UNIFORMED
UNIVERSITY
12th Annual
Amygdala, StressSERVICES
and PTSD Conference:
Understanding Stress
CENTER FOR THE STUDY OF TRAUMATIC STRESS

12th Annual Amygdala, Stress and PTSD
Conference: Understanding Stress
APRIL 18, 2017
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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12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress2

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

UNIFORMED SERVICES UNIVERSITYCENTER FOR THE STUDY OF TRAUMATIC STRESS

12th Annual Amygdala, Stress and PTSD
Conference: Understanding Stress
APRIL 18, 2017
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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12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

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 12th
Annual Amygdala, Stress and PTSD Conference: Understanding Stress.

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12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Table of Contents
Agenda............................................................................................................................. 3
Conference Speakers...................................................................................................... 4Moderators...................................................................................................................... 7
Conference Leadership.................................................................................................. 8
Conference Committee............................................................................................... 10
Conference Posters....................................................................................................... 11
Continuing Education Credit..................................................................................... 35

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12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress2

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

AGENDA
0800-0900

Registration and Poster Review

0900-0905

Conference Announcements — Gary H. Wynn, MD

0905-0915

Welcome and Introduction — Robert J. Ursano, MD

0915-1000
		Ronald S. Duman, PhD — Molecular and Cellular Studies of PTSD: Postmortem Transcriptome
Analysis and Novel Therapeutic Agents		

1000-1045
		

Doug Williamson, PhD — On the Road to Discovery: Identifying Novel Genes 				Associated with PTSD		

1045-1115

Coffee Break and Poster Review in Lobby

1115-1145

Discussion Panel 1 — Moderator, James Reeves, MD

1145-1245

Lunch

1245-1330

Regina C. Armstrong, PhD — Glia: Clues to Commonalities in TBI and PTSD Symptoms

1330-1415
		

Steven E. Bruce, PhD — Examination of Neural Improvements after Cognitive 				Behavioral Therapy for PTSD

1415-1445

Coffee Break and Poster Review in Lobby

1445-1530

Sandro Galea, MD — Trauma as a Foundational Cause of Population Health1530-1600

Discussion Panel 2 — Moderator, James C. West, MD

1600-1615

Robert J. Ursano, MD — Closing Remarks and Presentation of Poster Award3

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Conference Speakers
Regina C. Armstrong, PhD

Steven E. Bruce, PhD

Dr. Armstrong is Director of
the Center for Neuroscienceand Regenerative Medicine(CNRM). The CNRM is a collaborative intramural research
program of the Uniformed
Services University of the
Health Sciences (USU) with
the National Institutes of
Health (NIH) and the Walter
Reed National Military Medical Center (WRNMMC). The
CNRM focus is pre-clinical through clinical research topromote recovery from traumatic brain injury and to
improve psychological health in combat casualties cared
for at WRNMMC.
Dr. Armstrong earned a B.S. in Neuroscience fromthe University of Rochester, where she began researchtraining in multiple sclerosis at the Center for Brain
Research. She was a National Science Foundation
Fellow for work toward her Ph.D. in Neurobiology at
the University of North Carolina at Chapel Hill. She
did postdoctoral training at the National Institute for
Neurological Disorders and Stroke (NIH).
Dr. Armstrong’s primary academic appointment is
as Professor of Anatomy, Physiology, and Genetics in
the F. Edward Hebert School of Medicine at USU. Dr.
Armstrong holds secondary appointments in the Neuroscience and the Molecular and Cell Biology Graduate
Programs. Dr. Armstrong received the faculty award
for Outstanding Graduate Biomedical Educator fromthe School of Medicine in 2002. She served as Director of the USU Neuroscience Graduate Program from2002–2008 before stepping down to begin as Directorof the CNRM. Dr. Armstrong teaches in the first year
medical student module on the nervous system and inseveral graduate student courses. Dr. Armstrong’s laboratory focuses on mechanisms of damage and repair
in the brain and spinal cord. This work employs diverse
research approaches, from molecular techniques toneuroimaging, to address ways to improve neuroregeneration and repair capacity in the CNS. Research efforts
in her laboratory have been funded through peer-reviewed competitive awards from the NIH, the National
Multiple Sclerosis Foundation, and the Department of
Defense.

