UNIFORMEDSERVICES
UNIVERSITY
14th Annual Amygdala,Stress, and
PTSD Conference:
Risk, Resilience, and Recovery
Center for the Study of Traumatic Stress

PROGRAM
14th Annual Amygdala, Stress, and PTSD
Conference: Risk, Resilience, and Recovery
APRIL 16, 2019
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
and clinicians 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

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

214th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

UNIFORMED SERVICES UNIVERSITY
Center for the Study of Traumatic Stress14th Annual Amygdala, Stress, and PTSD
Conference: Risk, Resilience, and Recovery
APRIL 16, 2019
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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14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

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 14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, andRecovery.
The Amygdala, Stress, and PTSD Conference at the Uniformed Services University
brings together scientists and clinicians working towards solving the biological basis ofstress, fear, and posttraumatic stress disorder.

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14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Table of Contents
Agenda............................................................................................................................. 3
Conference Speakers...................................................................................................... 4Moderators...................................................................................................................... 7
Conference Leadership.................................................................................................. 8
Conference Committee............................................................................................... 10
Conference Posters....................................................................................................... 11
Continuing Education Credit..................................................................................... 40

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14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

214th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

AGENDA
0800-0900

Registration and Poster Review

0900-0905

Conference Announcements — Derrick A. Hamaoka, MD

0905-0915

Welcome and Introduction — Robert J. Ursano, MD

0915-1000

Wake up to Sleep! A Translational Perspective of the Role of Sleep in Readiness and 				Resilience — Anne Germain, PhD
1000-1045

Resilience: The Science of Mastering Life’s Greatest Challenges — Dennis S. Charney, MD

1045-1115

Coffee Break and Poster Review in Lobby

1115-1145

Discussion Panel 1 — Moderator — COL Christopher H. Warner

1145-1245

Lunch

1245-1330

Gene-activity and Proteins that Relate to Chronic PTSD Symptoms

					— Jessica M. Gill, PhD, RN
1330-1415

Mobilizing Hope in the Face of Despair: Applying Social Neuroscience Research in 				

Brief Clinical Encounters — James L. Griffith, MD

1415-1445

Coffee Break and Poster Review in Lobby

1445-1530

Preclinical Development of Ketamine and the Metabolite 2R,6R-Hydroxynorketamine 				for Depression and Other Disorders — Irwin Lucki, PhD

1530-1600

Discussion Panel 2 — Moderator — COL Wendi Waits

1600-1615

Closing Remarks and Presentation of Travel Award — Robert J. Ursano, MD

314th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Conference Speakers
Dennis S. Charney, MD

Anne Germain, PhD

Dennis S. Charney, MD, isAnne and Joel Ehrenkranz
Dean of the Icahn School of
Medicine at Mount Sinai and
President for Academic Affairs
for the Mount Sinai Health
System. Dr. Charney is a world
expert in the neurobiology
and treatment of mood andanxiety disorders, making
fundamental contributions to the understanding of
the causes of human anxiety, fear, and depression, andthe discovery of new treatment for mood and anxiety
disorders. His research on depression has led to discovery of new and novel therapies for treatment resistantdepression including Ketamine and the first digitaltreatment for depression (EFMT). He has been honoredwith all of the major awards in his field for his scientificresearch, including World’s Most Influential Scientific
Minds 2014 and 2015, Ranked 48 out of 1,360 of Most
Highly Cited Life Science Researchers in the World.
His discovery of Ketamine for Treatment-Resistant
Depression was named by Cleveland Clinic on its Top
10 list of 2017 Health Care Innovations. He holds 3 U.S.
Patents, and 19 U.S. and Foreign Patent Applications, 10of which are licensed to 2 companies. He has published
785 articles and book chapters, and 16 books, including Resilience: The Science of Mastering Life’s Greatest
Challenges, and Charney & Nestler’s Neurobiology of
Mental Illness 5th Edition. Charney was elected to the
National Academy of Medicine in 2000, and the National Academy of Inventors in 2017.

Dr. Anne Germain is Professorof Psychiatry at the University of Pittsburgh School of
Medicine at Western Psychiatric Institute and Clinic, andis Director of the University ofPittsburgh Sleep and Behavioral Neuroscience Center. She is
Director of Military Sleep Tactics of Resilience Research Team. At the University ofPittsburgh, Dr. Germain also holds secondary appointments in Psychology, and in Clinical and Translational
Science.
Dr. Germain received a Bachelor of Science in psychology from McGill University in 1996, and completed
her Ph.D. in Clinical Psychology from the Université deMontréal in 2001. She then pursued post-doctoral training in clinical sleep research and sleep neuroimaging at
the University of Pittsburgh, and joined the Faculty in
the Department of Psychiatry in 2005.
Dr. Germain’s research program has two mainareas of interest. A first area of interest focuses on theneural underpinnings and effects of acute sleep loss
and chronic sleep disturbances occurring in the context
of stress-related psychiatric disorders, with a special
emphasis on posttraumatic stress disorder (PTSD)
in military populations. To accomplish this, she uses
multimodal sleep measurement methods including
self-report measures, actigraphy and polysomnography,
quantitative EEG, pharmacological probes, sleep neuroimaging techniques, as well as novel animal models.
A second area of interest focuses on the development,
adaptation, testing, and implementation of treatments
targeting trauma-related sleep disturbances to enhance
psychological resilience and to hasten recovery fromtrauma exposure.
Dr. Germain has published over 120 peer-reviewed
articles, and recently co-edited a book entitled, Sleep
and Combat-Related PTSD (Spinger, 2018). She is also
the author of 25 book chapters and invited papers on insomnia, nightmares, treatments of sleep disorders, andsleep in the context of PTSD and other trauma-relateddisorders. Her h-index is 36. She has served on various
committees of the Sleep Research Society and Ameri-414th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Conference Speakers. Continued

Jessica M. Gill, PhD, RN
can Academy of Sleep Medicine. She currently serveson the Editorial Board of the journal Behavioral Sleep
Medicine, and is a regular peer reviewer for specialized journals on sleep, trauma, and psychiatry. She hasserved and continues to serve on various study sections
for the Department of Defense, the NIH, the Canadian
Institutes of Health Research, and the Department of
Veterans Affairs.

Dr. Gill is a tenure track
investigator at the National
Institutes of Health (NIH)
and co-director of thebiomarkers core for theCenter for Neurosciences
and Regenerative Medicine,
Dr. Gill has an establishedclinical and laboratory
infrastructure to examine
the biological mechanismsof traumatic brain injury (TBI), and related comorbidities including posttraumatic stress disorder (PTSD),
post-concussive disorder (PCD), depression and neurological deficits.
Current projects include a project coordinatedwith Madigan Army Medical Center. Findings include
alterations in tau and amyloid beta in acute and chronic
TBI patients using the SIMOA system and alterations insleep regulatory proteins and the activity of genes that
regulate sleep in patients with brain injuries. Other collaborations include analyses of epigenetic modificationsin athletes with repeated TBIs. Dr. Gill plans to use boththe insights and infrastructure from current projects toinitiate this novel project to address the critical issue ofthe molecular mechanisms of TBI-related symptoms inpatients with repeated injuries, and the role of sleep inthese biomarkers and patient outcomes. The project is
expected to initiate a program of research that will identify novel interventions to treat TBI related impairments
to address this critical issue in patients with TBIs.

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14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Conference Speakers. Continued

James L. Griffith, MD

Irwin Lucki, PhD

James L. Griffith, M.D. is theLeon M. Yochelson Professor
and Chair in the Departmentof Psychiatry and Behavioral
Sciences at the George Washington University School of
Medicine and Health Sciences. As a psychiatric educator,
Dr. Griffith has developed
treatment methods that use
cognitive and social science research to mobilize hope,strengthen resilience, and reduce stigmatization and social exclusion, reducing suffering and promoting mental
health more effectively. Dr. Griffith has published extensively on family-centered treatment of psychosomatic
disorders and chronic medical illnesses, including abook, The Body Speaks: Therapeutic Dialogues for MindBody Problems. His most recent book, Religion that
Heals, Religion that Harms, addressed destructive usesof religion and ideology in clinical settings and received
the Creative Scholarship Award from the Society for the
Study of Psychiatry and Culture.
Dr. Griffith provides psychiatric care for immigrants, refugees, and survivors of political torture at
Northern Virginia Family Services in Falls Church, VA.
He has received the Human Rights Community Award
from the United Nations Association of the National
Capital Area and the Margaret B. and Cyril A. Schulman Distinguished Service Award from the George
Washington University Medical Center, both for the
training of mental health professionals and development of mental health services for survivors of political
torture. He has received the Distinguished TeacherAward from the George Washington University Schoolof Medicine and the 2003 Psychiatrist of the Year and2014 Distinguished Service Award from the Washington Psychiatric Society. He was the 2017 recipient of
the Oskar Pfister Award from the American Psychiatric
Association for his contributions to the field of religion
and psychiatry.

Irwin Lucki, Ph.D. is Chair of
the Department of Pharmacology & Molecular Therapeutics
at the Uniformed Services
University of the Health
Sciences (USUHS). Dr. Lucki
received his Ph.D. (Biopsychology) from the Universityof Iowa in 1979. He conducted postdoctoral research inpsychopharmacology at the
University of Pennsylvania in 1979-1982 before joining
the faculty in 1984 as a researcher, an educator and Program Director of an NIMH predoctoral and postdoctoral training grant. He joined USUHS in 2016 as Professorof Pharmacology and Psychiatry.
The major focus of Dr. Lucki’s research is the investigation of neural mechanisms underlying the behavioral effects of psychiatric medications and translation toclinical development. His laboratory develops new therapeutic approaches for treating depression and anxiety
disorders based on studies involving relevant animalmodels and neurochemistry. Dr. Lucki started his careerby studying the behavioral and physiological functionsof different serotonin receptors and their relationship tothe effects of SSRIs, eventually directing an NIMH Program Project Grant. Dr. Lucki also directed an NIMH
Center grant on drug discovery in collaboration withindustry partners. His research led to the developmentof vilazodone as an FDA-approved clinical antidepressant. He is currently investigating opioid receptor antagonists and ketamine and its metabolites for the rapid
treatment of depression and other disorders. He has also
conducted clinical pharmacology research studies withpsychiatric patients and normal volunteers. Dr. Lucki isauthor of over 180 peer-reviewed publications and 40
reviews. Among awards for his research, he received theYoung Psychopharmacologist Award from the American Psychological Association (1984) and the Distinguished Investigator Award from NARSAD (2005). Dr.
Lucki is a Principal Editor for Psychopharmacology, andon the Editorial Boards for Neuropsychopharmacology, Journal of Psychopharmacology and Neurobiology ofStress. Dr. Lucki is a fellow of the American College of
Neuropsychopharmacology (ACNP) and the American
Psychological Association (APA).

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14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Moderators
Colonel Wendi Waits
Colonel Wendi Waits was bornin Portland, Oregon, and calls
Oregon and California home.
She received her bachelor’s degree and commission from theUnited States Military Academy in 1994. She received her
doctorate in medicine fromthe Uniformed Services University of the Health Sciences(USUHS) in 1998 and completed a psychiatry residency
at the National Capital Consortium (NCC) in 2002.
Her military assignments have included the following: 2ID Division Psychiatrist, Camp Casey, Korea;
Assistant Chief and subsequently Chief of Inpatient Psychiatry, Tripler Army Medical Center (TAMC), Honolulu, HI; Chief of Behavioral Health Services, Schofield
Barracks, Hawaii; Director for Behavioral Health, Fort
Belvoir Community Hospital (FBCH), Fort Belvoir, VA;
and Chief of Adolescent Inpatient Behavioral Health,
FBCH. COL Waits has served as the Director for Behavioral Health, Walter Reed National Military Medical
Center (WRNNMC), since July 2018.
Colonel Waits deployed to Iraq in 2006, where
she served as Fitness Section Leader, 1972nd Combat
Operational Stress Control (COSC) detachment, andto Afghanistan in 2010, where she served as Clinical

Operations (CLINOPS) OIC, 254th COSC detachment.
She has supervised interns, residents, and other trainees
as a member of the academic faculty at TAMC, Schofield Barracks, FBCH, and WRNNMC and has been an
examiner for the American Board of Psychiatry and
Neurology. COL Waits is a Clinical Associate Professorof Psychiatry at USUHS, a Distinguished Fellow of theAmerican Psychiatric Association, a member of theOrder of Military Medical Merit, and a recipient of the
MEDCOM “A” Designator.
Colonel Waits’ military education includes the
AMEDD Officer Basic Course, the AMEDD Officer
Advanced Course, and the Command and General Staff
College Intermediate Level Education core course. Herawards and decorations include the Defense Meritorious Service Medal (1 award), Meritorious Service Medal(3 awards), Joint Service Commendation Medal (1award), Army Commendation Medal (4 awards), Joint
Service Achievement Medal (1 award), Army Achievement Medal (3 awards), National Defense Service
Medal (1 service star), Global War on Terrorism Service
Medal, Iraq Campaign Medal, Afghanistan Campaign
Medal, Korean Defense Service Medal, Overseas Service Ribbon (5 awards), and the North Atlantic Treaty
Organization Medal. Her badges include the Air Assault
Badge and the Army Physical Fitness Badge.

