to cognitive failures (minor errors inthinking that interrupt physical or mental action)
and whether specific symptoms of CG are moreassociated with certain types of cognitive failures
than others.

Conclusions: These symptom profiles and their associated pattern of cognitive failures provide evidence
of individual differences in how cognitive capacity isaffected in day-to-day activities following bereavement, suggesting future targets for intervention.

18

13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Clinical Response Profiles in Bereaved Family Members FourteenYears after the September 11th Terrorist Attacks
Authors

Results: The analysis yielded three groups: Healthy,
Subclinical Symptomatic, and Highly Symptomaticand Impaired. Much of the sample (68.4%) was in
the Healthy group, endorsing low levels of grief,
depression and generalized anxiety. The SubclinicalSymptomatic (16.3% ) and Highly Symptomatic andImpaired (15.4%) each had higher probabilities ofmeeting cutoffs for depression, grief and generalized
anxiety. Both of these symptomatic groups also described fewer positive interim life events after 9-11
than the Healthy group. However, members in theHighly Symptomatic and Impaired group were more
likely to have grief-related impairment and to haveexperienced lifetime traumas. 60% of participants in
the Highly Symptomatic and Impaired group endorsed threshold level symptoms for PTSD compared to practically none in the other two groups.

Joscelyn E. Fisher, PhD1, Shenglin Chen, PhD1,Jing Zhou, MS1, Alexa Churan, B.A., Mary Fetchet,
MSW2, Carol S. Fullerton, PhD1, Robert J. Ursano,MD1, and Stephen J. Cozza, MD1

Affiliations

1. Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University of the Health Sciences, Bethesda, MD
2. Voices of September 11th, New Canaan, CT

ABSTRACT

Background: Bereavement research on sudden,
violent deaths often focuses on immediate or shortterm effects, rather than long-term effects.
Objective: To determine long-term (nearly 15 years
post death) patterns of clinical outcomes in family
members who lost loved ones on September 11,
2001.

Conclusions: Programmatic support needs to target
the Highly Symptomatic and Impaired group andclinicians must be prepared to identify and meet theneeds of these individuals. Programs should be developed to address risk contributors to these clinicaloutcomes. Monitoring of those in the SubclinicalSymptomatic group is also required.

Methods: 603 family members were recruited tocomplete an online survey about their experiences
and current symptom profiles. The questionnaire
assessed background demographics, lifetime trauma
history, prior mental health treatment requirements,
interim life events, income adequacy, use of grief
services and satisfaction with social support. To determine symptom profiles of individuals, latent classanalysis was conducted.

19

13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Effect of Stress and Polytrauma
in a Rat Model
Authors

after t3 or after a minimum of 48 hour recovery (t4).
Corticosterone, ACTH, and ACTH receptor gene
expression were measured at these time points. Rats
were distributed into the following groups: no-stress+ no-injury (n=9 for t3 and n=14 for t4), no-stress +injury (n=7 for t3 and n=11 for t4), stress + no-injury (n=10 for t3 and n=13 for t4), and stress + injury(n=8 for t3 and n=10 for t4). Physiological parameters were monitored throughout the study.
Results: Animals in the stress group had higher HR
than the no-stress group at t1. Corticosterone and
ACTH levels were low and similar for all conditions
at t1 and t2 and then became elevated in all groups
at t4 for corticosterone and at t3 for ACTH. The
ACTH receptor gene expression indicated a trend
to higher values at t4 for the stressed animals being
injured or not. Survival after injury was 83% in bothstress and no-stress groups vs 100% in controls.

Françoise Arnaud, PhD , Georgina Pappas, MD ,Ye Chen, MD, PhD1, Davis Frease3, Eric MaudlinJeronimo1, Richard McCarron, PhD1,2
1,2

1Affiliations

1. Naval Medical Research Center, NeuroTrauma
Department, Silver Spring, MD
2. Uniformed Services University of Health
Sciences, Department of Surgery, Bethesda, MD
3. Uniformed Services University of Health
Sciences, School of Medicine, Bethesda, MD

ABSTRACT

Background: A stressful environment may influence
the outcome of wounded persons and may trigger orexacerbate PTSD after traumatic brain injury (TBI).
The current study evaluates the impact of acutestress in a polytrauma rat model.