Steven E. Bruce, PhD is the
Director of the Center forTrauma Recovery, Director of
Clinical Training, and Associate Professor of Psychological
Sciences at the University ofMissouri-St. Louis. He received his Ph.D. in ClinicalPsychology from Virginia
Commonwealth University in Richmond, Virginia. He
then completed his internship at the Medical Universityof South Carolina in Charleston, SC and a post-doctoral
fellowship at Brown University School of Medicine inProvidence, RI. Dr. Bruce is a member of several scientific organizations including the Association for Behavioral and Cognitive Therapies (ABCT) and the Society
for Neuroscience (SFN) and has served on several editorial boards. He has authored or co-authored over 50
publications and over 150 presentations in the area ofanxiety disorders. Dr. Bruce’s primary research interestsand clinical specializations include the treatment ofanxiety and affective disorders, particularly post-traumatic stress disorder. Specifically, Dr. Bruce is interested
in conducting translational research incorporatingneuroimaging and psychophysiological assessment asboth predictors and outcomes of cognitive behavioral
treatment response.

412th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Ronald S. Duman, PhD

Sandro Galea, MD, MPH, DrPH

Dr. Duman is Professor of Psychiatry and Neurobiology and Directorof the Abraham Ribicoff Research
Facilities at the Yale University
School of Medicine. Studies fromDr. Duman’s laboratory havecontributed to the characterization of the molecular and cellular actions of stress,
depression, and antidepressants providing the basis fora neurotrophic and synaptic hypothesis of depression.
This hypothesis is based on work demonstrating thatchronic administration of a typical antidepressant or asingle dose of a rapid acting agent like ketamine blocks
or reverses the neuronal atrophy that is caused by stressand depression. Dr. Duman’s work has demonstrated
that increased neurotrophic factor levels and increased
synapse formation underlie the actions of rapid acting
antidepressants. These findings represent major advances in our understanding of the effects of antidepressants and provide a framework for the development ofnovel therapeutic agents. More recent studies from Dr.
Duman’s laboratory have focused on the cellular mechanisms underlying traumatic stress, including transcriptomic and proteomic studies of postmortem brain tissue
from PTSD subjects, and studies of novel rapid acting
agents for the treatment of PTSD. Dr. Duman has been
the recipient of several prestigious awards, including
the Anna-Monika Prize, Nola Maddox Falcone Prize,
Janssen Prize, NIMH MERIT Award, and a NARSAD
Distinguished Investigator Award. He is a member of
the National Academy of Sciences. Dr. Duman is authorof over 300 original articles, reviews and chapters andhas given over 250 invited lectures. He has also served
as a consultant to Pfizer, Lilly, Johnson & Johnson,
Lundbeck, Taisho, Naurex, Navitor, and Allergan.

Dr Galea is a physician andan epidemiologist. He is theRobert A. Knox Professor and
Dean at the Boston University
School of Public Health. Prior
to his appointment at Boston
University, Dr Galea served
as the Gelman Professor andChair of the Department of
Epidemiology at the Columbia
University Mailman School of Public Health. He previously held academic and leadership positions at the
University of Michigan and at the New York Academyof Medicine.
In his scholarship, Dr Galea is centrally interested
in the social production of health of urban populations, with a focus on the causes of brain disorders,
particularly common mood-anxiety disorders andsubstance abuse. He has long had a particular interest in
the consequences of mass trauma and conflict worldwide, including as a result of the September 11 attacks,
Hurricane Katrina, conflicts in sub-Saharan Africa, and
the American wars in Iraq and Afghanistan. This work
has been principally funded by the National Institutesof Health, Centers for Disease Control and Prevention,and several foundations. He has published over 640
scientific journal articles, 50 chapters, and 10 books andhis research has been featured extensively in current periodicals and newspapers. His latest book, co-authoredwith Dr Katherine Keyes, is Population Health Science,
was published by Oxford University Press in 2016.
Dr Galea has a medical degree from the University of Toronto, and graduate degrees from Harvard
University and Columbia University; he has an honorary doctorate from the University of Glasgow. He wasnamed one of TIME magazine’s epidemiology innovators and has been listed by Thomson Reuters as one of
the “World’s Most Influential Scientific Minds” for theSocial Sciences. He is past-president of the Society for
Epidemiologic Research and an elected member of the
National Academy of Medicine and of the American
Epidemiological Society. Dr Galea has received several
lifetime achievement awards for this research, including
the Rema Lapouse Award from the American Public
Health Association and the Robert S Laufer Award
from the International Society for Traumatic Stress. He
is a regular contributor to Fortune magazine and has
Continued on page 65

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Sandro Galea, MD, Continued

Doug Williamson, PhD

published widely in lay press including in the Wall Street
Journal, Harvard Business Review, the Boston Globe, the
New York Times. His research has been cited in thesejournals and in BBC, Slate, WBUR, and NPR, among
others.
Dr Galea serves frequently on advisory groups tonational and international organizations. He currently
serves on the Advisory Council on Minority Health and
Health Disparities and has formerly served as chair of
the New York City Department of Health and Mental
Hygiene’s Community Services Board and as member of
its Health Board.