Colonel Christopher H. Warner

functional Medical Battalion at Fort Hood, Texas. He
served as the Consultant to The US Army Surgeon General for Psychiatry from 2012 to 2018. COL Warner has
deployed twice in support of Operation Iraqi Freedom,
where he was noted for his efforts in pushing behavioral
health care forward to maneuver units and was nameda recipient of the 2006 Surgeon General’s Physician
Recognition Award. COL Warner has published two
books on military mental health and primary authoredmore than forty articles including recent entries in
the American Journal of Psychiatry, the Annals of Psychiatry, and Lancet. His service and achievement have led
to his selection to the Order of Military Medical Meritand the Army A Designator. Additionally, COL Warneris on the editorial board of Academic Psychiatry and theAmerican College of Psychiatrists.

Christopher H. Warner, COL,
MC, USA, FAPA, FAAFP
COL Warner is currently aStudent and Class President
at the National War College
in Washington, DC. He is a
graduate of the U.S. Military
Academy and Uniformed
Services University of the
Health Sciences. He completed
his residency training in Family Practice and Psychiatry at Walter Reed Army Medical Center where he wasnamed the General Graves B. Erskine Award winner.
COL Warner has commanded Winn Army Community
Hospital at Fort Stewart, Georgia and the 61st Multi-

714th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Conference Leadership
Derrick A. Hamaoka, MD

Robert J. Ursano, MD

Col (Dr.) Derrick A. Hamaoka
serves as the Assistant Chair,
Medical Education, for the
Uniformed Services Universityof the Health Sciences Department of Psychiatry. In thiscapacity, he oversees the entire
psychiatry education portfolio for the medical school to
include the preclinical, clinical,
and advanced clinical rotations as well as the combat/
operational psychiatry component for the medical
school’s field exercise, OPERATION BUSHMASTER.
Col Hamaoka is a graduate of the Uniformed Services
University of the Health Sciences School of Medicine(1999) and the University of Texas Health Science
Center Psychiatry Residency Program (2003). Prior toserving in his current position, he was the Associate
Program Director, University of Texas Health San Antonio Psychiatry Residency Program, leading one of thelargest programs in the nation and responsible for the
majority of the active 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 and subject 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.

Dr. Ursano is Professor of
Psychiatry and Neuroscienceat the Uniformed Services
University of the Health Sciences, Bethesda, Maryland andDirector of the Center for the
Study of Traumatic Stress. He
served as Chairman of the Department of Psychiatry at USU
for 25 years. In addition, Dr.
Ursano is Editor of Psychiatry, the distinguished journalof interpersonal and biological processes, founded byHarry Stack Sullivan. Dr. Ursano completed twenty
years of service in USAF medical corps and retired as
Colonel in 1991. He was educated at the University ofNotre Dame and Yale University School of Medicine
and did his psychiatric training 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 Institute of Mental Healthand is a past member of the Veterans Affairs Mental Health Study Section and the National Instituteof Mental Health Rapid Trauma and Disaster Grant
Review Section. He is a Distinguished Life Fellow in theAmerican Psychiatric Association and a Fellow of theAmerican College of Psychiatrists. Dr. Ursano was thefirst Chairman of the American Psychiatric Association’s Committee on Psychiatric Dimensions of Disaster.
This work greatly aided the integration of psychiatry
and public health in times of disaster and terrorism. Dr.
Ursano was an invited participant to the White House
Mental Health Conference in 1999. He has received theDepartment of Defense Humanitarian Service Award,
the Lifetime Achievement Award of the International
Society for Traumatic Stress Studies, and the American
Psychiatric Association’s Bruno Lima Award in Disaster
Psychiatry. He is the recipient of the William C. Porter
Continued on page 98

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Robert J. Ursano, MD, Continued
Award from the Association of Military Surgeons of
the United States, the William Menninger Award of theAmerican College of Physicians and the James Leonard
Award of the Uniformed Services University. He is afrequent advisor on issues surrounding psychologicalresponse 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 the University of California, San Diego,
the Army STARRS and STARRS-LS grants will be the
Framingham Study of suicidal behavior, and address anational as well as DoD mental health need. In 2014,
Dr. Ursano and Dr. Matthew Friedman of the VA National Center for PTSD co-founded the Friedman-Leahy Brain Bank supported through Senator Patrick Leahy(D-VT). It is the first human brain bank dedicated to
PTSD. This joint effort of many people was a 12 year
project developing concepts, pilot data and support. Dr.
Ursano has over 300 publications and is co-author or
editor of eight books.

914th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Conference Committee
Derrick A. Hamaoka, MD, 2019 Chairman
Col, USAF, MC, FS
Assistant Chair and Associate Professor
Department of Psychiatry
Scientist
Center for the Study of Traumatic Stress
Uniformed Services University of the Health Sciences

James A. Naifeh, PhD
Research Assistant Professor
Department of Psychiatry
Scientist
Center for the Study of Traumatic Stress
Uniformed Services University of the Health Sciences
Holly H. Mash, PhD
Research Assistant Professor
Department of Psychiatry
Scientist
Center for the Study of Traumatic Stress
Uniformed Services University of the Health Sciences

David Mears, PhD, 2019 Co-Chairman
Associate Professor
Department of Anatomy, Physiology, and Genetics
Uniformed Services University of the Health Sciences
Gary H. Wynn, MD, 2019 Scientific Co-Chairman
LTC, MC, USA
Assistant Chair and Professor
Department of Psychiatry
Scientist
Center for the Study of Traumatic Stress
Uniformed Services University of the Health Sciences

Ioana M. Horotan-Enescu, MD
Resident, PGY-3
NCC Psychiatry Residency Program
Walter Reed National Military Medical Center
Amy E. Steward, TSgt, USAF
Center 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

Katherine Pokorny, BA
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
Eric Meyer, MD, 2019 CME Chair
Maj, USAF, MC
Assistant 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 M. Jackson Foundation for the Advancement ofMilitary Medicine
Thank you to the Henry M. Jackson Foundation for
their kind support for the reception.

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14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Conference Posters
Presented in the Lobby
Impact of the Previous Night’s Sleep Disturbances on Post Traumatic Stress Symptoms
among Individuals With and Without PTSD.............................................................. 13
Incidence Rates of Posttraumatic Stress Disorder in the US Military(2007-2015): Trends Across Military-Specific Variables............................................ 14
Risk and Resilience of Lifetime Stressful Experiences among U.S. Army Soldiers
at Risk for Suicide.....................................................................................................................................15
Inflammatory Cytokines and Cardiovascular Disease are Associatedwith Neuroimaging Findings after Acute Mild Traumatic Brain Injury.................. 16
Elevated Tau Relates to Persistent PTSD, Depression and Post-Concussive
Symptoms in Military Personnel with History of Traumatic Brain Injury.............. 17
Prevalence of Medical Conditions and Healthcare Utilization in Treatment-Seeking,Bereaved Military Widows: A Prospective, Case-Controlled,
Longitudinal Study.......................................................................................................... 18
The Impact of Child Health on Parental PTSD................................................................... 19
Whole-Genome Sequencing of 1,688 Veteran Twins to Detect Risk andMeasure Rare Variation Associated with Major Depressive Disorder .................... 20
Antidepressant Activity of the Selective Kappa Opioid Receptor Antagonist JNJ67953964 in Mice ........................................................................................................... 21
Safety and Confidence in Law Enforcement During Terrorist-Related Events:
Association with Daily Life Activities........................................................................... 22
Effect of Prior Hurricane Experience on Preparedness in Florida Department
of Health Workers........................................................................................................... 23
The 3 Predator Exposure Model as a Robust Animal Model of Traumatic Stress.......... 24
Does Damage to the Medial Frontal Gyrus in Chronic Mild TBI Patients
Affect Post Traumatic Stress Symptoms?..................................................................... 25
Longitudinal Changes in Children’s Mental Health and Physical Injury
Rates Following Father Death ....................................................................................... 26
Influence Of Attentional Bias on Scanpaths In Posttraumatic Stress Disorder:
Assessment of Vigiliance-Avoidance Scanning Patterns During Visual Search
Paradigm.......................................................................................................................... 27
Continued
1114th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Mild Traumatic Brain Injury with Concurrent PTSD is Associatedwith Peripheral Tau Concentrations............................................................................. 28
The Relationship of PTSD to Anxiety and Depression: An Examination of theModerating Effect of Sleep Quality and Nightmares.................................................. 29
A Population Study of Incidence Rates of Posttraumatic Stress Disorder in the US
Military (2007-2015): Analysis of Age, Sex, and Marital Status................................ 30
Sex-related Differences of Intravenous Ketamine Infusion on StressHormone and Fear Memory in Rats............................................................................. 31
Gene Expression Differences in PTSD Are Uniquely Related to the Intrusion
Symptom Cluster: A Transcriptome-Wide Analysis in MilitaryService Members............................................................................................................. 32
Nightmare Deconstruction and Reprocessing: Proof of Concept of a Novel
Treatment for PTSD-Related Nightmares and Insomnia.......................................... 33
Region- and Time-Dependent Gene Regulation in the Amygdala andAnterior Cingulate Cortex of a PTSD-Like Mouse Model........................................ 34
The Effects of Comorbid TBI and PTSD Symptoms among U.S. Active Duty Service
Members on an Objective Cognitive Performance Measure..................................... 35
Fear Memory Extinction is Blocked In Rats Following Acute Glial Cell Inhibition:
Implications for Targeting Neuroinflammation in Traumatic Stress Exposure...... 36
Sex Differences in Cued Fear Responses and Parvalbumin Cell Density in the
Hippocampus Following Repetitive Concussive Brain
Injuries in C57BL/6J Mice.............................................................................................. 37
Influence of Number of Awakenings during the Previous 1-3 Nights on
Post Traumatic Stress Symptoms Among Individuals with PTSD........................... 38
Sex-Related Differences of Mitochondrial DNA Copy Number in
Active Military Service Members with PTSD............................................................. 39

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14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Impact of the Previous Night’s Sleep Disturbances on Post
Traumatic Stress Symptoms among IndividualsWith and Without PTSD
Authors

Nine items from the Pittsburgh Sleep Quality Index(PSQI) were adapted to measure sleep disturbances.
Linear mixed models with control for demographic
characteristics were applied to examine the association between sleep disturbances and PTSS. An interaction of sleep disturbances by PTSD group tested
whether the association differed between individuals
with and without PTSD.

Quinn M. Biggs, Ph.D., M.P.H., Robert J. Ursano,
M.D.,1 Jing Wang, Ph.D.,1 Gary H. Wynn, M.D.,1 David S. Krantz, Ph.D., 1 Russell B. Carr, M.D.,1,2 Nicole
M. Dacuyan, B.S.,1 Katherine Pokorny, B.A.,1 Ametisse Gover-Chamlou, B.A.,1 Samantha Martinez,
B.A.,1 and Carol S. Fullerton, Ph.D.1
1

Author Affiliations

Results: There was a significant interaction of previous night’s sleep disturbances and PTSD group. In
both groups, sleep disturbances were positively associated with PTSS. Among individuals with probable
PTSD (n = 42), one more sleep disturbance during
the previous night was associated with a 3.75 increase in PTSS the following day (p < .001). Amongindividuals without probable PTSD (n = 38), one
more sleep disturbance during previous night was
associated with a 1.65 increase in PTSS the following
day (p = .001).

1. Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University of the Health Sciences, 4301 Jones
Bridge Road, Bethesda, MD 20814
2. Walter Reed National Military Medical Center,
8901 Wisconsin Avenue, Bethesda, MD 20889

ABSTRACT

Background: Sleep problems and Post TraumaticStress Disorder (PTSD) are highly related, but it is
not known whether sleep problems affect Post Traumatic Stress Symptoms (PTSS) on a daily basis. This
study examined the relationship between the previous night’s sleep disturbances and the following day’s
PTSS among individuals with and without PTSD.

Conclusions: These first preliminary findings indicate that sleep disturbances affect next day PTSS
and the influence is stronger for individuals with
PTSD. Behavioral interventions to ameliorate sleep
disturbances may reduce the daily burden of PTSD
symptoms for individuals with PTSD.

Methods: Current and former U.S. service members(N = 80) were assessed for probable PTSD at enrollment. PTSS were assessed four times daily and sleep
disturbances were assessed once daily by self-reportfor 15 days using an ecological momentary assessment methodology. Eighteen items from the PTSD
Checklist for DSM-5 were used to measure PTSS.

Keywords: post traumatic stress disorder, sleep disturbances, symptom assessment, ecological momentary assessment, military personnel

1314th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Incidence Rates of Posttraumatic Stress Disorder in the US
Military (2007-2015): Trends Across Military-Specific Variables
initial diagnosis of PTSD were identified and rates
calculated based on counts from the Defense Enrollment Eligibility Reporting System (DEERS).