Conclusion: Overall, corticosterone and laboratory
outcomes were not significantly affected following
acute stress in ketamine anesthetized rats. Mortality was primarily due to polytrauma with co-morbidities appearing at t4 post trauma. The effect ofketamine anesthesia or the surgery may have overshadowed the effect of the initial stress.

Methods: Stress was produced by a 45-minute immobilization period and rats were then instrumented under ketamine anesthesia for blood collection(t1). Polytrauma was produced by blast overpressure
and controlled hemorrhage (t2). Rats were monitored for 3 hours simulating MEDEVAC-transport
time (t3). Rats were then euthanized immediately

20

13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Prevalence of Mental Health Conditions in Bereaved MilitaryService Widows: A Longitudinal Case-Controlled Study
Authors

ment and rank), time-yoked controls (n=1375), fromone year prior (Yr-1) to two years following (Yr+1
and Yr+2) service member death. Prevalence risk
ratios and confidence intervals were used to compare prevalence rates of psychiatric conditions andoutpatient mental health visits among spouses overtime.

Kathryn Hefner, PhD , Joscelyn Fisher, PhD ,Christin Ogle, PhD1, Jing Zhou, MS1, Trevor
Stephens, BA1, Amy Lee, PhD1, David Krantz, PhD1,
Carol Fullteron, PhD1, Robert Ursano, MD1, Stephen
Cozza, MD1
1

1

Affiliations

Results: Spouses were an average of 32.2 years old(SD=8.4). Service member deaths related to combat(30.0%), non-hostile in-theater (9.3%) or others
outside theater (60.7%). Compared to controls,
prevalence of both unique psychiatric conditions(depression, adjustment disorder, PTSD) and any
psychiatric disorder significantly increased fromYr-1 to Yr+1 and Yr+2 for cases. Cases, but notcontrols, had significantly greater outpatient mental
health visits following service member death (Yr+1
and Yr+2, vs. Yr-1).

1. Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University of Health Sciences, Bethesda, MD

ABSTRACT

Background: Bereavement is associated with deleterious psychiatric effects, particularly for young
widows and/or when deaths are sudden and violent. Deaths of military service members are often
sudden and violent and impact young widows, yetlittle research systematically examines psychologicalconsequences of military bereavement. Further, few
studies include control groups or examine changesin psychiatric functioning pre- and post-bereavement.

Conclusions: Bereavement among a large sample ofyoung military widows was associated with increases
in diagnosis of depression, adjustment disorder, and
PTSD and overall rates of psychiatric conditions.
This was accompanied by increases in mental healthservice utilization. Present data lack information
related to complicated grief diagnosis, which may
have been coded as another disorder. However, thesenovel findings can inform improved intervention
and screening for bereaved military spouses.

Methods: Using outpatient medical records fromwives of active duty service members (n=1375), we
compared prevalence of mental health conditions
and mental health care visits among bereaved widows to matched (age, baseline physical and mental
health utilization. service member spouse deploy-21

13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Gene Expression Based Measures ofChronic Stress Exposure
Authors

isolation, social defeat, social defeat with isolation,
grid housing, chronic variable stress (CVS), andchronic shock (CS). RNA sequencing was used tomeasure changes in the transcriptome of the adrenal
gland following exposure to the two most intensestress protocols, CVS and CS. Expression changes
in candidate genes were confirmed using real-time
PCR. Selected genes, whose expression levels consistently changed, were used to construct a SSGE index
that was then validated across all six stress models.

Moriah L. Jacobson, PhD1,5, Barbara Rosati, PhD2,4,
David McKinnon, PhD3,4Affiliations

1. Department of Psychology, Stony Brook
University, Stony Brook, NY
2. Department of Physiology and Biophysics, Stony
Brook University, Stony Brook, NY
3. Department of Neurobiology and Behavior, Stony
Brook University, Stony Brook, NY
4. Veterans Affairs Medical Center, Northport, NY
5. Department of Pharmacology and Molecular
Therapeutics, Uniformed Services University of
the Health Sciences, Bethesda, MD

Results: The SSGE index allowed a diagnostic
distinction between control and stressed animals,
detecting every type of stress exposure in a mannerthat was relatively independent of the modality ofstress and that paralleled the intensity of stress exposure in a dose-dependent manner. There were also a
subset of modality-specific genes that could distinguish between types of stress protocols.