Douglas E. Williamson is a
Professor at Duke University
in the Department of Psychiatry and Behavioral Sciences
and the Director of the Translational Center for Stress-Related Disorders. Dr. Williamson’s research interests fallwithin the emerging field oftranslational epidemiology – adiscipline that considers the
population level characteristics of stress-related diseases
and integrates mechanistic studies in the identificationand characterization of risk factors associated with theironset.
Dr. Williamson’s earlier research examined thefamilial aggregation of depression in children and adolescents and the role of familial risk for depression on
the risk to develop depression early in the life span. This
research has led to insight into potential genetic andenvironmental risk factors for depression and anxiety
and has extended to understanding the role of the developing brain. This research has shown that adolescentsat high familial risk for depression have a heightened
amygdala response to stimuli and that subtle shifts inepigenetic state of gene (e.g. DNA methylation) further
potentiate this heightened reactivity resulting in theemergence of initial symptoms of depression.
Currently, Dr. Williamson is leading efforts for
the STRONG STAR Multidisciplinary Research Consortium to identify genetic and environmental contributors to PTSD. Toward this end, Dr. Williamson
and colleagues are using population samples of active
duty soldiers screened before and after deployment to
identify genetic variants associated with PTSD as well as
genes that are uniquely dysregulated following exposure
to combat-related trauma among soldiers developing
PTSD. Dr. Williamson also currently leads efforts for
the Consortium to Alleviate PTSD (CAP), a national
effort established as part of the White House’s National Research Action Plan in 2013 to address the publichealth burden of PTSD. Dr. Williamson and colleagues
are identifying unique genetic and epigenetic biomarker
signatures of PTSD, risk to develop PTSD, and predictors of treatment response for PTSD.

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12th Annual Amygdala, Stress and PTSD Conference: Understanding StressModerators
James Reeves, MD

James C. West, MD

Born in Portsmouth, Virginia
and raised in Houston, Texas,
CAPT Reeves graduated fromSouthwestern University witha degree in Biology in 1992.
He completed his Doctor of
Medicine at the University ofTexas Health Science Center
San Antonio in 1996 and his
residency in psychiatry at the
University of North Carolina Hospitals in Chapel Hill
where he was chief resident in 2000.
CAPT Reeves began his Navy career in 2000 asa staff psychiatrist at the Walter Reed Army Medical
Center and the National Naval Medical Center. He
assisted in the relief efforts both at Washington DC and
New York City during 9/11 and published 3 papers on
the topic. CAPT Reeves was then selected to become the
1st Marine Division (1MARDIV) psychiatrist at Camp
Pendleton where he oversaw mental health for the 1st
Marine Expeditionary Force in Al Anbar province, Iraq
during 2004 and published in the Marine Corps Gazette on operational stress control. From 2005 to 2009
he served as the psychiatry residency director at theNaval Medical Center San Diego. In 2009 CAPT Reeves
was selected to become the Office of the Secretary of
Defense’s (OSD) lead on global health in OSD-Policy
where he oversaw the Department of Defense’s $99
million HIV/AIDS prevention program. CAPT Reeves
was selected as the Director for Mental Health at Naval
Medical Center Portsmouth where he led 320 personnel
across Hampton Roads to include inpatient, outpatientand substance abuse services as well as 2 training programs and served on the Command Executive Board.
CAPT Reeves is currently serving as the Director ofTraining and Professional Development for the Center for Global Health Engagement at the Uniformed
Services University of the Health Sciences (USUHS). He
also serves as the Specialty Leader for Navy Psychiatry
where he leads the Navy’s 145 psychiatrists and manages
Navy mental health policy.
CAPT Reeves remains an Associate Clinical Professor of Psychiatry at the Uniformed Services Universityof the Health Sciences and previously served as a board
examiner for the American Board of Psychiatry and
Neurology. He received the 2015 Sears Award for mostoutstanding Navy psychiatrist.