Authors

Jeffrey Cook, PhD (1,2); Maegan M. Paxton, BS (1);Jennifer Phillips, PhD (1,2); Avni Patel , MPH (1); Lisa
French, PsyD (2); David S. Riggs, PhD (1,2); Tracey
Koehlmoos, PhD (1)Results: During the study period, rates of initial
PTSD diagnosis were higher for AD members, withboth AD and RC rates peaking in 2012 before declining through 2015. Rates were consistently highest for the Army, followed by the Marines, lowest for
the Coast Guard, and intermediate for Navy and Air
Force. Enlisted personnel had higher rates of PTSD
than officers, and PTSD rates were inversely related
to rank in both the Enlisted and Officer categories.

Author Affiliations

1. Uniformed Services University of the Health
Sciences
2. Center for Deployment Psychology

ABSTRACT

Background: Providing effective support and treatment for Posttraumatic Stress Disorder (PTSD) isa priority of the Department of Defense. Thus, it iscritical to know how rates of PTSD differ across military-specific variables, including component (Active
Duty [AD] or Reserve Component [RC]), branchof service, and rank. However, current estimates of
PTSD in the US military vary widely dependent on
the sample and study methodology.

Conclusions: The present results provide a population analysis of the incidence rates of PTSD within
the Military Health System. These findings highlight
subgroups within the military with higher rates of
PTSD diagnosis, which can enable DoD to tailor
prevention and treatment interventions for thesegroups.
The opinions and assertions expressed herein arethose of the author(s) and do not necessarily reflect
the official policy or position of the Uniformed
Services University or the Department of Defense.
Additionally, the authors have no conflicts of interests to report.

Methods: This study examined the rates of initialdiagnoses of PTSD across these variables in the US
Military between 2007 and 2015. Data, consistingof direct care inpatient and outpatient records for
AD and RC military were accessed via the Military
Health System Data Repository. ICD-9 codes for the1414th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Risk and Resilience of Lifetime Stressful Experiences among
U.S. Army Soldiers at Risk for Suicide
Authors

1[95% CI= 1.1, 65.3]) and NOK (OR=4.2 [95% CI =1.5, 11.5]). NOK reported exposure to the suicide ofa close friend or relative NOK (OR=3.0 [95% CI = 1.5,0.2]) as a risk factor for suicide. Interestingly, NOK and
SUP reported service members who experienced adisaster were less likely to die by suicide compared topropensity-matched controls NOK (OR =0.2 [95% CI=0.1, 0.9]) and SUP (OR = 0.2 [95% CI = 0.0, 0.6]). SUP
reports also demonstrated the protective effects of saving
the life of a Soldier or civilian during deployment (SUP OR= 0.3 [95% CI = 0.1, 0.7]).

1

Catherine L. Dempsey , Ph.D., David M. Benedek ,22MD., Kelly Zuromski , Ph.D., Matthew K. Nock , Ph.D.,
1
1
Tsz Hin Ng , MPH., Charlotte Riggs , MS., Catherine
11Broshek , BA., Samantha Martinez , BA., and Robert J.
Ursano1, MD.

Author Affiliations

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

Conclusions. This study identified interpersonal
violence and suicide of a close friend or relative wereassociated with increased odds of suicide death. Results
suggest that exposure to disaster and saving the lifeof a Soldier or civilian, and the ability to handle stress
may be protective of suicide. Our findings may assist
both supervisors and family members in identifying
those most at risk and inform preventive intervention efforts.

ABSTRACT

Background/ Objectives. The purpose of this study is
to identify the extent to which the presence of lifetimestressful events (military/deployment-related and family/social-related) are risk factors for suicide among US
Army Soldiers as reported by third parties.
Methods. The data are from a psychological autopsy
study conducted as part of the Army Study to Assess
Risk and Resilience in Servicemembers (ArmySTARRS**). Data were gathered from next of kin(NOK) and Army supervisors (SUP) using structured interviews. Propensity-matched controls werematched on known sociodemographic risk factors
for suicide and Army history variables. Associations
were examined using multivariate logistic regression.

** Army STARRS was sponsored by the Department of the Army and funded under cooperative
agreement number U01MH087981 with the U.S.
Department of Health and Human Services, National Institutes of Health, National Institute of Mental
Health (NIH/NIMH). The contents are solely the
responsibility of the authors and do not necessarily
represent the views of the Department of Health andHuman Services, NIMH, Department of the Army,
Department of Defense, Uniformed Services University of the Health Sciences, or Center for the Study ofTraumatic Stress.

Results. The odds of suicide were higher for those
Soldiers who experienced lifetime interpersonal
violence (sexual assault or rape) compared to propensity-matched controls as reported by SUP (OR =8.6

15

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Inflammatory Cytokines and Cardiovascular Disease are
Associated with Neuroimaging Findings after
Acute Mild Traumatic Brain Injury
Authorsof IL-6, IL-10, TNF-alpha, and VEGF in mTBI are
unknown.

Katie A Edwards, PhD, RN ; Cassandra L Pattinson, PhD1; Vivian Guedes, PhD,1; Jordan Peyer, BS1;
Chen Lai, PhD1; Christina Devoto, MS1,2; Lawrence
Latour, PhD1; Jessica M Gill, PhD, RN1
1,2

Methods: Participants presented to the emergency department with suspected mTBI (n=341) andunderwent blood draw, CT, and MRI. Subjects werecategorized into three neuroimaging groups: CT
positive (n=94); MRI-only positive (n=112); control (negative neuroimaging, n=135). IL-6, IL-10,
TNF-alpha, and VEGF plasma concentrations were
measured using single-molecule array (SIMOA). We
evaluated whether cytokine levels and/or CVD canpredict specific neuroimaging groups.

Author Affiliations

1. National Institute of Nursing Research, National
Institutes of Health, Bethesda, MD.
2. Henry M. Jackson Foundation for the
Advancement of Military Medicine, Bethesda,
MD.

ABSTRACT

Results: Neuroimaging outcomes were significantly associated to CVD histories of hyperlipidemia(p<0.001) and hypertension (p=0.005); neuroimaging outcomes were significantly associatedto increased concentrations of IL-6 and VEGF
(p’s<0.001). As such, these variables were put into a
regression model. Results indicate hyperlipidemia
and hypertension were not significant predictors,
but IL-6 and VEGF differentiated patients with andwithout MRI abnormalities, with IL-6 being thestrongest predictor (p’s<0.001).

Background/Objectives: Identification of peripheral
blood biomarkers related to mild traumatic brain
injury (mTBI) that inform neuroimaging may be asafe, cost-effective method to identify individuals
with intracranial injury. Previous data shows bloodbiomarkers discriminate mTBI subjects with/without magnetic resonance imaging (MRI) abnormalities (tau, NFL, GFAP), and with/without computed
tomography (CT) findings (GFAP). In this study,
we analyzed the relationship between peripheral
blood levels of cytokines IL-6, IL-10, TNF-alpha,and VEGF and neuroimaging results following acutemTBI (<48 hours). Increased acute levels of circulating cytokines (IL-6, IL-10, VEGF, TNF-alpha) havebeen linked to worse clinical outcomes after moderate and severe TBIs. In addition, epidemiological,
clinical, and preclinical studies have linked chronic
inflammation and immune system activation to
cardiovascular disease (CVD) pathogenesis. Associations between neuroimaging, CVD, and levels

Conclusions: Results suggest IL-6 and VEGF as
promising markers of brain injury in patients withacute mTBI, and may differentiate those with CVD
history. A multi-biomarker approach, including
blood-based biomarkers and patient CVD history,
may facilitate neuroimaging and clinical decision
making.

16

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Elevated Tau Relates to Persistent PTSD, Depression andPost-Concussive Symptoms in Military Personnel with
History of Traumatic Brain Injury
Authors

derstood. This study examined associations among
TBI, blood biomarkers and symptoms of PTSD,
depression, and PCS.

Vivian A Guedes, Ph.D. ; Cassandra L Pattison,
Ph.D.1; Pashtun Shahim, M.D., Ph.D.1,2; Patricia
Taylor, MBA2; Kerri Dunbar, M.A.2; Vida Motamedi, BA1; Chen Lai, Ph.D.1; Christina Devoto, M.S.1;
Jordan Peyer, BA1; Michael J. Roy, Ph.D.2; Jessica M
Gill, R.N., Ph.D1.
1

Methods: PTSD, depression and PCS were evaluatedusing PTSD checklist-civilian version (PCL), patient
health questionnaire-9 (PHQ-9), and neurobehavioral symptom inventory (NSI), respectively, in
military personnel (n = 109) with or without chronic
TBI. Serum concentrations of tau, Aβ40, Aβ42, andNFL were measured using an ultra-sensitive assay.

Author Affiliations

1 National Institute of Nursing Research, National
Institutes of Health.
2 Department of Medicine, Uniformed Services
University of the Health Sciences.

Results: The TBI group reported significantly worse
PTSD, depression, and post-concussive symptoms
than the control group (no TBI). Within the TBI
group, controlling for age, sex, time since last injury
and anti-anxiety/depression medication use, Tau
was positively correlated with PHQ (p = .01) andNSI (p = .008) total scores. Tau was also correlatedwith the subscales of NSI-somatosensory (p < .001),
and PCL-negative mood (p = .047). NFL was correlated with PCL-hyperarousal (p = .017). However,Aβ40 and Aβ42A were not significantly correlatedwith the symptoms measured.

ABSTRACT

Background/Objectives: Posttraumatic stressdisorder (PTSD), depression, and post-concussive
syndrome (PCS) are highly prevalent in military
populations and frequently occur comorbidly withtraumatic brain injury (TBI), resulting in substantial
health risks. Elucidating the biological variancesthat are associated with TBIs featuring comorbid
chronic PTSD and PCS may ultimately enable theidentification of the mechanisms that underlie these
symptoms in military personnel to improve care andinform novel interventions. Tau, amyloid-beta (Aβ),
and neurofilament light chain (NFL) have been associated with TBI-related pathological mechanisms.
However, the relationship between biomarkers andbehavioral alterations after TBIs remains to be un-Conclusions: Our findings indicate that tau and
NFL may play a role in maintenance of psychological symptoms in those who have experienced TBI.
Furthermore, there is a critical need for studies ofbiomarkers longitudinally following TBI.

17

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Prevalence of Medical Conditions and Healthcare Utilizationin Treatment-Seeking, Bereaved Military Widows:
A Prospective, Case-Controlled, Longitudinal Study
Authors

lence risk ratios and confidence intervals were used
to compare medical condition prevalence rates andoutpatient healthcare visits between cases and controls across each time period.

Kathryn Hefner, PhD ; Joscelyn Fisher, PhD ; Jing
Zhou, MS1; Alexandra Burris BA1; Stephen Cozza,
MD1
1

1

Results: Compared to controls, prevalences of
ill-defined conditions and mental health conditions(MHCs) increased among cases from Yr-1 to Yr+1
as well as from Yr-1 to Yr+2. Physical and mental
healthcare visits generally increased for both casesand controls throughout the study period; however,in Yr+2, widow cases accrued greater numbers ofphysical healthcare visits as compared to controls.
Mental health visits also increased following SM
death in Yr+1 and Yr+2 among widows.

Author Affiliations

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

ABSTRACT

Background: Spousal bereavement is associatedwith physical and mental health consequences,
however, little is known about the specific impact of
military bereavement. Due to their typically younger
age at bereavement and likelihood of being impacted
by sudden and violent deaths, military widows may
be especially vulnerable to negative health outcomes.

Conclusions: The increase in ill-defined physicalhealth conditions among widows in the early years
following SM death suggests bereavement may be
manifested via somatic symptoms, corroboratingother recent research indicating military spouses
often manifest somatic indicators of stress (Steenkamp et al., 2018). The combination of increases inphysical health conditions, MHCs and healthcare
utilization among widows highlights the need for
improved access to healthcare services that are prepared to adequately treat grief-related conditions.

Method: Using outpatient medical records fromwives of active duty military service members (SMs),
we compared prevalences of medical diagnoses
and frequency of healthcare visits among treatment-seeking military widow cases (n=1375) andmatched (on age, baseline healthcare utilization, SM
deployment and rank), time-yoked control military
wives (n=1375), from one year prior (Yr-1) to two
years following (Yr+1 and Yr+2) SM death. Preva-

18

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

The Impact of Child Health on Parental PTSD
ing injury. Family data identified number of children, and age of youngest child. Logistic regression
determined odds of PTSD diagnosis and treatment
by child mental health diagnosis, controlling forfamily and military factors.

Authors

Elizabeth Hisle-Gorman, MSW, PhD1, Apryl Susi, MS1,
Gregory Gorman, MD, MPH1,2

Author Affiliations

1. Department of Pediatrics, Uniformed Services
University, Bethesda, MD 20814
2. Walter Reed National Military Medical Center,
Bethesda MD 20814

Results: There were 234,911 injured parent with 1
or more injury; 1,312 (0.56%) were battle injured,parents were deployed a man of 1.38 years, and had
a median of 1.1 injures not including PTSD. There
were a median of 1.8 children per family and the
median youngest age was 6.2 years. In unadjusted
and adjusted analysis parents of a child with a mental health diagnosis were 7% (OR 1.07 [95% CI 1.041.10]) more likely to have diagnosed PTSD. Odds ofparental PTSD were also increased with each additional child (2%), total pre-injury deployment years(37%), number of injuries (351%), and sustaining abattle injury (196%), odds of PTSD decreased withage of the youngest child (2%).