ABSTRACT

Background: The risk of developing post-traumaticstress disorder (PTSD) in response to stress exposure may be dose-dependent, increasing with boththe severity of the stressors as well as cumulative
exposure to multiple stressors. Effects of stress arelikely to be encoded, in part, by changes in the gene
regulatory network. We tested these hypotheses andshowed that we can construct a stress-sensitive gene
expression (SSGE) index that functions as a measureof stress exposure.

Conclusions: A sensitive, quantitative, and robust
measure of chronic stress exposure can be constructed from gene expression data. The SSGE index
could reliably assess stress exposure across a wide
range of stress modalities. Gene expression indexes
may prove to be a useful adjunct to behavioral andhormonal measures of stress exposure since they are
relatively inexpensive to implement and many steps
can be automated to be scaled for large numbers ofanimals.

Methods: Male rats were exposed to one of six
different three-week long stress paradigms: social

22

13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Poor Responses to Intravenous Morphine Analgesia Predict
Opioid Addiction Vulnerability in Sprague-Dawley Rats
Authors

model. Adult male Sprague-Dawley rats with indwelling catheters in the jugular vein were screened
based on their analgesic responses to an IV bolus
morphine (2.5 mg/kg) using a hot plate test.

Affiliations

Results: Using a median split of hot plate data, theanimals were divided into 2 groups: Good Analgesia(GA) including top 50% and Poor Analgesia (PA)including bottom 50% of the animals. The animals
were allowed to self-administer either IV saline ormorphine (0.5 mg/kg/injection) 4 hours per day
for 15 days. Morphine self-administering animals
displayed reduced defecation, urination, and delayed body weight gain as compared to the saline
self-administering animals. Among the morphine
animals, acquisition of morphine self-administration(MSA) behavior was not different between the GA
and the PA group. However, the PA group escalated
morphine intake and exhibited a greater locomotor
activity during the maintenance phase of MSA, as
compared to those of the GA group.

Kevin S. Nishida, MS1,2, Thomas Y. Park, BA1,2, Bong
Hyo Lee, PhD3 , Robert J. Ursano, MD1,2,4 and Kwang
H. Choi, PhD1,2,4
1. Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University of Health Sciences, Bethesda, MD
2. Department of Psychiatry, Uniformed Services
University of the Health Sciences, Bethesda, MD
3. Department of Acupuncture, Moxibustion andAcupoint, College of Korean Medicine, Daegu
Haany University, South Korea
4. Program in Neuroscience, Uniformed Services
University of the Health Sciences, Bethesda, MD

ABSTRACT

Background: More than 110 Americans die every
day after overdosing on opioids and the misuse of
and addiction to opioids is a national crisis that costs$78 billion a year due to healthcare, lost productivity,
addiction treatment, and criminal justice involvement. Therefore, developing improved strategies forpain management and opioid addiction are urgently
needed.

Conclusion: The current results suggest that certain
individuals showing poor responses to opioid analgesia may be at increased risk of developing opioid
addiction after repeated use of opioids. Therefore
early identification and intervention of vulnerable
individuals to opioid addiction may improve thecurrent opioid crisis in the U.S.

Methods: We investigated association between responses to intravenous (IV) morphine analgesia anddevelopment of morphine addiction using a rodent

2313th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Fear Learning Deficits and Myelin-Related Structural Changes
in a Blast Model of Mild Traumatic Brain Injury (mTBI)
Authorslearning/extinction/retrieval/renewal or trace fear
conditioning tests. Two days after the behavior test,
we perfused and collected the brain tissues underdeep anesthesia, and performed RT-qPCR for glial/
myelin-related genes from several brain areas. Other
cohorts were perfused for immunohistochemicaland electron microscopy analyses.