Dr. West is Assistant Professorof Psychiatry and a Scientist
at the Center for the Study ofTraumatic Stress, Uniformed
Services University of the
Health Sciences. He earned his
B.S.E. from the United States
Naval Academy in 1989 andhis M.D. from the Universityof Michigan Medical Schoolin 2001. He served eight years as a submarine warfare
officer in the Navy and completed residency training in
psychiatry at Naval Medical Center Portsmouth, Virginia. He has completed tours with First Marine Divisionin Camp Pendleton, California and National Naval
Medical Center, Bethesda, Maryland. He deployed in2006 to Fallujah, Iraq as Operational Stress Control andReadiness (OSCAR) psychiatrist for Regimental Combat Team 5 and in 2010 to Helmand Province, Afghanistan as Combat and Operational Stress Control Officer
for Combat Logistics Regiment 15 (Fwd). He served on
the leadership team integrating with Walter Reed Army
Medical Center as Assistant Deputy Commander and
Deputy Commander of Behavioral Health at Walter
Reed National Military Medical Center.
Dr. West is a fellow of the American Psychiatric Association and currently serves as assembly representative for the Society of Uniformed Services Psychiatrists.
His professional interests include research into assessment methods in psychiatry education, and translating
understanding of biological underpinnings of PTSD
and trauma-related disorders into more effective treatments.

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12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Conference Leadership
Gary H. Wynn, MD
LTC, MC, USA

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

Dr. Wynn is Associate Professor of Psychiatry and Neuroscience and Assistant Chair of
the Department of Psychiatryat the Uniformed Services University of the Health Sciences.
He is a Scientist at the Centerfor the Study of TraumaticStress. He is also a Distinguished Fellow of the American Psychiatric Association and on the editorial boardsof Psychosomatics and the Journal of Neuroscience
Research. Dr. Wynn received his education at the UnitedStates Military Academy at West Point and Uniformed
Services University of the Health Sciences. He completed a dual residency in psychiatry and internal medicine
at the Walter Reed Army Medical Center in Washington,
DC. During his military career Dr. Wynn has served asa Division Psychiatrist (2nd Infantry Division, Korea),
Assistant Chief of Inpatient Services (Walter Reed), andas a Research Psychiatrist (Walter Reed Army Instituteof Research) prior to transitioning to the Uniformed
Services University of the Health Sciences.
Dr. Wynn has served as a frequent member of DoD
level committees and working groups on the topics of
PTSD and suicide. He currently serves as the Chair for
the DoD’s Joint Program Committee working group on
Diagnosis and Treatment of PTSD. Dr. Wynn has served
as a member of VA Merit Review Boards, as a memberof a National Institutes of Mental Health Data Safety
and Monitoring Board, and as US Representative to theNATO Human Factors in Medicine panel on technology in military mental health. He is the recipient of the
AMEDD “A” Proficiency Designator, the Rundell Award,
the Artiss Award, and three Meritorious Service Medals
as well as a member of the Order of Military Medical
Merit. Dr. Wynn is Chair for the Amygdala, Stress, and
PTSD conference currently in its 12th year and President of the Society of Uniformed Services Psychiatrists.
In addition, Dr. Wynn has over 50 publications including being co-author and editor of three books.

Continued on page 98

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

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

912th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Conference Committee
Robert J. Ursano, MD
Professor and Chair
Department of Psychiatry
Director
Center for the Study of Traumatic Stress
Uniformed Services University

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

Gary H. Wynn, MD, 2017 Chairman
LTC, MC, USA
Assistant Chair and Associate Professor
Department of Psychiatry
School of Medicine
Scientist
Center for the Study of Traumatic Stress
Uniformed Services University

Eric Meyer, MD
Assistant Professor
Department of Psychiatry
Scientist
Center for the Study of Traumatic Stress
Uniformed Services University
Jorge M. Hastings, Tsgt, USAFNCOIC, Department of Psychiatry
Center for the Study of Traumatic Stress
Uniformed Services University

David Mears, PhD, 2017 Co-Chairman
Associate Professor
Department of Anatomy, Physiology and Genetics
Uniformed Services University

Mackenzie Franz, BA
Research AssistantCenter for the Study of Traumatic Stress
Uniformed Services University

Ronald J. Whalen, PhD LTC, MSC, USA
Assistant Professor, Counseling Services Department of Family Medicine Uniformed Services
University

Nicole Caulfied, BA
Research AssistantCenter for the Study of Traumatic Stress
Uniformed Services University