ABSTRACT

Background/Objective: Research indicates parenthood increased veterans’ likelihood of PTSD care.
Results cannot determine if parenthood increases risk or increases motivation for treatment. We
sought to examine the impact a child’s mental healthcondition on parental treatment for PTSD after controlling for deployment related variables.
Methods: Utilizing the Military Healthcare System(MHS) database we identified parents injured 200216, with a child/children aged 2-16 at time of injury.
Parental inclusion in the Ill, Injured, and Wounded
Warrior dataset identified service members diagnosed with PTSD and other injures. Parental records
included total pre-injury deployment, battle injuries,
and number of injuries. ICD-9 codes identified outpatient child mental healthcare for two years preced-

Conclusion: Odds of PTSD diagnosis was increased
in injured parents of children with mental healthdiagnoses. Results may relate to underlying familyrisk, or suggest family stress exacerbates PTSD risk.
Results suggest providing preventative and family
focused care may ameliorate some PTSD risk.

Odds of PTSD in Injured Parents

Child with Mental Health Diagnosis
Pre-Injury Deployment Length in Years
Each Additional Child in Family
Age in Years of Youngest Child in Family
Each Additional Parental Injury
Sustaining Injury in Battle

Unadjusted Odds of PTSD Adjusted Odds of PTSD
OR [95% CI]
OR [95% CI]
1.07 [1.04-1.10]
1.07 [1.04-1.10]
1.39 [1.38-1.41]
1.37 [1.36-1.39]
1.05 [1.04-1.07]
1.02 [1.01-1.03]
0.97 [0.97-0.98]
0.99 [0.99-0.99]
3.71 [3.62-3.81]
3.51 [3.42-3.60]
8.02 [7.18-8.96]
1.96 [1.72-2.24]

19

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Whole-Genome Sequencing of 1,688 Veteran Twins to Detect
Risk and Measure Rare Variation Associated withMajor Depressive Disorder
Authors

Daniel Hupalo PhD1, Christopher Forsberg MS2,
Jack Goldberg PhD2,3, William S. Kremen PhD4,5,
Michael J. Lyons PhD6, Anthony Soltis PhD1, Coralie
Viollet PhD1, Robert J. Ursano MD7, Murray B. Stein
PhD4, Carol E. Franz PhD4, Yan V. Sun PhD8, Viola
Vaccarino PhD8, Nicholas L. Smith PhD2,3, Clifton L.
Dalgard PhD1, Matthew D. Wilkerson PhD1, Harvey
B. Pollard PhD1

Author Affiliations

1. The American Genome Center, Collaborative
Health Initiative Research Program, Uniformed
Services University, Bethesda, MD
2. Seattle Epidemiologic Research and Information
Center, Office of Research and Development, U.S.
Department of Veteran Affairs, Seattle, WA
3. Department of Epidemiology, University ofWashington, Seattle, WA
4. Department of Psychiatry, University ofCalifornia, San Diego, San Diego, CA
5. VA San Diego Center of Excellence for Stress andMental Health, San Diego, CA
6. Department of Psychological & Brain Sciences,
Boston University, Boston, MA
7. Department of Psychiatry, Uniformed Services
University, Bethesda, MD
8. Department of Epidemiology, Emory University,
Atlanta, GA

ABSTRACT

Background: Major Depressive Disorder (MDD) is
a complex neuropsychiatric disease that can havelarge impacts on military readiness. However, newinsights from genomic associations allow for predicition of an individual’s lifetime genetic risk, and provide for the possibility of proactive therapy. Initialstudies have identified 47 regions associated with
20
MDD among individuals of European ancestry.

Methods: Here, we report the sequencing of 1,688
whole genomes at 30X mean depth, including 958
monozygotic twins, 626 dizygotic twins, and 73
singletons sequenced in an effort to identify rare
genetic variation associated with MDD. Sequencing
results were hierarchically clustered using 54 quality
metrics to identify and remove bias, resulting in 70
samples being excluded. Veterans were classified ashaving MDD based on psychiatric interview diagnostic criteria. Using previously published genome-wide association summary statistics from one
independent study, we calculated a polygenic risk
score (PRS) using 44 loci.
Results: No significant difference was found in PRS
among Veterans with a binary history of MDD
compared to those without a history as determinedby logistic regression. When considering the variable describing the lifetime accrual of symptoms of
MDD, there was a trend of increasing PRS among
those with symptoms compared to without symptoms by increasing symptom count as determinedby negative-binomial regression. Additionally, when
considering the severity of illness, there was a significant difference in PRS when comparing Veterans with severe depression to those without severe
disease as determined by logistic regression.
Conclusions: A deeper exploration of the 44 lociis underway. These preliminary results may represent a replication of the MDD associations in a new
independent cohort and provide support for undertaking a deeper investigation of MDD rare variation.
Precise quantification of genetic risk can potentiallyprovide an early warning allowing for the avoidance of exposures that may cause this complex andchronic disease.

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Antidepressant Activity of the Selective Kappa Opioid Receptor
Antagonist JNJ-67953964 in Mice
Authors

we investigated the ability of JNJ-67953964 to ameliorate the behavioral deficits produced by exposure
to a chronic mild stress paradigm.

Moriah L. Jacobson, PhD , Hildegard A. Wulf, MA ,Caroline A. Browne, PhD1, Irwin Lucki, PhD1,2
1

1

Author Affiliations

Method: Adult male C57BL/6J mice were exposed
to four weeks of unpredictable chronic mild stress(UCMS). After three weeks of stress, JNJ-67953964(10 mg/kg) was administered for 12 days. Behavioral
assessments included nest building, sucrose preference test, forced swim test (FST), and the hot plate.

ABSTRACT

Result: Exposure to UCMS reduced nesting, increased immobility on the FST, induced deficits insucrose preference, and produced thermal hyperalgesia. Exposure to JNJ-67953964 reversed all ofthese deficits. JNJ-67953964 reversal of stress-induced behavioral deficits persisted for 3 weeks post
treatment cessation.

1. Department of Pharmacology and Molecular
Therapeutics, Uniformed Services University,
Bethesda, MD
2. Department of Psychiatry, Uniformed Services
University, Bethesda, MD
Background: Major depressive disorder (MDD)
is a leading cause of disability worldwide that isprecipitated and/or exacerbated by stress exposure.
Dysregulation of the endogenous opioid system is
implicated in the emergence of MDD. Stress increases dynorphin-induced activation of kappa opioid
receptor (KOR) signaling, which is known to produce negative affect, dysphoria, and aversion. KOR
blockade produces behavioral effects in rodent tests
used to screen novel antidepressant compounds thatare indicative of potential antidepressant-like activity. JNJ-67953964 (previously LY2456302 and CERC501) is the only selective KOR antagonist currently
in clinical trials for MDD, yet there are no preclinical studies systematically evaluating this compoundin animals exposed to stress. In these experiments

Conclusions: Our data show that the KOR antagonist JNJ-67953964 is capable of counteracting a
stress-induced phenotype on several behavioral
tests. In addition, this is the first study to evaluate
the effects of chronic mild stress on nesting, and we
demonstrated that nesting is a useful assay to test
the effects of stress. In sum, these results encourage
further clinical development of JNJ-67953964 as atherapeutic for stress-related disorders.

21

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Safety and Confidence in Law Enforcement During TerroristRelated Events: Association with Daily Life Activities
tation; 6)travelling by automobile; and 7)attending
faith-based activities. Univariate and multivariate
logistic regression analyses investigated the relationship of confidence in law enforcement and perceived
safety to any changes in routine life activities.

Authors

Holly B. Herberman Mash, PhD1, Carol S. Fullerton,
PhD1, Joshua C. Morganstein, MD1,
Brian W. Flynn, EdD1, & Robert J. Ursano, MD1

Author Affiliations

Results: A majority of participants (52%, n=640)
reported changes in daily life activities, with approximately one-third identifying changes related
to being in large places (37%, n=461) and gettinggas (36%, n=445). Perceived safety was associatedwith confidence in law enforcement (r =.32, p<.001).
After adjusting for demographics, lower feelings ofsafety and less confidence in law enforcement, both
independently and together in separate models, wererelated to a higher likelihood of changes in daily
activities.

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

ABSTRACT

Objective: This study examined the relationship ofperceived safety and confidence in law enforcement
to changes in daily life activities during the Washington, D.C. sniper attacks, which occurred over a
3-week period in October, 2002.

Conclusions: Terrorist events affect feelings of safetyand disrupt routine activities. Safety is both anindividual perception and community experience.
Focus on strengthening community relationships
with law enforcement and community resourcesthat provide support, may enhance perceived safety,
decrease feelings of threat, and maintain community
members’ involvement in daily life activities. Additional research is needed to further articulate how
perceived safety and confidence in law enforcement
interact to influence community behaviors following
terrorist and other disaster events.

Methods: Participants were 1238 Washington, D.C.
area residents assessed using an internet surveythat included items related to safety (at work, athome, and in general), confidence in law enforcement, and changes in routine activities of daily life.
These changes were defined as either increases ordecreases in the following activities: 1)being in large
public places (e.g., shopping malls); 2)getting gas; 3)sending one’s child(ren) to school and activities; 4)attending large public gatherings (e.g., concerts or
sporting events); 5)travelling by public transpor-

22

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Effect of Prior Hurricane Experience on Preparedness inFlorida Department of Health Workers
than a BA/BS degree (49.6%). Participants completed a questionnaire that included items examining
hurricane preparedness, defined by having thefollowing resources: 1) home emergency preparedness plan; 2) 2+ days of food and water; 3) flashlight;
4) portable radio; 5) spare batteries; 6) emergency
phone numbers; and 7) plan to communicate withfamily/friends. Additional items assessed the extent
to which participants felt prepared before and after
the 2004 and 2005 hurricanes, indicating whether
experience affected preparedness over time.

Authors

Holly B. Herberman Mash, PhD1, Joshua C. Morganstein, MD1, Carol S. Fullerton, PhD1
Leming Wang, MS1, Alexander G. Liu, MPH1, Sumr
Farooq, BA1, & Robert J. Ursano, MD1

Author Affiliation

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

Results: A majority of participants at Time 1 (72%)
and Time 2 (77%) reported having at least six preparedness items, demonstrating a high level of hurricane preparedness. Perceived levels of preparedness
increased from before the 2004 hurricane season(23%) to after the hurricanes (41%), decreasedslightly in the period before the 2005 hurricane
season (34%), increasing again following hurricane
exposure (47%), suggesting an effect of experienceon feelings of preparedness.

ABSTRACT

Objective: The extent to which one feels prepared
may influence initial responses to disaster exposure,
such as fear, anxiety, and helplessness, and affectthe time it takes to recover. This study examined
preparedness behaviors in Florida Department of
Health (FDOH) workers following the 2004 and2005 hurricane seasons, and the effect of hurricane
experience on feelings of preparedness.

Conclusions: Findings illustrate the high levelof preparedness among FDOH workers, who aretrained in disaster response. Disaster-related experiences may further influence feelings of preparedness
and have emergency public health implications forenhancing preparedness behaviors that optimize
disaster response and improve community safety.

Methods: Participants were FDOH workers assessed
9 months following four hurricanes and one tropical storm during a seven-week period in Augustand September of 2004 (n=4676) and one year later,
after the 2005 hurricane season (n=3460). During
the first assessment, participants’ ages ranged from
18-79 years (M=47.81). Most were female (79.8%),
married (65.5%), White (71.6%). Nearly half had less23

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

The 3 Predator Exposure Model as a Robust Animal
Model of Traumatic Stress
Authors

hours, 48 hours, and 192 hours (7 days) following
a single-day sequential exposure to three predator
species (snake, ferret and cat) to model a threat tolife exposure. Rats spend 5-10 minutes with each of
the predators, in a protective enclosure that maximizes sensory exposure to each predator.

Matthew May, M.S. , Isaac Jeong, B.S. , Rachel
Taylor, Ph.D.,1 Nicole Moore, Ph.D.1, Emily Lowery-Gionta, Ph.D.,1* Liana Matson, Ph.D.1*
1

1

Author Affiliations

1. Performance Assessment and Chemical
Evaluation Laboratory, Behavioral Biology
Branch, Center for Military Psychiatry and
Neuroscience, Walter Reed Army Institute of
Research, 503 Robert Grant Avenue, Silver
Spring, MD 20910* Asterisk indicates co-last authorship

Results: Predator-exposed (n = 33) and control
sham (n = 35) group data was compiled frommultiple studies to analyze model effectiveness andto assess the trajectory of traumatic-stress related
behaviors. Preliminary analyses indicate that predator exposure results in increased anxiety-like behavior in the elevated plus maze compared to control
animals at 24H using the anxiety index formula by
Cohen et al. 2008 (t = 2.363, p = 0.02) but not at 48Hor 192H.

ABSTRACT
Background: An estimated 12-20% of soldiers
exposed to psychological trauma during the courseof a deployment in present-day conflicts go on todevelop adverse symptoms of post-traumatic stressdisorder (PTSD). The Performance Assessment andChemical Evaluation (PACE) Laboratory identifies and tests novel compounds for efficacy using apreclinical rat model of traumatic stress to develop
treatments for combat-related stress.