Mio Nonaka, PhD , William W. Taylow , Olena
Bukalo, PhD1, Laura B. Tucker, MS2,3, Amanda H.
Fu, PhD2,3, Yeonho Kim, PhD2,3, Joseph T. McCabe,
PhD2,3, Andrew Holmes, PhD1,3
1,31Affilliation

1. National Institutes of Health, National Institute of
Alcohol Abuse and Alcoholism, Rockville, MD
2. Department of Anatomy, Physiology & Genetics,
Uniformed Services University of the Health
Sciences, Bethesda, MD
3. Center for Neuroscience and Regenerative
Medicine, Uniformed Services University of the
Health Sciences, Bethesda, MD

Results: Following single or repeated blast exposures, fear extinction learning and retrieval/renewal
were not markedly altered when tested at various
time points after the injury. However, in a trace fear
conditioning test, a form of associative leaning, blast
produced an impairment in the temporal organization of fear behavior in relation to the onset andoffset of the conditioned stimulus. RT-qPCR analysis for glial markers revealed altered expression of
myelin-related genes in the hippocampus 2-4 weeks
after blast and a more widespread effect 8 weeks after blast. Myelin basic protein staining and nodes ofRanvier marker staining by immunohistochemistry
supported these alterations at the protein level.

ABSTRACT

Background: PTSD and other psychiatric symptoms
are often comorbid with mild traumatic brain injury(mTBI). In military and civilian settings, some mTBI
results from exposure to blasts. We used a mouse
blast model to investigate whether emotional andcognitive effects are seen at acute and long-termtime points from the blast injury, detect structural
alterations of glial cells and myelin, and infer whichbrain region(s) are mostly affected.

Conclusions: We revealed learning deficits in both
single and repeated blast exposure. Moreover, wefound that the blast is affecting the myelin in specificbrain areas, viz., hippocampus and corpus callosum.
These observations suggest possible therapeutic
opportunities for blast injury.

Methods: We subjected cohorts of mice to one or
four blasts (once a day) and performed cued fear24

13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Family Risk Factors
for Child Neglect Types
Authors

Methods: Data were drawn from 390 case files ofsubstantiated child neglect in U.S. Army families.
Multivariate logistic regression was used to examine unique associations between each family factor
and elevated risk of each neglect type in models
with family demographic characteristics included ascovariates.

Christin M. Ogle, PhD , Jing Zhou, MS , Alexandra
L. Burris, BA1, Joscelyn E. Fisher, PhD1, Stephen J.
Cozza, MD1
1

1

Affiliations

1. Center for the Study of Traumatic Stress,
Uniformed Services University of the Health
Sciences, Bethesda, MD

Results: Approximately 73% of families reported
at least one of the 15 risk factors examined. Neglecttypes were associated with relatively distinct constellations of family risk factors. Family mental healthproblems and larger family size were associated withrisk of failure to provide physical needs, childcare
problems and larger family size were associatedwith risk of supervisory neglect, and family disagreements were associated with risk of emotional
neglect. None of the family factors were associatedwith elevated risk of moral-legal or educational
neglect.

ABSTRACT

Background: Child neglect is the type of childmaltreatment most commonly reported in the U.S.
and most frequently associated with child fatality.
However, neglect remains understudied compared toother types of child maltreatment. Although recent
empirical research suggests that neglect is a heterogeneous phenomenon characterized by distinct
types, the factors that increase the likelihood ofdifferent types of neglectful parenting are largely
unknown.

Conclusions: Findings provide evidence of family
factors differentially associated with elevated risk ofphysical, supervisory, and emotional neglect. Results
inform the development of targeted preventive interventions for families affected by different neglecttypes.

Objectives: To advance knowledge concerning risk
factors for specific types of child neglect, this study
examined family factors associated with five neglecttypes including failure to provide physical needs, lackof supervision, emotional neglect, moral-legal neglect,and educational neglect in substantiated cases ofchild neglect.

25

13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Post-Traumatic Stress Disorder in Female Service
Members and Veterans
Authors

the intervention participants completed a consent,
demographics form and pre-test to obtain baselineknowledge. After watching introductory slides andfive, three-minute videos from the National Center
for PTSD, participants completed a post-test, anevaluation of the videos, and a survey of intent toseek medical and/or mental health care.

Denise Proctor, BSN, MS, APN, CWOCN1, Kevin
Emmons, DrNP, RN, AGPCNP-BC, CWCN,DAPWCA1, Elizabeth Scannell-Desch, RN, PhD,
OCNS1

Affiliations

1. Rutgers School of Nursing, Camden, NJ

Results: Using SPSS Version 24, the dependent t-test
was calculated. The mean of the post-test 21.0, wassignificantly higher than the pre-test, 15.59, t(43) =-11.472, p = .000. Descriptive statistics were conducted for the survey of intent with 18 of the 44 participants indicating they would seek medical care; 19
indicating they would seek mental health care.