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

1012th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Conference Posters
Presented in the Lobby
MicroRNAs Expression in Basolateral Amygdala of Rats Associated with Stress
Vulnerability and Resilient Sleep Patterns: Implications for Posttraumatic Stress
Disorder............................................................................................................................ 13
Reversal of Stress-Induced Social Interaction Deficits by Buprenorphine...................... 14
Analysis of Traumatic Stress and Depression Self-Report Measures in a Civilian
Population Sample.......................................................................................................... 15
Functional Connectivity of Centromedial-Amygdala Predicts its Response to Fearful
Faces.................................................................................................................................. 16
Association of General Belief in a Just World and Mental Health Outcomes
Following the 9/11 Terrorist Attacks............................................................................. 17
The Protective Effect of Social and Support Networks among U.S. Army Soldiers
at Risk for Suicide............................................................................................................ 18
Promoting Family Safety Through Personal Firearm Safety Education.......................... 19
Perceived Environmental Stress Mediates the Relationship Between PTSD
Symptoms and Coping in a Neighborhood-Matched Substance-Using Sample.... 20
Multiple Notifications of Human Remains in Families of September 11th Decedents
Associated with Depression and Posttraumatic Stress Disorder.............................. 21
Grief, Anxiety, and Depression Independently Predict Cognitive Failures in Bereaved
Family Members.............................................................................................................. 22
Community Strength and Disasters: Collective Efficacy Following the 2004 Florida
Hurricanes........................................................................................................................ 23
Regression Modeling of Post-Deployment Survey Data Identifies Areas of Needed
Resiliency Training ......................................................................................................... 24
Effects of Isoflurane Anesthesia and Intravenous Morphine Self-administration on
Regional Cerebral Glucose Metabolism in Sprague Dawley Rats:
18
F-FDG PET/CT Study ................................................................................................. 25
Effect of Intravenous Ketamine on Corticosterone and Brain-Derived Neurotrophic
Factor in Sprague-Dawley Rats..................................................................................... 26
Heterogeneity of the DSM-5 PTSD Diagnostic Criteria: A Quantitative Analysis........ 27
Continued
1112th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Aberrant Default Mode Connectivity Associated with Combat-Related
Posttraumatic Stress Disorder....................................................................................... 28
Use of Neuromodulation Techniques in the Treatment of Post-TraumaticStress Disorder................................................................................................................. 29
Neurophysiology of Aggression in PTSD............................................................................ 30
Accelerated Resolution Therapy: Short-Term Trauma-focused Therapy forOperational Military Environments............................................................................. 31
Decomposition of Daily Variation in the Posttraumatic Stress and Depression
Symptoms in U.S. Military Service Members: Trait, State and Error........................ 32
Dissociable Meta-Analytic Networks Contribute to Post-Traumatic Stress Disorder... 33
Association Between Leukocyte Telomere Length and Hostility in Soldiers Deployed
During the Iraq and Afghanistan Wars........................................................................ 34

1212th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

MicroRNAs Expression in Basolateral Amygdala of Rats
Associated with Stress Vulnerability and Resilient Sleep Patterns:
Implications for Posttraumatic Stress Disorder
Authors

injections into BLA. The rats were then randomly
assigned to a non-stressed, home cage control group(HC), or to a shock training (ST) (20 trials, 0.8 mA,
0.5 sec, 1 min ISI) group. Based on relative amountsof REM sleep in the first 2 hrs following ST, the rats
were further designated as vulnerable (Vul, lower
REM) or resilient (Res, higher REM). One subgroupof rats was sacrificed at 2 hrs after ST (ST-Vul and
ST-Res), and another subgroup received MUS microinjections before ST and were subsequently sacrificed at 2 hrs after context re-exposure (CTX-Vul)and CTX-Res). Global miRNA expression profiles
from the BLA and their alterations were generatedusing TaqMan® MicroRNA Array cards and StatMiner® software.

Nagaraja S Balakathiresan PhD1, Manish Bhomia
PhD1, Min Zhai, MD1, Amy M. Sutton, BS2, Olga
Hallum, BS2, Mairen E. Fitzpatrick, BS2, Brook L.
Williams, BS2, Mayumi Machida, PhD2, Laurie L.
Wellman, PhD2, Larry D. Sanford, PhD2, Barbara
Knollmann-Ritschel, MD1

Affiliations

1. Department of Pathology, Uniformed Services
University of the Health Sciences, Bethesda, MD
2. Sleep Research Laboratory, Department of
Pathology and Anatomy, Eastern Virginia
Medical School, Norfolk, VA

ABSTRACT

Background: Sleep problems are prevalent in military veterans with PTSD. An animal model of PTSD
shows that the basolateral amygdala (BLA) mediates
the effects of fear memory on REM sleep. However, the molecular mechanisms underlying throughwhich the BLA affects sleep are virtually unknown.
The main objective of this study was to identify andcharacterize the role of stress-associated miRNAs
that mediate the relationship between stress-related memories and sleep, using an animal model of
PTSD.