Conclusions: Elevated plus maze data from multiple
studies support the hypothesis that the 3 predator
exposure increases anxiety 24 hours after exposure.
Additionally, rats showing increased anxiety-likebehaviors at baseline also demonstrate elevatedanxiety-like behaviors across time compared toanimals showing low anxiety-like behaviors at baseline. There are individual differences in anxiety-like
response to predator exposure that can be used tomodel the trajectory of human response to traumatic stress. Additional predictive factors are being
evaluated.

Methods: The PACE laboratory developed a three
predator stress model, combining the live exposure of multiple predators: (snake, cat, and ferret).
Exploratory and anxiety-like behaviors are measured
in male rats under basal conditions, as well as 24

24

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Does Damage to the Medial Frontal Gyrus in Chronic Mild TBI
Patients Affect Post Traumatic Stress Symptoms?
Authors

the default mode network to compare the control
group, and each of the mTBI groups, using age as a
nuisance regressor.

Dominic E. Nathan, PhD , Louis M. French,
PsyD1,2,4, Wei Liu, PhD4,5, John Ollinger, PhD4, Grant
H. Bonavia, MD, PhD2,4, Gerard Riedy, PhD, MD2,4
1,2,3

Results: A pattern of disrupted connectivity was observed in the right medial frontal gyrus (Brodmannarea 10) across all chronic mTBI subjects. However, connectivity within a network of brain regions
comprising the anterior cingulate, temporal lobes
and parahippocampal gyrus, varied with intensity of
PCL-C scores. Damage to Brodmann area 10 could
disrupt executive function and attention processes
involved with emotional regulation and memory
encoding, rather than a fear related response.

Author Affiliations

1. Center for Neuroscience and Regenerative
Medicine, Bethesda, MD, USA
2. Uniformed Services University, Bethesda, MD,
USA
3. Henry M. Jackson Foundation, Bethesda, MD,
USA
4. National Intrepid Center of Excellence, Bethesda,
MD, USA5. North Tide LLC, Sterling, VA, USA

Conclusions: The results suggest a potential contextual dependent construct of fear, in which the brain
attempts to regulate memories and emotions relating
to prior traumatic experiences. Such consolidationof memories or emotions may occur during the absence of explicit external stressful stimuli, and may
differ from a fear related response that involves theamygdala. Future work will test amygdala connectivity in the task free context. Results from this study
have the potential for the development of in-vivo
indicators for future research pertaining to PTSD
and chronic mTBI.

ABSTRACT

Background: Differentiating between post traumaticstress disorder (PTSD) and chronic mild Traumatic
Brain Injury (mTBI) is challenging due to significant symptom overlap, and the absence of objective
indicators. The focus of this work is to examine how
post-traumatic stress influences task-free restingstate brain connectivity of the default mode network
in a sample of military chronic mTBI subjects.
Methods: Control subjects (N=44, age=36±9.7
years, M=28) without a history of TBI were compared with chronic mTBI subjects with low (N=58, PCL-C total < 30), medium (N= 124, PCL-C
total = 31–49), and high (N= 105, PCL-C total ≥60)
post-traumatic stress symptoms. Functional MRI
data were acquired on a 3T scanner for a six-minutetask-free scan. Voxel-wise t-tests were performed onDisclaimer: Views expressed in this abstract arethose of the author(s) and do not necessarily reflect
the official policy or position of the Department of
the Navy, Army, Department of Defense, nor the
U.S. Government.

25

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Longitudinal Changes in Children’s Mental Health and PhysicalInjury Rates Following Father Deathand two years following (Yr+1, Yr+2) father death inbereaved compared to non-bereaved children.

Authors

Christin M. Ogle, Ph.D.1, Joscelyn E. Fisher, Ph.D.1,
Jing Zhou, M.S.1, Ametisse N. Gover-Chamlou,
B.A.1, Stephen J. Cozza, M.D.1

Results: Comparisons of pre- and post-loss prevalence rates of mental health conditions among
bereaved children indicated that rates of depression,anxiety, stress disorder/PTSD, and adjustment disorder were two- to nine-times higher 1- to 2-years
following father death. Prevalence of behavioral
disturbances and fractures also increased in thesecond year post-loss. With the exception of depression, no pre- to post-loss increases in prevalence ofmental health conditions and physical injuries wereobserved among non-bereaved youth. Comparisonsof longitudinal changes in prevalence of mental
health conditions and physical injuries between
bereaved and non-bereaved children indicated that
only adjustment disorder increased at a significantly
higher rate from Yr-1 to Yr+1 in bereaved compared
to non-bereaved youth. In addition, the average
number of mental healthcare visits was significantly higher for bereaved compared to non-bereaved
youth both years post-loss.

Author Affiliation

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

ABSTRACT

Objective: In a prospective, case-controlled study,
we examined longitudinal changes in prevalence
rates of mental health conditions, physical injuries,
and outpatient healthcare visits among children of
deceased active-duty male service members compared to their non-bereaved peers.
Methods: International Classification of Diseases
codes drawn from outpatient medical records wereused to determine the rates of mental health conditions, physical injuries, and outpatient healthcare
visits among bereaved children (n = 1142; M age =8.8, SD = 5.0) and time-yoked controls (n = 1142;
M age = 9.2, SD = 4.7) matched on age, baseline
physical and mental health utilization, service member parent deployment history, and service member parent rank. Logistic regressions were used to
examine prevalence risk ratios one year prior (Yr-1)

Conclusions: Father death is associated with increased prevalence of psychiatric conditions, physical injuries, and mental health care utilization 1- to
2-years post-loss in children from treatment-seeking
military families.

26

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Influence Of Attentional Bias on Scanpaths In Posttraumatic Stress
Disorder: Assessment of Vigiliance-Avoidance Scanning Patterns
During Visual Search Paradigm
Authors

direction tasks under two conditions; (1) standard
condition (STD) that utilized square and circle
images, and (2) face condition (FACE) that utilized
neutral and negative emotional face images. The
nearest neighbor index (NNI) algorithm was employed to measure the spatial pattern of gaze points.
Two Gaussian generalized linear models were used
to estimate the linear relationships between the NNI
and three predictors (Group, Condition, and Direction), and between the NNI and CAPS.

Hyuk Oh, Ph.D. , Matthew Reinhard, Psy.D. , Nathaniel Allen, B.S.2, Arghavan Hamedi, M.A.2, Kyle
Jaquess, Ph.D.2, Michelle Costanzo, Ph.D.2
12

Author Affiliations

1 Department of Kinesiology, University of
Maryland, College Park, MD 20742, USA.
2 War Related Illness and Injury Study Center,
Veterans Affairs Medical Center, Washington,
DC, 20422, USA.

Results: The linear model indicated that: (a) there
is a significant linear relationship between the NNI
and three predictors; (b) eye tracking patterns inveterans with PTSD were less clustered than controls
regardless of Condition or Direction; (c) all participants’ clusters were tighter during STD and PS; (d)NNI and CAPS were positively correlated.

ABSTRACT

Objective: Eye-tracking tasks allow investigation ofsustained attention to threat, which has been implicated in posttraumatic stress disorder (PTSD). Antisaccade performance in the context of affective cues
has revealed inhibitory control deficits in a Veteran
PTSD population. This study aims to examine visualscanning patterns in Veterans with PTSD by quantifying the spatial arrangements of visual fixations
during eye-tracking tasks with and without cognitive-emotional interference.

Conclusions: This study revealed that the Veteranswith PTSD exhibited face avoidance and more scattered scanning in the antisaccade eye-tracking tasks,
and such avoidance symptom of PTSD can be successfully assessed through visual scanning patternanalysis. Thus, our results demonstrated that thistask and analytical approach can be used as a novelcost-effective tool for assessing PTSD in a veteran
population with the future possibility of informing
diagnosis.

Method: Thirty-six veterans were recruited from the
Washington DC Veterans Affairs Medical Center,and classified into two groups (17 PTSD diagnosed
vs. 19 controls) based on the Clinician Administered
PTSD Scale (CAPS). Participants completed prosaccade (PS) and antisaccade (AS) eye movement27

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Mild Traumatic Brain Injury with Concurrent PTSD
is Associated with Peripheral Tau Concentrations
included personnel who were referred to the Madigan Sleep Disorders Clinic. Participants were split
into four groups: mTBI-Neg/PTSD-Neg (n=59),
mTBI-Neg/PTSD-Pos (n=11), mTBI-Pos/PTSDNeg (n=17), and mTBI-Pos/PTSD-Pos (n=25); Age
M=33.3 years (SD=7.9). The cohorts were analyzed
separately using ANOVA models, with Bonferroni
adjustment.

Authors

Cassandra L. Pattinson, Ph.D.1, Jessica M. Gill, R.N
Ph.D.1, Tracey Brickell, Ph.D.2, Louis M. French,
Ph.D.3, Sara M. Lippa, Ph.D. 2, Rael Lange, Ph.D.2

Author Affiliations

1. National Institutes of Health, National Institute of
Nursing Research
2. Defense and Veterans Brain Injury Center, Walter
Reed National Military Medical Center
3. National Intrepid Center of Excellence (NICoE),
Walter Reed National Military Medical Center
Objective: Mild traumatic brain injuries (mTBIs)
with comorbid post-traumatic stress disorder(PTSD) is common in military personnel following
recent deployments. Given that TBI and PTSD areassociated with an increased risk of Alzheimer’s
disease and related dementias, we aimed to examine
if mTBI and comorbid PTSD had cumulative effects
on peripheral tau concentrations in two cohorts ofmilitary veterans and service members.

Results: For Cohort 1, ANOVA showed significant
group differences on tau (p<.01). Post-hoc analyses
revealed that the mTBI-Pos/PTSD-Pos group had
significantly higher tau than the mTBI-Neg/PTSDNeg group (p=.02) and trended towards higher
than the mTBI-Pos/PTSD-Neg group (p=.06). The
mTBI-Pos/PTSD-Pos and mTBI-Neg/PTSD-Pos
groups did not significantly differ (p>.05). These results were validated with Cohort 2; ANOVA showed
group differences on tau (p<.05). Post-hoc analyses
revealed that the mTBI-Pos/PTSD-Pos group had
significantly higher tau than both the mTBI-Neg/
PTSD-Neg and mTBI-Pos/PTSD-Neg groups(p<.05).

Method: Cohort 1 included military personnel who
were treated at Walter Reed National Military Medical Center following mTBI. Participants were divided into three groups: mTBI-Neg/PTSD-Neg (n=18),
mTBI-Pos/PTSD-Neg (n=64), and mTBI-Pos/PTSDPos (n=21); Age M=34.1years (SD=10.1). Cohort 2

Conclusion: These results are the first to identify
that a history of mTBI and comorbid PTSD is associated with increased peripheral tau. This provides
insight into potential pathways for intervention andmonitoring to ameliorate negative outcomes following mTBI in military personnel.

ABSTRACT28

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

The Relationship of PTSD to Anxiety and Depression:
An Examination of the Moderating Effect ofSleep Quality and Nightmares
Authorsment) active duty service members and veterans of
OIF, OEF, and OND. Participants were recruited forparticipation in a randomized control trial examining the effectiveness of Riluzole as an augmentation medication for PTSD. Riluzole is a glutamate
modulator that may improve outcomes compared totreatment with SSRIs or SNRIs alone.

Maegan M. Paxton, BS , Larissa L. Tate, MPS , 		Patricia T. Spangler, PhD1,2, Eva Asabre, MPH2, 		
and David S. Riggs, PhD1,31

1Author Affiliations

1. Uniformed Services University of the Health
Sciences
2. Center for the Study of Traumatic Stress
3. Center for Deployment Psychology

Results: Notably, sleep disturbance was found to bea moderating factor in the relationship of PTSD toanxiety and depression. Also, nightmares moderated
the relationship of PTSD to depression. Additional analyses indicate that the relationship between
PTSD and anxiety and depression is strengthened
as symptoms of sleep disturbance and nightmares
increase.

ABSTRACT

Background and Objectives: PTSD is a significant
health concern for the United States military population. It causes significant distress in a service
member’s life and is often accompanied by othermental health symptoms. As many as 70% of service
members with PTSD experience significant sleep
disturbance and upwards of 90% report trauma-related nightmares. These sleep problems are known to
exacerbate PTSD symptom development as well as
negatively impact patient functioning. Patients with
PTSD also often report symptoms of anxiety anddepression. The numerous co-occurring conditionsand varied presentations make PTSD challenging
to treat. Interventions may be improved by better
understanding the relationship of these comorbid
conditions. Because sleep disturbances are hallmark
features of PTSD, anxiety, and depression, we examined the role of sleep disturbances in the relations
among these disorders.

Conclusions: These results demonstrate the potentially important role sleep plays in understanding
the comorbidity of PTSD and anxiety or depression.
By targeting sleep disturbances in treatment for
PTSD, patients may see greater reductions in symptoms of comorbid anxiety and depression than treatment for PTSD alone, perhaps leading to increased
functioning and quality of life.
The opinions and assertions expressed herein are thoseof the author(s) and do not necessarily reflect theofficial policy or position of the Uniformed Services
University or the Department of Defense. Additionally, the authors have no conflicts of interests to report.