ABSTRACT

Background: The response to horrific events canlead to post-traumatic stress disorder (PTSD) (Eagle& Kaminer, 2015). As the number of women serving in the U.S. military increases, it is important todetermine what female veterans know about PTSD.
The purpose of this study was to determine if an educational program on the symptoms and treatment
of PTSD increases the knowledge level of female
veterans and encourages them to seek medical andmental health care.

Conclusions: After completing this educational program on PTSD, participants were able to define andrecognize symptoms of PTSD; discuss current typesof evidence-based treatments for PTSD; and indicate
willingness to seek medical and mental health care.
There was a statistically significant improvement in
the knowledge level of the participants following the
educational program.

Methods: Forty-four U.S. female reservists, Guardsmen, and veteran volunteers from a military base in
New Jersey participated in this quantitative pre-test/
post-test educational intervention study. Prior to26

13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Sub-Anesthetic Intravenous Ketamine Infusion Enhances Fear
Memory and Brain Glucose Metabolism (18f-Fdg Pet)in Sprague-Dawley Rats
Authors

Methods: We investigated the effects of different
doses of intravenous ketamine infusion on fear
memory and in vivo regional brain glucose metabolism (BGluM) in rats. Male Sprague-Dawley rats
received a sub-anesthetic ketamine infusion (0, 2, 10,
or 20 mg/kg, over 2 hours) either immediately afteror 1 day after auditory fear conditioning (3 tone andfootshock [0.6 mA, 1-sec] pairing). Fear memory
retrieval, extinction, and renewal were tested ondays 2, 3, and 4 post-fear conditioning and ketamine
infusion. The effects of ketamine infusion (0 and 10
mg/kg) and fear memory retrieval on BGluM were
measured using 18F-fluoro-deoxyglucose positronemission tomography (FDG PET) and computed
tomography (CT).

Kennett Radford, PhD, CRNA1, Thomas Park, BS2,3,
Shalini Jaiswal, MS4, Hongna Pan, MD4, Andrew
Knutsen, PhD4, Lisa Osborne-Smith, PhD, CRNA5,
Bernard Dardzinski, PhD4,6, Kwang Choi, PhD1-3

Affiliations

1. Daniel K. Inouye Graduate School of Nursing,
Uniformed Services University of the Health
Sciences, Bethesda, MD
2. Department of Psychiatry, Uniformed Services
University of the Health Sciences, Bethesda, MD
3. Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University of Health Sciences, Bethesda, MD
4. Center for Neuroscience and Regenerative
Medicine, Uniformed Services University of the
Health Sciences, Bethesda, MD
5. Nurse Anesthesia Program, Oregon Health andScience University, Portland, OR
6. Department of Radiology and Radiological
Sciences, Uniformed Services University of the
Health Sciences, Bethesda, MD

Results: The ketamine infusion, both immediately
after and 1 day after fear conditioning, dose dependently enhanced cued fear memory retrieval,delayed fear extinction, and enhanced contextual
and cued fear renewal in rats. The ketamine infusion(10 mg/kg) increased BGluM in the hippocampus,
amygdala, hypothalamus, and midbrain, while decreasing it in the cerebellum of rats.

ABSTRACT

Conclusion: The current findings suggest that
sub-anesthetic doses of ketamine infusion following traumatic events may enhance fear memory via
activation of brain regions that are critical for fearand stress.

Background: Ketamine is the most common battlefield analgesic administered to traumatically injured
service members in Afghanistan. However, theimpacts of peri-trauma ketamine administration on
the development of post-traumatic stress disorder(PTSD) are controversial and remain largely unknown. Moreover, there is a gap between pre-clinicaland clinical studies because they utilize different
doses and routes of ketamine administration.