Results: Altered miRNAs were observed in the BLA.
Animals with reduced REM sleep showed increased
miRNA dysregulation. Ingenuity pathway network
analysis indicates that these altered miRNAs in the
BLA may play an important role in the regulation ofgenes associated with PTSD and sleep.
Conclusions: This study suggests that directionallydifferent alterations in REM following stress are associated with differential miRNA expression in BLA,a region that mediates the effects of stress and stressful memories on sleep. Further studies are needed
to delineate the role of these miRNAs in mediatingstress outcomes.

Methods: Adult Wistar rats were prepared for recording sleep and possible muscimol (MUS) micro-

1312th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Reversal of Stress-Induced Social Interaction
Deficits by Buprenorphine
Authors

Methods: The effects of acute and repeated treatment with low dose buprenorphine (BPN, 0.25
mg/kg/day) on social interaction deficits in male
C57BL/6 mice were studied. A separate cohort ofmice were treated with either the SSRI fluoxetine(FLX, 10 mg/kg/day), the NMDA antagonist ketamine (KET, 10 mg/kg/day) or the selective kappa
opioid receptor antagonist CERC-501 (1 mg/kg/
day). Changes in mRNA expression of Oprm1 andOprk1 were assessed in a separate untreated CSDS
exposed cohort.

Caroline A. Browne, PhD1,3, Edgardo Falcon, PhD1,
Shivon A. Robinson, PhD1, Olivier Berton, PhD1,
Irwin Lucki, PhD1,2,3

Affiliations

1. Department of Psychiatry, University ofPennsylvania, Philadelphia, PA
2. Systems Pharmacology and Translational
Therapeutics, University of Pennsylvania,
Philadelphia, PA
3. Department of Pharmacology and Molecular
Therapeutics, Uniformed Services University of
the Health Sciences, Bethesda

Results: BPN significantly reversed social interaction deficits following 7 days of administration, but
not after acute injection. Treatment with FLX for 7days, but not 24 h, also reinstated social interaction
behavior in CSDS-stressed mice. In contrast, CERC501 and KET failed to reverse social avoidance. Gene
expression analysis identified reduced Oprm1 andOprk1 mRNA in the amygdala and hippocampus
and increased expression in the frontal cortex of
CSDS-exposed mice.

ABSTRACT

Background: Post-traumatic stress disorder (PTSD)
symptom clusters as defined by the DSM 5 criteria
include intrusion, avoidance, altered arousal andnegative cognition/mood. Frequently, patients reportpersistent problems with social interactions andsignificant detachment from others. Chronic social
defeat stress (CSDS) is a widely used rodent modelof stress that produces robust and persistent social
interaction deficits. Avoidance of other rodents canbe reversed following chronic administration of
selective serotonin reuptake inhibitors (SSRIs), theonly pharmaceutical class for treating PTSD approved by the U. S. Food and Drug Administration.
In this study, the sensitivity of social interaction
deficits evoked by 10 days of CSDS to prospective
treatments for PTSD was examined.

Conclusions: Short-term treatment with BPN and
FLX normalized social interaction after CSDS. In
concert with the changes in opioid receptor expression produced by CSDS, we speculate that BPN’s
efficacy in this model of PTSD relies on the ability ofthis compound to engage multiple opioid receptors.

14

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Analysis of Traumatic Stress and Depression Self-Report
Measures in a Civilian Population Sample
Authors

from the field of psychiatric epidemiology, theCenter for Epidemiological Studies Depression
Scale Revised (CESD-R). It was hypothesized thatthe robust interaction seen between the PCL-5 and
BDI in other psychometric studies would be replicated when using the CESD-R. A sample of sixty-six(n=66) treatment-seeking women who recently
experienced a traumatic event were included. Eachparticipant completed a battery of general outcome
measures, including the PCL-5 and CESD-R, onceat baseline and once at the completion of a novel
treatment model that facilitated engagement andself-efficacy in the trauma-exposed cohort.

Pietra Bruni, BS1, Jeffrey Girard, MS1, Taylor Wulf1,
Jeffrey Cohn, PhD1, Charles Benight, PhD2

Affiliations

1. Affect Analysis Group, Department of
Psychology, University of Pittsburgh, Pittsburgh,PA
2. Trauma Clinical Training Program, Departmentof Psychology, University of Colorado, Colorado
Springs, CO

ABSTRACT

Background: Research has shown the negative
influence trauma exposure has on the psychological,
social, emotional and health functioning of both acivilian and veteran population. The PTSD Checklist
for DSM-5 (PCL-5) is a self-report measure that canbe used to monitor symptom change in trauma-exposed individuals and make a provisional PTSD
diagnosis. Recent psychometric evaluations haveexamined the correlation between scores on the
PCL-5 and scores of other criterion measures. The
Beck Depression Inventory (BDI) has been used innearly all published psychometric evaluations thatexamine PCL-5 severity scores in relation to depression severity.