Methods: Participants were 51 treatment-resistant(i.e., not fully responsive to SSRI and/or SNRI treat-29

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

A Population Study of Incidence Rates of PosttraumaticStress Disorder in the US Military (2007-2015):
Analysis of Age, Sex, and Marital Status
and outpatient records for Active Duty and Reserve
Component military. Rates were calculated basedon counts from the Defense Enrollment Eligibility
Reporting System (DEERS).

Authors

Maegan M. Paxton, BS1; Jeffrey Cook, PhD1,2;
Jennifer Phillips, PhD1,2; Avni Patel , MPH1; Lisa
French, PsyD2; David S. Riggs, PhD1,2; Tracey Koehlmoos, PhD1

Results: During the study period, the rate of PTSD
diagnosis peaked in 2012 (9.69 per 1000-person
years) before declining through 2015. Notably, ratesof PTSD diagnosis in females steadily increased after
2012, while male rates decreased. Rates were consistently highest among those over age 40 and lowest
in those under 20. Single Service members had thelowest PTSD diagnosis rates, followed by married,
and then divorced personnel.

Author Affiliations

1. Uniformed Services University of the Health
Sciences
2. Center for Deployment Psychology

ABSTRACT

Background: The rate of Posttraumatic Stress Disorder (PTSD) in the military is a frequently-studied
and often-contested area in trauma research. Prevalence rates vary widely from 1.4% to 41.3%. Further,systematic reviews suggest a rate between 8% and15%. Additionally, the literature differs in terms ofrates across demographic factors. The wide rangeof rates reported across the literature may be due tofactors such as the size and composition of the sample as well as the method of assessment.

Conclusions: These findings provide the most comprehensive view of rates of PTSD diagnoses in the
military to date. Additionally, they highlight important differences across basic demographic characteristics within the US military. Therefore, thesefindings may help to identify service members atgreater risk of developing PTSD as well as to informtargeted interventions.

Methods: By accessing the Military Health System
Data Repository (MDR), this study aimed to determine the overall rate and demographic trends ofinitial diagnosis of PTSD in the US Military population between 2007 and 2015. PTSD diagnosis wasdetermined by ICD-9 code in direct care inpatient

The opinions and assertions expressed herein are thoseof the author(s) and do not necessarily reflect theofficial policy or position of the Uniformed Services
University or the Department of Defense. Additionally, the authors have no conflicts of interests to report.

30

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Sex-related Differences of Intravenous Ketamine Infusion
on Stress Hormone and Fear Memory in Rats

nous (IV) ketamine infusion (0–10 mg/kg) dose-dependently increased stress hormone corticosterone(CORT) levels and fear memory in male rats.

Authors

Kennett D Radford, PhD1, Michael Zhang, BS2,3,
Rina Y Berman, BS2, T John Wu, PhD4, and Kwang
H Choi, PhD1,2,3

Method: We investigated the effects of IV ketamine
infusion on those measures in intact female rats.
Adult female Sprague-Dawley rats received a 2-hour
IV ketamine infusion (0 or 10 mg/kg) immediately
after the fear conditioning (3 times of auditory tone
and mild footshock pairing). Spontaneous locomotor activity was monitored during the infusion andplasma CORT levels were measured using the ELISA
method. Fear memory retrieval, fear extinction, andfear recall were tested between 2 and 4 days after thefear conditioning/ketamine infusion.

Author Affiliations

1. Daniel K. Inouye Graduate School of Nursing,
Uniformed Services University, Bethesda, MD,
20814
2. Department of Psychiatry, Uniformed Services
University, Bethesda, MD, 20814
3. Center for the Study of Traumatic Stress,
Uniformed Services University, Bethesda, MD,
20814
4. Department of Obstetrics and Gynecology,
Uniformed Services University, Bethesda, MD,
20814

Results: The IV ketamine infusion reduced locomotor activity and elevated plasma CORT levels
in female rats. The elevated CORT levels following
ketamine infusion were greater in female rats thanin male rats. The ketamine infusion following fear
conditioning enhanced fear memory and this effectappeared to be greater in female rats than in malerats.

ABSTRACT

Background: The U.S. Department of Defense
has recently opened combat roles to women thatwere previously restricted to men. As a result of
this policy change, military doctors and nurses cananticipate an increased frequency of combat-related injuries in female service members in future
military conflicts. Ketamine, an NMDA receptor
antagonist, is a preferred battlefield analgesic due toits hemodynamic stability and a lack of respiratory
suppression in wounded service members. However,ketamine administration in the peri-trauma period
can produce dissociation and hallucination which
may strengthen the traumatic memory formation.
We previously reported that subanesthetic intrave-

Conclusions: The study is in progress to confirm thecurrent findings and to further investigate potential
contribution of sex hormones (estrogen and progesterone) to the effects of IV ketamine infusion on
fear-related disorders.
Funding: TriService Nursing Research Program andCenter for the Study of Traumatic Stress31

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Gene Expression Differences in PTSD Are Uniquely Related to the
Intrusion Symptom Cluster: A Transcriptome-Wide Analysis in
Military Service Members
Authors

by comparing military service members: (1) with vs.
without PTSD, (2) with high vs. low PTSD cluster
symptom severity, and (3) with improved vs. not
improved PTSD symptoms following 4 to 8 weeks
of sleep-focused treatment. Data were analyzed at a±2.0-fold change magnitude, FDR≤0.05 with subsequent pathway analysis.

Heather L. Rusch, MS , Jeffrey Robinson, PhD ,Sijung Yun, PhD2, Nicole D. Osier, PhD2, Christina
Martin, BS1, Chris R. Brewin, PhD3, & Jessica M.
Gill, PhD1
1,

1

Author Affiliations:

1. National Institute of Nursing Research, National
Institutes of Health, Bethesda, MD 20892, UnitedStates
2. Yotta Biomed, LLC, Bethesda, MD 20817, UnitedStates
3. University College London, London WC1E 6BT,
United Kingdom

Results: In participants with PTSD (n=39), 89 differentially expressed genes were identified. In participants with high intrusion symptoms (n=22), 1040
differentially expressed genes were identified. No
differentially expressed genes were identified for theremaining PTSD symptom clusters, which overlap
with other conditions. Ten discrete genes (C5orf24,
RBAK, CREBZF, CD69, PMAIP1, AGL, ZNF644,
ANKRD13C, ESCO1, and ZCCHC10) were upregulated in participants with high intrusion symptoms
at baseline and downregulated in participants withimproved symptoms following treatment. Pathway
analysis identified upregulated immune response
systems and metabolic networks with a NF-kB hub
linked to high intrusion symptoms, which were
downregulated with symptom reduction.

Corresponding Author:

Heather L. Rusch
3 Center Drive, Building 3, Room 5E/26; Bethesda,
MD 20892
Tel: 301-496-5198; E-mail: heather.rusch@nih.gov

ABSTRACT

Background: Posttraumatic stress disorder (PTSD)
is associated with wide-spread immune dysregulation; however, little is known about the gene expression differences attributed to each PTSD symptom
cluster: intrusions (flashbacks), avoidance, negative
alterations in cognition and mood, and arousal
symptoms. This is an important consideration whenidentifying diagnostic and treatment response markers in highly comorbid populations with overlapping
symptoms.

Conclusion: Between group (PTSD vs. control) gene
expression differences were almost entirely attributed to the intrusion symptom cluster (98%). We previously reported that brain volume alterations wereunrelated to overall PTSD severity, but inversely
related to intrusion symptom scores. Taken together,
our findings provide a novel reference dataset, which
can inform the development of precise PTSD diagnostic biomarkers and therapeutic targets.

Methods: We utilized a transcriptome-wide analysis
of differential gene expression in peripheral blood

32

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Nightmare Deconstruction and Reprocessing: Proof of Concept ofa Novel Treatment for PTSD-Related Nightmares and Insomnia
rehearsal. Our aims are to test NDR’s plausibility
as a treatment for PTSD-related nightmares and totest the feasibility of methods intended for use in a
future large-scale randomized controlled trial.
Methods: Treatment plausibility will be tested by analyzing pre-to-post-treatment changes in nightmare
and insomnia. Methods being tested include collection of blood samples within a prescribed circadianwindow (0800-1200) and participant compliancewith daily download of physiologic data from awristband device and completion of psychometricmeasures. Participants are up to 30 combat veteranswith trauma-related nightmares and insomnia whoare being recruited at Walter Reed National Military
Medical Center. Primary outcomes are nightmare
severity (Disturbing Dreams and Nightmare Severity Index) and insomnia severity (Pittsburgh Sleep
Quality Index). The Empatica E4 wristband enables
collection of actigraphic data to measure sleep disturbance and heart rate variability and electrodermal
activity to monitor in-session stress during nightmare exposure. Finally, brain-derived neurotrophic
factor and inflammatory markers (IL-2, IL-6, andCRP) will be assayed from blood samples taken atbaseline, first exposure to nightmare images, andpost-treatment.

Authors

Patricia Spangler, PhD1, Alvi Azad, DO1,2, James
West, MD1,2, David Benedek, MD1,2, Catherine
Dempsey, PhD1, Keke Schuler, PhD1, Megan Paxton,
BA3, Eva Asabre, MPH1, Ashley Phares, BA1, Jessica
Canales, BA1

Author Affiliations

1. Center for the Study of Traumatic Stress,
Uniformed Services University, Bethesda, MD,
20814
2. Department of Psychiatry, Uniformed Services
University, Bethesda, MD, 20814
3. Department of Medical and Clinical Psychology,
Uniformed Services University, Bethesda, MD,
20814

ABSTRACT

Background/Objectives: Nightmares and insomnia are signature symptoms of posttraumatic stressdisorder (PTSD) and are commonly refractory
following evidence-based treatment (EBT). EBTssuch as Prolonged Exposure and Cognitive Processing Therapy utilize fear memory extinction andreconsolidation but do not target sleep symptoms.
Given that nightmares may play a role in trauma
memory maintenance, developing a psychotherapy
that activates trauma memory through exposure tonightmare images may facilitate trauma memory reconsolidation. This proof-of-concept study is investigating Nightmare Deconstruction and Reprocessing (NDR), a three-stage treatment that integrates
exposure to nightmare images, meaning-making
and reprocessing, and nightmare reconstruction and

Results: Results for the current study are pending.
Discussion: Results on NDR’s plausibility as a treatment and feasibility of study methods will provide
evidence for testing NDR in a large-scale randomized clinical trial.

33

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Region- and Time-Dependent Gene Regulation in the Amygdalaand Anterior Cingulate Cortex of a PTSD-Like Mouse Model
test, and light/dark box test at 2 and 4 weeks PS.
Acoustic startle response test was performed at 2
and 4 weeks PS. The amygdala (AMY) and anterior cingulate cortex (ACC) were dissected from themice at 2 and 5 weeks PS and employed RNA-sequencing analysis.

Authors

Mikiei Tanaka Ph.D.1, Hongyun Li Ph.D.1, Xijun
Zhang Ph.D.2, Jatinder Singh Ph.D.2, Clifton Dalgard
Ph.D.1,2, Matthew Wilkerson Ph.D.†,‡, and Yumin
Zhang Ph.D.1,2

Author Affiliations

Results: Contextual fear memory was sustained up
to 5 weeks PS. Anxiety-like behavior was shown
after 2 weeks and continued at 4 weeks PS, while exaggerated startle response emerged after 4 weeks PS.
RNA sequencing revealed more than 1,000 differentially expressed genes were identified at 2 weeks PS
in both regions. The number of the regulated genes
remained constant in AMY at 5 weeks PS, whereas
those in ACC were plummeted. Although synaptic
remodeling and endocrine system were the mostenriched signaling pathways in both ACC and AMY,
the individual gene expression profile was regulated differentially in a region- and time-dependent
manner. In addition, several genes associated with
PTSD involved in Hypothalamic-Pituitary-Adrenal
axis were regulated.

1. Department of Anatomy, Physiology andGenetics
2. Collaborative Health Initiative Research Program(CHIRP), Uniformed Services University of
Health Sciences, 4301 Jones Bridge Rd, Bethesda,
MD 20814, USA

ABSTRACT

Background/Objectives: PTSD is developed byexposure to a threatening and/or a horrifying eventand characterized by the presence of re-experiencing, hyperarousal, and avoidance for a prolonged
period of time. However, the stage-dependent
alteration of gene regulation in emotional regulatory
regions is not well-elucidated.
Method: PTSD-like mouse model was constructedby electric foot shock (1.5 mA for 2 sec ×8 times)
followed by situational reminders. Fear memory
sustainability was assessed by measuring avoidance
latency and freezing behavior in the same context
up to 5 weeks post stress (PS). Anxiety-like behavior
was assessed by open field test, elevated plus maze

Conclusion: In our PTSD-like mouse model, global
gene expression profile showed synaptic remodelingand endocrine systems are most critical for diseasedevelopment. The dynamic gene regulation could
provide a clue to the molecular mechanism for disease development.