27

13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Self-Reported Insomnia Symptoms Prior to a Simulated
Deployment Training Operation Robustly Predicts Post-Training
Posttraumatic Stress Symptoms in the Warfighter
Authors

Results: Group differences in TST were found between number of years served in the military, [pre:F (2, 355) = 3.91, p = .021; post: F (2, 309) = 3.35, p =.036] and rank type, [pre: F (3, 375) = 2.75, p = .042;
post: F (3, 325) = 5.59, p < .001.] ISI items indicatedsubthreshold insomnia at pre-training (M = 8.33 ±3.72) and post-training (M = 8.35 ± 3.84). Soldiers
had significantly less PTSS pre-training comparedto post-training, t (346) = -5.07, p < .001. Groupdifferences in PTSS were found in rank type, [post:t (67.68) = -2.24, p = .028], and in number of years
served in the military [pre: F (2, 356) = 4.39, p =.013; post: F (2, 306) = 3.10, p = .047]. Multiple linear
regression models showed pre-training ISI items and
TST both individually and synergistically predicted post-training PTSS. However, the final model
determined to best fit the data contained only ISI asa significant predictor of PTSS, β = .35, p = .001 andexplained 44.2% of model variance, R2 = .20, F (1, 55)= 13.35, p = .001.

Maria E. St. Pierre, MA1, Lillian Skeiky, BS1, Jake J.
Choynowski, BS1, Julie Merrill, MA2, Walter Sowden,
PhD1, and Ashlee A. McKeon, PhD 1

Affiliations

1. Walter Reed Army Institute of Research, Silver
Spring, MD
2. U.S. Army Medical Research Directorate-West,
Tacoma, WA

ABSTRACT

Background: This study investigated the relationships between self-reported sleep quality and posttraumatic stress symptoms (PTSS) in a large military
unit prior to and immediately following a simulated
deployment training operation.
Methods: 427 US Army Soldiers (24.9 y/o ± 5.57;
89% male) self-reported on Insomnia Severity Index(ISI) items, total sleep time(TST) extracted fromthe Pittsburgh Sleep Quality Index (PSQI), and
the Posttraumatic Stress Disorder Checklist-Military Version, four-item version (PCL-4) pre- andpost-training.

Conclusion: This study is one of the first of its kindshowing military-related factors help to characterize
and predict sleep quality and PTSS in Soldiers. Future research will test the effectiveness of sleep-related interventions for reducing PTSS risk in Soldiers.

28

13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Neurophysiology of Anger in PTSD

AuthorResults:
1. θ MeA evokes behaviorally evinced anger in therat, but not violence.
n During this anger, synaptic transmission from
MeA to HC and Pyr, but not LS, is enhanced,
200% to HC, 100% to Pyr.
n No enhancement was recorded during vigilanceor chases.

Stanley Smerin, PhD1, He Li, MD, PhD1

Affiliations

1. Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University of the Health Sciences, Bethesda, MD

ABSTRACT

2. LFO in HC, LS, Pyr:n Varies between 7 Hz and 8Hz theta at rest.
n Complex waves lasting a few seconds appear
during vigilance, chase, and anger. These waves
are an order of magnitude greater in amplitude
than the baseline theta, and composed of the fullrange of frequencies - delta, theta, alpha, beta,
gamma.
n Ongoing analysis is determining which
components of the LFO in each structure arecorrelated with which behavior or behaviorally
evinced emotion.

Background: Traumatic stress in PTSD patients maylead to explosive anger, but not necessarily violence.
To help target interventions to reduce anger prior to
becoming violence, the research herein is directed atneurophysiology of anger per sé.
Methods: A rodent model of anger is developedin which theta-frequency electrical stimulation inmedial amygdala of a resident rat (“θ MeA”) results in the resident pushing, pining, and putting its
mouth to the throat of the intruder — that is, being
angry — but not biting the intruder, which is being
violent. Using implanted electrodes, (1) magnitudeof evoked synaptic transmission and (2) frequencyof local field oscillation (LFO or EEG) are measured
in medial amygdala (MeA), hippocampus (HC),pyriform cortex (Pyr), and lateral septum (LS):Conclusions: Whereas anger is a state-of-mind described by humans, its animal equivalents can only
be inferred. Regardless, that this state is distinct fromviolence in a rat model suggests there may be targets
specific for anger intervention.