Results: Descriptive statistics and measures ofinternal validity yielded an observed correlation
between participant’s responses on the PCL-5 andthe CESD-R, both at baseline and at study completion. Both depressive and trauma-related symptoms
decreased in the sample after completing the novel
treatment approach.
Conclusion: For the DSM-5 criteria for PTSD to be
met, the occurrence of negative mood and cognition must be present. A high degree of comorbidity
is observed between depression and PTSD; the useof effective diagnostic measurement tools is of theutmost importance. Further work could include a
comparison of multiple depression inventories usedin conjunction with the study of traumatic stress.

Method: This study aimed, in part, to examine therelationship between the PCL-5 and another tool15

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Functional Connectivity of Centromedial-Amygdala
Predicts its Response to Fearful Faces
Authors

the Human Connectome Project (HCP), were usedin this analysis. Data were analyzed in AFNI. The
t-fMRI data were modeled in a block design, contrasting face with shape condition. Partial correlation maps were calculated using individual amygdala subdivisions, obtained from a Lovain modularity
analysis, as seeds. A t-test was used to determine
significant activation and correlation maps; a ROI
analysis was used to extract the average activation
and rsFC signals from each subdivision.

Elisabeth C. Caparelli, PhD1, Thomas J. Ross, PhD1,
Hong Gu, PhD1, Xia Liang, PhD1,2, Elliot A. Stein,
PhD1, Yihong Yang, PhD1

Affiliations

1. Neuroimaging Research Branch, National
Institute on Drug Abuse, National Institutes of
Health, Baltimore, MD
2. Research Center of Basic Space Science, Harbin
Institute of Technology, Harbin, China

Results: The modularity analysis identified threemain subdivisions for the amygdala: laterobasal,
centromedial (CM) and superficial. The amygdala
activation in respond to fear/anger faces was localized only to the CM. In turn, the CM showed strong
connectivity with the insula, dorsal ACC and striatum.

ABSTRACT

Background: The amygdala has shown to be involved in emotional processing such as responses tofearful faces. Preclinical studies have demonstrated
that the central nucleus of the amygdala plays a keyrole in fear expression. However the specific role ofthe subcomponents of the human amygdala in emotional processing is much less known. In this study,
we aimed to evaluate the specificity of fear/anger
expression in subdivisions of the human amygdala,defined from a modularity analysis, by correlating
brain activation during a face processing task withresting-state functional connectivity (rsFC) relevantto the activated regions.

Conclusions: Our findings indicate that functional connections of the CM are associated with thedegree of activation elicited by fear/anger faces. The
unique functional connectivity of CM with areas belonging to the salience network suggests its involvement in the identification of the emotional significance of environmental stimuli. Finally, our findings
point to the potential prediction of fear-elicited
activation by intrinsic functional connectivity in thisarea.

Method: Resting-state fMRI (rsfMRI) and task fMRI
(t-fMRI, face-task: faces (fear or anger) and shapes
blocks) data from 100 adult healthy volunteers, from16

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Association of General Belief in a Just World and Mental Health
Outcomes Following the 9/11 Terrorist Attacks
Authors

Method: We utilized a dataset of 603 individuals
who lost a family member as a result of the 9/11
attacks (83.2% female; age [M = 56.3 years, SD =12.4]; and 90.5% White). Participants completed theGeneral Belief in a Just World Scale (Dalbert, 1987),
a validated self-report instrument that measures
BJW, as well as measures of participant depression(PHQ-9), complicated grief (ICG) and posttraumatic stress disorder (PCL-C).

Enryka Christopher, BA1, Joscelyn E. Fisher, PhD1,Jing Zhou, MS1, Alexander G. Liu, MPH1, JeremyKarp, BA1, Shenglin Chen, PhD1, Carol S. Fullerton,
PhD1, Robert J. Ursano, MD1, Stephen J. Cozza, MD1

Affiliations

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

Results: Results of multivariate logistic regressions
indicate that participants who scored lower on
the General Belief in a Just World Scale endorsed
threshold symptoms of depression (OR = 1.76; p <.01), complicated grief (OR = 1.71; p < .01), posttraumatic stress disorder (OR = 1.93; p < .05) andgeneralized anxiety disorder (OR = 2.25; p < .01).