34

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

The Effects of Comorbid TBI and PTSD Symptoms
among U.S. Active Duty Service Members on an Objective
Cognitive Performance Measure
Authors

ously collected as part of a larger clinical databaseat the National Intrepid Center of Excellence’s Brain
Fitness Center (BFC) at Walter Reed National Military Medical Center. In accordance with the BFC’s
normal standard of care procedures, service members completed a variety of self-reports, including
the PTSD Checklist (PCL-C), as well as an objective
cognitive assessment, the Automated Neuropsychological Assessment Metrics version 4 Traumatic
Brain Injury (ANAM-4 TBI).

Larissa L. Tate, MPS , Maegan M. Paxton, BS , LouisM. French, PsyD1,2,3, Wendy A. Law, PhD1,2,
Katherine W. Sullivan, SLP2,3, & David S. Riggs,
PhD1
1

1

Author Affiliations

1. Uniformed Services University of the Health
Sciences,
2. Walter Reed National Military Medical Center,
National Intrepid Center of Excellence
3. Defense and Veterans Brain Injury Center

Results: Notably, service members with TBI did not
significantly differ from those with PTS-only on
cognitive performance; however, individuals withboth TBI and PTS performed worse than those witheither condition alone.

ABSTRACT

Background and Objectives: More than 2.8 million
US military personnel have deployed to Iraq and Afghanistan since September 11, 2001. Both traumaticbrain injury (TBI) and posttraumatic stress disorder(PTSD) have been labeled “signature wounds” ofthese conflicts, and often co-occur as brain injuries
are frequently sustained during traumatic events.
Nearly 380,000 service members were diagnosed
with a TBI between 2000 and 2017, and upwardsof 440,000 service members returned home fromthese conflicts with PTSD. Both of these debilitating
conditions can result in considerable cognitive concerns for a significant number of service members.
Despite their frequent comorbidity and overlapping
symptoms, there is a dearth of knowledge regarding
the combined effects of TBI and PTSD on cognitive
performance.

Conclusions: Our findings suggest there may besomething unique about the combination of TBI and
PTSD and their subsequent influence on cognitive
performance. Results illustrate the complexity of therelationship between PTSD and TBI and highlightthe need for further research in this area.
The views expressed in this abstract are those of theauthor(s) and do not reflect the official policy of the
Uniformed Services University, Department of Army,
Navy, Air Force, Department of Defense, or U.S. Government. The identification of specific products, scientific instrumentation, or organizations is considered
an integral part of the scientific endeavor and does notconstitute endorsement or implied endorsement on thepart of the author, DoD, or any component agency.
Additionally, the authors have no conflicts of interest
to report.

Methods: The present study examined the potentially synergistic effects of comorbid TBI and PTSD
symptoms (PTS) on cognitive functioning using
data from 211 active duty service members previ35

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Fear Memory Extinction is Blocked In Rats Following
Acute Glial Cell Inhibition: Implications for Targeting
Neuroinflammation in Traumatic Stress Exposure
once-daily 1-h prior to a 10-min extinction test fora total of four days, in which freezing behavior wasmeasured. Additionally, behavioral performancein acoustic startle response and elevated plus maze
tests was measured under drug-free conditions at
various timepoints before and after fear conditioning occurred. Terminal blood and various brain
regions were collected for later evaluation of inflammatory cytokine levels.

Authors

Rachel Taylor, PhD1, Matthew May, MS1, Nicole
Moore, PhD1, Liana Matson, PhD1, Emily Lowery-Gionta, PhD1

Author Affiliations

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

ABSTRACT

Results: Ibudilast administration to shock-exposed
rats resulted in a sustained level of freezing behavior,suggesting fear extinction was delayed or blocked.
Freezing behavior was also observed in the sham-exposed, Ibudilast-treated control group, however
the levels did not reach those of the shock-exposedgroups and only appeared on the 2nd-4th test day.
Moreover, freezing behavior decreased over test days
for the sham-exposed, Ibudilast-treated group, but
did not reach sham-exposed, vehicle-treated levels.

Background: Emerging evidence suggests a rolefor both central and peripheral inflammation in
post-traumatic stress disorder (PTSD). Moreover,
inflammation has been reported to disrupt fear
memory extinction as observed in preclinical fear
conditioning paradigms. Ibudilast, a PDE4 inhibitor
and putative glial cell inhibitor, has been shown to
reduce neuroinflammation as well as inflammation-induced behavioral impairments. Here, wecharacterized Ibudilast for its efficacy in facilitating
fear extinction in rats to better understand the roleof inflammation in fear learning.

Conclusions: Although experiments are ongoing,
the present results suggests that while a mild Ibudilast-specific effect on motor ability may be involved,
Ibudilast modulates aspects of fear learning relative
to extinction. These results may have clinically-relevant implications for current pharmacologicaltargets of traumatic stress exposure.

Methods: Adult male rats underwent a single fear
conditioning session in which delivery of light andtone cues were associated with the delivery of amild footshock. The following week, Ibudilast (3or 10 mg/kg, i.p.) or its vehicle was administered36

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Sex Differences in Cued Fear Responses and Parvalbumin Cell
Density in the Hippocampus Following Repetitive Concussive
Brain Injuries in C57BL/6J Mice
digm to assess amygdala and hippocampal function.
Mice were also tested in the elevated zero maze andtail suspension test for anxiety- and depressive-like
symptoms, respectively.

Authors

Laura B. Tucker, M.S.1,2, Brian S. Winston2, Jiong
Liu, M.D.2, Alexander G. Velosky, B.A.2, Amanda H.
Fu, M.D.1,2, Antigone A. Grillakis, B.S.3, and Joseph
T. McCabe, Ph.D1,2,3

Results: All mice with rCBI showed less freezing behavior than sham control mice during thefear conditioning context test. Injured male, but
not female, mice also froze less in response to theauditory cue (tone). Injured mice spent more timein the open quadrants of the elevated zero maze,suggesting decreased anxiety, but there were nodifferences between injured mice and sham-controls
in depressive-like activity on the tail suspension
test. Pathologically, injured mice showed increased
astrogliosis in the injured cortex and white matter
tracts (optic tracts and corpus callosum). There were
no changes in the number of parvalbumin-positive
interneurons in the cortex or amygdala, but injured
male mice had fewer parvalbumin-positive neurons
in the hippocampus.

Author Affiliations

1. Pre-Clinical Studies Core, Center for
Neuroscience and Regenerative Medicine,
Uniformed Services University of the Health
Sciences, Bethesda, MD
2. Department of Anatomy, Physiology & Genetics,
Uniformed Services University of the Health
Sciences, Bethesda, MD
3. Graduate Program in Neuroscience, Uniformed
Services University of the Health Sciences,
Bethesda, MD

ABSTRACT

Background/Objectives: Repetitive concussive brain
injuries (rCBI) may be a risk factor for depression
and anxiety disorders, including post-traumatic stress disorder. Animal models of brain injury
afford the opportunity for controlled study of theeffects of injury on functional outcomes. Despite theparticipation of female athletes in contact sports,
few pre-clinical studies include both sexes in TBI
research.

Conclusions: Parvalbumin-reactive interneurons of
the hippocampus have been previously demonstrated to be involved in hippocampal-cortical interactions required for memory consolidation, and it ispossible memory changes in the fear-conditioning
paradigm following rCBI are the result of more
subtle imbalances in excitation and inhibition bothwithin the amygdala and hippocampus, and between
more widespread brain regions that are injured following a diffuse brain injury.

Methods: Male and cycling female C57BL/6J micesustained rCBI (3x) at 24-hr intervals and were
tested in a context and cued fear conditioning para-37

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Influence of Number of Awakenings during the Previous
1-3 Nights on Post Traumatic Stress Symptoms Among
Individuals with PTSD
Authors

during the previous night. Similar variables werecreated for number of awakening from the sleep
during the previous two or three nights. Linear
mixed models were applied, with controlling for
demographic characteristics.

Jing Wang, Ph.D., Robert J. Ursano, M.D., Quinn
M. Biggs, Ph.D., M.P.H.,1 David S. Krantz, Ph.D.,1
Gary H. Wynn, M.D.,1 Russell B. Carr, M.D.,1,2
Nicole M. Dacuyan, B.S.,1 and Carol S. Fullerton,
Ph.D.1
1

1

Results: Number of awakenings during the previous
night was not associated with PTSS (b = 0.86, p =.064). However, number of awakenings during theprevious two (b = 1.76, p = .035) or three nights (b =1.56, p = .029) was positively associated with PTSS.
The overall variables of number of awakenings were
not associated with PTSS in all three models.

Author Affiliations

1. Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University of the Health Sciences, 4301 Jones
Bridge Road, Bethesda, MD 20814
2. Walter Reed National Military Medical Center,
8901 Wisconsin Avenue, Bethesda, MD 20889

Conclusions: These preliminary findings suggestthat number of awakenings did not have an immediate influence on the following day’s PTSS. However,two or three days of disruptive sleep awakenings
may have an accumulative effect with more awakenings associated with higher PTSS. Assessing andmonitoring changes in sleep and implementing
interventions to improve sleep quality may reduce
PTSS for individuals with PTSD.

ABSTRACT

Background: Little is known how sleep affects Post
Traumatic Stress Symptoms (PTSS) from day today. This study examined the relationship between
the number of awakenings from sleep during theprevious 1-3 nights and daily level of PTSS amongindividuals with Post Traumatic Stress Disorder(PTSD).

Keywords: post traumatic stress disorder, sleep,
symptom assessment, ecological momentary assessment

Methods: Subjects (N = 80) were assessed forprobable PTSD at enrollment and individuals withprobable PTSD (n = 42) were included in the analyses. Using an ecological momentary assessment
methodology, PTSS were assessed four times daily
and number of awakenings was assessed once daily
by self-report for 15 days. An overall awakenings
variable (i.e., person mean) and a previous nightawakenings variable (i.e., the difference between
the previous night and the individual’s mean) werecreated for number of awakenings from the sleep

Disclaimer: The opinions and assertions expressedherein are those of the author(s) and do not necessarily reflect the official policy or position of the
Uniformed Services University, Department of
Army/Navy/Air Force, Department of Defense, or
U.S. Government.

38

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Sex-Related Differences of Mitochondrial DNA Copy
Number in Active Military Service Members with PTSD
Authors

sample size study might be needed in the future.
The Institutional Review Board at the Uniformed
Service University of Human Sciences approved all
study procedures and all participants were given
written informed consent. PTSD symptoms wereassessed using the PTSD Checklist (PCL), a 17-item,
DSM-based, self-report questionnaire with well-established validity and reliability. PTSD diagnosis
was determined based on endorsement of DSM-IV
criteria and a PCL total score ≥ 44. The severity of
PTSD symptoms was determined using the PCL total score. Subjects with depression, substance abuse,or any medication use were excluded. Demographic
data, such as age, gender, and race, were collected.

Lei Zhang MD , Xian-Zhang Hu MD & PhD ,Xiaoxia Li BS1, David M. Benedek MD1, Carol S.
Fullerton PhD1, Gary Wynn MD1, Biomarker Study
Group, Robert J. Ursano MD1
1

1

Author Affiliations

1. Center for the Study of Traumatic Stress,
Department of Psychiatry, USUHS, Bethesda,
MD 20814, USA
ABSTRACT
Background: The lifetime prevalence of PTSD has
been observed to be about 10–12% in women and
5–6% in men suggesting a sex-related difference in
PTSD prevalence. PTSD is associated with mitochondrial DNA copy number (mtDNAcn), which
is an emerging systemic index of mitochondrial
biogenesis and function. Together, these results leadto a hypothesis that there is a sex-related difference
between mtDNAcn levels, which may allow mtDNAcn levels to be used as a potential biomarker to
identify PTSD or monitor PTSD symptoms.

Results: mtDNAcn was significantly higher infemale service members with PTSD compared witheither male/female non-PTSD controls or male service members with PTSD (p<0.05). However, there
was no significant difference of mtDNAcn between
male service members with PTSD and male/female
non-PTSD controls.
Discussion: This study provides the first evidence
showing significantly increased mtDNAcn levels infemale service members with PTSD, but not in maleservice members with PTSD. This suggests that altered mtDNAcn in PTSD may be sex-dependent, atleast relating to active service members, and reflect
impaired energy metabolism, which might represent
a novel aspect of PTSD pathophysiology and serve
as a biomarker for PTSD in females.

Methods: mtDNAcn was assessed with a TaqMan
assay using white blood cells from service members with (n=137; male: 123, female: 14) or without(n=673; male: 606, female: 67) PTSD, who served
during combat operations in the Afghanistan and/or Iraq wars between 2008 and 2016. The limitation of this study is a relatively small female sample
size, and so a comprehensive with a larger female

39

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Continuing Education Credit
The Amygdala, Stress, and PTSD Conference,in conjunction with the Center for Deployment
Psychology at the Uniformed Services University
is pleased to offer continuing education credits for
Physicians, Psychologists, Social Workers, and Nurs-

es. The credits are available through live in person
attendance.
Continuing Education made possible in part by
the generous support of the Center for Deployment
Psychology.

American Psychiatric Association (APA)
proceed to the evaluation and certificate. Select“AMA PRA Category 1 Physician” as yourcertificate type.