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13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Association of N-Acetylaspartate Concentration in Anterior
Cingulate and Amygdala with Treatment Response to Riluzole
Augmentation for Posttraumatic Stress Disorder
Authors

Methods: Thirty-two OEF/OIF/OND veterans, aged
18 to 65 at Walter Reed National Military Medical
Center with suboptimal response to SSRI or SNRI
treatment for PTSD were randomized to augmentation with riluzole or placebo for 8 weeks. 1H-MRS
acquisition was performed on a 3.0 Tesla GE750,
targeting a 20x20x20cm voxel in midline ACC anda 15x12x12cm voxel in right amygdala. We assessed
pre-to-post-treatment NAA/Cr ratios and absolute
NAA concentrations. We hypothesized that (1)NAA/Cr ratios and absolute NAA concentration in
the amygdala and ACC would increase after 8-weektreatment with riluzole.

Patricia T. Spangler, PhD1, Jason Cole1, James C.
West, MD1, Catherine L. Dempsey, PhD, MPH1,
Brian Andrews-Shigaki, PhD2, Gail H. Kohls3,
Andrea Gould, BA1, Mark Jimerson, BA1, David M.
Benedek, MD1

Affiliations

1. Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University of Health Sciences, Bethesda, MD
2. Office of Naval Research, Arlington, VA
3. Walter Reed National Military Medical Center,
Bethesda, MD

Results: 1H-MRS imaging results will indicate
whether there was a significant difference in response to riluzole versus placebo as measured bychanges in pre- to post-treatment NAA/Cr ratios
and absolute NAA concentration in the anterior
cingulate and amygdala.

ABSTRACT

Background: Drugs that alter neuronal survival
pathways through reduction of glutamate activity
may play a role in reversing the loss of neuronal
integrity and possible focal atrophy in regions of
the brain implicated in the pathophysiology of
posttraumatic stress disorder (PTSD). Riluzole is a
glutamatergic modulator with demonstrated antidepressant and anxiolytic properties. Proton magnetic
resonance spectroscopy (1H MRS) studies using
N-acetylaspartate-to-creatine (NAA/Cr) ratios havefound reduced NAA/Cr ratios in the hippocampus
and anterior cingulate (ACC) of PTSD patients. Thisrandomized controlled trial evaluated the efficacy ofacute riluzole augmentation treatment in veteranswith PTSD, with or without mild traumatic brain injury, who were suboptimally responsive to trial withan SSRI or SNRI.

Conclusions: 1H-MRS imaging results may provide
evidence of riluzole’s efficacy in increasing neuronalhealth in the ACC and amygdala as evidenced bychanges in pre- to post-treatment NAA/Cr ratios
in the ROIs. This indicator of neuronal integrity inthe areas of interest may serve as a biomarker fortreatment response.

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13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Daily Influence of Sleep Duration on Post Traumatic Stress
Symptoms in Individuals with and without
Post Traumatic Stress Disorder
Authors0-180). Sleep duration was assessed daily, and partitioned into overall (person mean) and daily (difference between hours of sleep during the previous
night and person mean). Linear mixed models were
used.

Jing Wang, PhD1, Robert J. Ursano, MD1, Quinn M.
Biggs, PhD, MPH1, David S. Krantz, PhD1, Russell
B. Carr, MD2, Gary H. Wynn, MD1, Deborah Probe,
MA1, Nicole M. Dacuyan, BS1, and Carol S. Fullerton,
PhD1

Results: Preliminary results indicate that amongindividuals with PTSD, there was a negative association between daily sleep duration and PTSS. One
more hour of sleep than usual was associated with adecrease of 1.23 in PTSS the following day. Amongindividuals without PTSD, overall sleep duration
was negatively associated with PTSS, but PTSS did
not vary by sleep duration on a daily basis.

Affiliations

1. Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University of the Health Sciences, Bethesda, MD
2. Walter Reed National Military Medical Center,
Bethesda, MD

ABSTRACT

Conclusions: These first preliminary findings support the possibility that sleeping longer is a means
to reduce PTSS in individuals with PTSD. Assessing
and monitoring changes in sleep and PTSS acrosstime may therefore lead to a better understanding ofindividual sleep patterns and their effect on PTSS.