Accreditation

This activity has been planned and implemented
in accordance with the accreditation requirements
and policies of the Accreditation Council for Continuing Medical Education through the joint providership of the American Psychiatric Association(APA) and Society of Uniformed Services Psychiatrists. The APA is accredited by the ACCME to provide continuing medical education for physicians.

You must claim your CME credit within 60 days ofthe conference. Certificates will not be issued afterJune 16, 2019. For customer support, please email
apalms@psych.org.

Disclosure Information

Derrick A. Hamaoka, MD – Nothing to disclose
Eric Meyer II, MD – Nothing to disclose
Katy Pokorny – Nothing to disclose
Dennis S. Charney, MD – (See next page)
Anne Germain, PhD – CEO and Equity – Rehat,
LLC, Consultant – Jazz Pharmaceuticals, Inc.
Jessica M. Gill, PhD, RN. – Nothing to disclose
James L. Griffith, MD – Nothing to disclose
Irwin Lucki, PhD – Consultant – Alkermes
COL Wendi Waits, MD – Capital Equity –Reimbursify
COL Christopher H. Warner, MD – Nothing todisclose
Kwang Choi, PhD – Nothing to disclose
Kelly L. Cozza, MD – Nothing to disclose
Iona M. Horotan-Enescu, MD – Nothing to disclose
Holly H. Mash, PhD – Nothing to discloseDavid Mears, PhD – Nothing to disclose

Designation

The APA designates this live activity for a maximum of 5 AMA PRA Category 1 Credit.™ Physicians
should claim only the credit commensurate with theextent of their participation in the activity.

Physician CME Certificates

At the conclusion of the conference, physician
participants will be provided with an opportunity toclaim hours of participation and receive an official
CME certificate by completing the online CME conference evaluation.
1. Go to http://apapsy.ch/amygdala
2. Click ACCESS ACTIVITY and log in with your
APA username and password or create a new
account.
3. Enter the Group ID: SUSP191
on the Purchase page and click SUBMIT to40

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

James A. Naifeh, PhD – Nothing to disclose
Amy E. Steward, TSgt, USAF – Nothing to disclose
Robert J. Ursano, MD – Nothing to disclose
Gary H. Wynn, MD – Nothing to disclose

applications - Method for Treating Post TraumaticStress Disorder (PTSD) ; US Serial No. 14/889,746
and a related foreign patent application - Treatmentof Mood and Anxiety Disorders ; US CON PatentAppl Nos. 15/379,013 and 15/417,689 - Intranasal
Administration of Ketamine to Treat Depression.

Dennis S. Charney, MD
Ongoing Research Support P01HL131478 (PI:
Fayad) 03/17/17-02/28/22 National Heart, Lung,
and Blood Institute/NIH/DHHS Stress and atherosclerotic plaque macrophages – a systems biology
approach Role: Co-Investigator N/A (PI: Bevilacqua)
07/15/18-07/15/20 Brain and Behavior Research
Foundation Intranasal NPY

Meeting Objectives

At the end of this educational activity, the learner
will be able to:• Understand how gpsychological stress alters
brain function.
• Understand psychobiological mechanisms ofhuman resilience to stress.
• You can train to be more resilient.
• Implications for your own life.
• Describe the importance of sleep as a biologicalforce multiplier in psychological health,resilience, and readiness.
• Explain the interaction between sleep and neuralcircuits underlying threat- and goal-oriented
behaviors.
• Detail the nature and impact of sleep-focusedinterventions on psychological health.
• Describe the proteins that relate to PTSD as wellas traumatic brain injury (TBI) symptoms.
• Describe gene-activity profiles that relate tochronic PTSD symptoms.
• Determine the long-term biological changes
that relate to TBI and PTSD, which may havemorbidity risks associated with them.
• Conceptualize hope as a practice, i.e. “something
you do” rather than “something you feel.”• Demonstrate rapid assessment of patients’competencies for mobilizing hope in stressful
circumstances.
• Formulate and design interventions to mobilize
hope when a patient is demoralized.
• Show how empirical social psychology and social
neuroscience can expand the scope and potencyof psychotherapeutic interventions to mobilize
hope and counter demoralization.
• The state of research on developing rapid
acting antidepressants for treatment-resistantdepression.
• The potential benefits of using ketamine in thetreatment of mental health disorders.
• The potential negatives of using ketamine in thetreatment of mental health disorders.

Role: Key Personnel, Co-Mentor 23629 (PI: Balchandani) 01/15/16-01/14/19 Brain and Behavior Research Foundation Development of 7T MRI protocol
to establish imaging biomarkers for depression Role:
Key Personnel, Mentor Completed Research Support (Past 3 Years K23MH099223 (PI: Iacoviello)
08/19/13 – 07/31/18 (Transferred) NIMH A Novel
Cognitive Training Intervention for Depression
Role: Key Personnel, Mentor 2013098 (PI: Murrough) 07/01/13-06/30/17 (Ended Early) Doris Duke
Charitable Foundation Ketamine Plus Lithium asa Novel Pharmacotherapeutic Strategy fin Treatment-Resistant Depression
Role: Key Personnel, Mentor K23MH094707 (PI:
Murrough) 07/15/11-05/31/16 NIH Functional MRI
Studies of Emotion IN Depression and Rapid Antidepressant Response
Named co-inventor US Patent No. 9,592,207 - Intranasal Administration of Ketamine to Treat Depression (Issued March 14, 2017); US Patent No.
9,539,220 - Methods for Treating Suicidal Ideation(Issued January 10, 2017) ; US Patent No. 8,785,500- Intranasal Administration of Ketamine to Treat
Depression (Issued July 22, 2014) ; US Patent No.
10,123,737 - Systems and Methods for Treating a
Psychiatric Disorder (Issued November 13, 2018) ;US CON Patent Appl No. 16/189,059 – and related
foreign patent applications - Systems and Methods
for Treating a Psychiatric Disorder US Provisional
Patent Appl No. 62/649,469 – Brain Plasticity Following Cognitive-Emotional Training ; US CON Patent Appl No. 14/974,576 and related foreign patent41

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Brooke Army Medical Center (BAMC)Free Continuing Education (CE) Credits are available for this workshop. This event is sponsoredthrough the Department of Behavioral Health,
Brooke Army Medical Center. Department of Behavioral Health, Brooke Army Medical Center is approved by the American Psychological Association
to sponsor continuing education for psychologists.

Department of Behavioral Health, Brooke Army
Medical Center maintains responsibility for this program and its content. 3.75 credit hours will be given
for full attendance at the workshop. No partial credit
will be provided. A sign-in /sign-out sheet as well as
an evaluation form must be completed in order toreceive CE credits and a certificate.

PESI, Inc.
tion. Credit requirements and approvals vary perstate board regulations. Please save the course outline, the certificate of completion you receive fromthe activity and contact your state board or organization to determine specific filing requirements.

Program Content provided by Center for Deployment Psychology Continuing Education hours
provided by PESI, Inc.
Program Title: 14th Annual Amygdala, Stress, and
PTSD Conference: Risk, Resilience, and Recovery

MARRIAGE & FAMILY THERAPISTS: This activity consists of 225 minutes of continuing education
instruction. Credit requirements and approvals vary
per state board regulations. You should save thiscourse outline, the certificate of completion you receive from the activity and contact your state board
or organization to determine specific filing requirements.

Date: April 16, 2019
Location: Uniformed Services University, Bethesda,
MD
PESI Program Code: 72883BET (Please reference
this code when contacting PESI regarding this program)

NURSES/NURSE PRACTITIONERS/CLINICALNURSE SPECIALISTS: This activity consists of 3.75
clock hours of continuing education instruction.
Credit requirements and approvals vary per stateboard regulations. Please save the course outline,
the certificate of completion you receive from thisactivity and contact your state board or organization
to determine specific filing requirements.

Duration of Instructional Content: 225 minutes
Must attend entire seminar to receive credit. No partial credit will be awarded.
ADDICTION COUNSELORS: This activity consistsof 3.5 clock hours of continuing education instruction. Credit requirements and approvals vary perstate board regulations. Please save the course outline, the certificate of completion you receive fromthe activity and contact your state board or organization to determine specific filing requirements.

SOCIAL WORKERS: PESI, Inc., #1062, is approved to offer social work continuing educationby the Association of Social Work Boards (ASWB)
Approved Continuing Education (ACE) program.
Organizations, not individual courses, are approved
as ACE providers. State and provincial regulatoryboards have the final authority to determine whether

COUNSELORS: This intermediate activity consistsof 3.75 clock hours of continuing education instruc42

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

an individual course may be accepted for continuing
education credit. PESI, Inc. maintains responsibility for the course. ACE provider approval period:
January 27, 2017 - January 27, 2020. Social Workers
completing this course receive 3.75 Clinical Practicecontinuing education credits for completing thiscourse. Course Level: Intermediate. A certificate ofattendance will be awarded at the end of the program to social workers who complete the program
evaluation. Full attendance is required; no partial
credits will be offered for partial attendance.

and certificate of completion, and contact your own
board or organization for specific requirements.
Credits listed are for full attendance only. Certificates of Completion are emailed 3-4 weeks after the
event and after attendance has been verified to those
who attend the full seminar. Please see “live seminarschedule” for full attendance start and end times.
NOTE: Boards do not allow credit for breaks orlunch. If your profession is not listed, please contact
your licensing board to determine your continuing
education requirements and check for reciprocal
approval. Materials that are included in this course
may include interventions and modalities that are
beyond the authorized practice of mental healthprofessionals. As a licensed professional, you areresponsible for reviewing the scope of practice,including activities that are defined in law as beyond
the boundaries of practice in accordance with and incompliance with your professions standards. PESI,
Inc. offers continuing education programs and products under the brand names PESI, PESI Healthcare,
PESI Rehab and Psychotherapy Networker.

PENNSYLVANIA SOCIAL WORKERS, MARRIAGE & FAMILY THERAPISTS AND PROFESSIONAL COUNSELORS: This intermediate activity
consists of 3.75 clock hours of continuing education
instruction. Credit requirements and approvals vary
per state board regulations. Please contact yourlicensing board to determine if they accept programsor providers approved by other national or state
licensing boards. A certificate of attendance will beawarded at the end of the program to participants
who are in full attendance and who complete theprogram evaluation. Full attendance is required; nopartial credits will be offered for partial attendance.

**CE hours for this activity are being provided by
PESI, Inc. Have an inquiry on continuing educationcredit that is not listed here? Please contact Bridget
Schaub at PESI, Inc. before the event. You may reachher via email at bschaub@pesi.com.

OTHER PROFESSIONS: This activity qualifies for
225 minutes of instructional content as required bymany national, state and local licensing boards andprofessional organizations. Save your course outline

43

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Amygdala Conference Training Titles and Learning Objectives
1. Dennis S. Charney, MD — “Resilience: The Science of Mastering Life’s Greatest
Challenges”
a. Learning Objectivesi.

Articulate how psychological stress alters brain functionii.

Appraise the psychobiological mechanisms of human resilience tostressiii.

Point out training methods that increase resilience

iv.

Communicate the implications of improved resilience in their own
lives

2. Anne Germain, PhD — “Wake up to Sleep! A Translational Perspective of theRole of Sleep in Readiness and Resilience”
a. Learning Objectivesi.

Deduce the importance of sleep as a biological force multiplier inpsychological health, resilience, and readiness

ii.

Assess the interaction between sleep and neural circuits underlying threat- and goal-oriented behaviors

iii.

Communicate the nature and impact of sleep-focused interventions on psychological health

3. Jessica M. Gill, PhD, RN — “Gene-activity and Proteins that Relate to Chronic
PTSD Symptoms”
a. Learning Objectivesi.

Point out the proteins that relate to PTSD as well as traumaticbrain injury (TBI) symptoms

ii.

Diagnose gene-activity profiles that relate to chronic PTSD symptoms

iii.

Determine the long-term biological changes that relate to TBI andPTSD, which may have morbidity risks associated with them

4. James L. Griffith, MD— “Mobilizing Hope in the Face of Despair: Applying
Social Neuroscience Research in Brief Clinical Encounters”
a. Learning Objectivesi.

Appraise how hope is a practice, i.e. “something you do” rather
than “something you feel”
44

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

ii.

Consider methods on assessing patients’ competencies for mobilizing
hope in stressful circumstancesiii.

Provide an overview of interventions to mobilize hope when a patientis demoralizediv.

Analyze how empirical social psychology and social neuroscience can
expand the scope and potency of psychotherapeutic interventions tomobilize hope and counter demoralization.

5. Irwin Lucki, PhD — “Preclinical Development of Ketamine and the Metabolite
2R,6R-Hydroxynorketamine For Depression and Other Disorders”
a. Learning Objectivesi.

Characterize the state of research on developing rapid-acting antidepressants for treatment-resistant depression.

ii.

Critique the potential benefits of using ketamine in the treatment of
mental health disorders.

iii.

Assess the potential negatives of using ketamine in the treatment of
mental health disorders.

45

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Notes

46

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Notes

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

47

14th Annual Amygdala, Stress, and PTSD Conference: Risk, Resilience, and Recovery

Center for the Study of Traumatic Stress
Department of Psychiatry
Uniformed Services University
4301 Jones Bridge Road, Bethesda, MD 20814-4799
www.CSTSonline.org
48