Background: This study examined the daily association between PTSS and sleep duration in individuals
with and without PTSD.
Methods: Subjects (N = 80) were assessed forprobable PTSD at enrollment (n = 42 with PTSD, n= 38 without PTSD). Using an ecological momentary assessment methodology, PTSS were assessed
four times daily by self-report for 15 days (range =31

13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Genetic Association of FKBP5 with PTSD throughMitochondrial Dysfunction
Authors

Methods and Results: Samples (n=3890) werecollected from US Army service members between
2008 and 2016. PTSD symptoms were assessed using
the PTSD Checklist (PCL). All study procedures
were approved by the Institutional Review Board
at USUHS and all participants were given written
informed consent. We first demonstrate that four
single-nucleotide polymorphisms (SNPs, rs3800373,
rs9296158, rs1360780, rs9470080) covering the
FKBP5 gene are associated with lifetime PTSD in
soldiers, using genotyping. An up-regulated FKBP5
protein and increased cortisol levels were also observed in soldiers with PTSD using enzyme-linked
immunosorbent assay. Accordingly, treatment of
SH-SY5Y cells with dexamethasone (Dex), which
resembles the traumatic condition in vitro, led toa FKBP5 mitochondrial redistribution and subsequent changes in mitochondrial membrane potential(ΔΨm) and mitochondria reactive oxygen species(mROS). The FKBP5 inhibitor FK506 pharmacologically attenuated these effects of Dex, indicating thatFKBP5 is necessary for the regulation of mitochondrial function. Further studies found that FKBP5
co-localizes with the mitochondria in leukocytesof PTSD subjects. In addition, we found significant
down-regulation of mitochondrial complexes I, II
and III in PTSD compared to non-PTSD controls,
supporting our finding of possible mitochondrial
dysfunction in this disorder.

Lei Zhang, MD1, Xian-Zhang Hu, MD, PhD1,
Tianzheng Yu, MD2, Jacob Dohl, BS2, Xiaoxia Li, BS1,
David M. Benedek, MD1, Carol S. Fullerton, PhD1,
Gary H. Wynn, MD1, Dragan Meric, PhD3, James E.
Barrett, PhD4, Mian Li, MD5, Dale W. Russell, PhD1,2,
Jeffery L. Barker, MD3, and Robert J. Ursano MD1

Affiliations

1. Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University of the Health Sciences, Bethesda, MD
2. Consortium for Health and Military
Performance, Department of Military andEmergency Medicine, Uniformed Services
University of the Health Sciences, Bethesda, MD
3. National Institute of Neurological Disorders andStroke, National Institutes of Health, Bethesda,
MD
4. Department of Neurology, Drexel University
College of Medicine, Philadelphia, PA
5. Department of Neurology, Washington VA DC
Medical Center, Washington, DC

ABSTRACT

Background: Post-traumatic stress disorder (PTSD)
is a debilitating mental disorder with prevalence
rates of more than 7% in the US population1 and
12% in the military.2 FKBP5, a glucocorticoid-regulated immunophilin, is thought to be associated with
PTSD. However, the underlying mechanisms are
unknown.

Conclusions: Our study provides new insight into amechanism of FKBP5 in PTSD. Specifically, FKBP5
is associated with PTSD through its mitochondrial
redistribution leading to mitochondrial dysfunction
during stress and therefore represents a promisingtreatment target.

Objectives: We use both in vivo and in vitro methods to study the association of FKBP5 with PTSD ina high-risk military population.
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13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Continuing Education Credit
Continuing Education made possible in part by thegenerous support of the Center for Deployment Psychology.

The Amygdala, Stress, and PTSD Conference,in conjunction with the Center for Deployment
Psychology at the Uniformed Services University
is pleased to offer up to 4.75 continuing educationcredits for Physicians, Psychologists, Social Workers,
and Nurses. The credits are available through live inperson attendance and as a webinar.

Please visit us at www.CSTSonline.org
Follow us on Twitter and like us on Facebook and receive notices when we add content.
www.twitter.com/CSTS_USU | www.facebook.com/USU.CSTS

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13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Notes

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13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Notes

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13th Annual Amygdala, Stress and PTSD Conference: The Sequela of Trauma

Center for the Study of Traumatic Stress
Department of Psychiatry
Uniformed Services University
4301 Jones Bridge Road, Bethesda, MD 20814-4799
www.CSTSonline.org
36