ABSTRACT

Background: The developed world has seen a threefold increase in terrorism since the 9/11 World Trade
Center attacks, which makes research regarding theimpact of mass casualties on survivors essential.
Previous research has shown an association between
one’s perceptions of justice in the world and mental
health outcomes in Indian and American students.
Belief in a just world (BJW) is a construct that
describes the extent to which people believe that theworld is fair and everyone’s fate is deserved. A study
focusing on BJW and terrorism-related distress in
American students after 9/11 noted that individuals who strongly endorsed BJW before the terrorist
attacks experienced more distress after the attacks.
The present study examined the connection between
BJW and mental health after a terrorist attack.

Conclusions: These unexpected findings suggest aunique association between BJW and mental healthoutcomes after terrorist attacks. Additional researchis needed to replicate these findings and examine
how perceptions of injustice in the world affect mental health outcomes in different types of populations.

1712th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

The Protective Effect of Social and Support Networks
Among U.S. Army Soldiers at Risk for Suicide
Authors

August 01, 2011–November 01, 2013. We utilized asemi-structured interview of next of kin (NOK) andfirst line supervisors (SUP) of 168 Soldiers who diedby suicide and 389 similar living (control) soldiers
matched on known sociodemographic risk factors for
suicide and Army history variables to obtain information on social support networks for these Servicemembers.

1Catherine L. Dempsey, PhD, MPH , David M. Bene1
2
dek, MD , Matthew K. Nock, PhD , Charlotte Riggs,
1
1
1
MS , Leming Wang, MS , Tsz Hin Ng, MPH , Wendy
1
1
Long, BA , and Nicole Caulfield, BA

Affiliations

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

Results: NOK of Soldiers who died by suicide reported
these Soldiers were more likely to be married 2 or moretimes when compared to NOK reports of controls (OR= 3.1) and case NOK also reported these Soldiers had
more casual acquaintances (4-5) than controls (OR =2.9). NOK of Soldiers who died by suicide reported
that these Soldiers were less likely to seek help from achaplain or religious counselor than controls (OR =0.4). SUP reported fewer close relationships in decedents (6 or more) (OR = 0.5) than did SUP of controls.
SUP reported Soldiers who died by suicide were lesslikely to seek help from a mental health counselor (OR= 0.4).

ABSTRACT

Background: The suicide rate among US Army Soldiers
has increased dramatically over the past decade; despite
increased and ongoing research efforts, an understandingof risk and protective factors for suicidal behavior among
Soldiers is far from complete. The purpose of this study
is to identify whether social and support networks
mitigate suicide risk among US Army soldiers using a
psychological autopsy study.

Conclusions. Results suggest third parties identify
differences in social networks and supports between
suicide decedents and matched controls. This information may inform prevention efforts.

Methods: Data are from the Army Study to Assess
Risk and Resilience among Servicemembers (ArmySTARRS). Soldier Health Outcomes Study - B is
and Army STARRS case-control study of Soldiers
who died by suicide while on active duty between

18

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Promoting Family Safety Through PersonalFirearm Safety Education
Authors

Methods: The Center for the Study of TraumaticStress developed a collection of training materials
targeting active duty and reserve service members
who may own personal firearms. These materials include an in-person interactive workshop, self-guided
online learning. Topics covered include: basic principles of safe firearm storage, communication between
household members about firearms, and alternative
storage plans for times of distress. Materials also
include Fact Sheets for medical providers to discuss
personal firearm safety with patients.

Anne V. Fisher MIDN, USN1, Alex G. Liu, MPH2,
Trevor Stephens, BA2, James C. West, MD2

Affiliations

1. United States Naval Academy, Annapolis, MD
2. Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University, Bethesda, MD

ABSTRACT

Background: Every year in the United States approximately 33,000 people are killed by firearms andanother 730,000 are injured. Two-thirds of firearm
deaths are suicides. Since 2011, suicide has become
the second leading cause of death among military
members. Firearms make up 61.1% of military suicides in the United States. Personal Firearm Safety
involves taking simple measures to protect the life of
loved ones from injury by accidental or intentional
firearm use. Previous research has shown that safe
storage practices place barriers between suicidal
ideation and action, thereby increasing the probability of reconsideration or intervention. Healthcare
providers can use such resources for firearm counseling and education for military members and theirfamilies.

Discussion: Personal Firearm Safety education
applies principles of safe storage and alternative
storage planning. Proper storage and safety measures keep firearms out of the curious and untrained
hands while still accessible for self-defense andrecreational purposes. Public health interventions
are an effective strategy. A past example is the dramatic reduction of automobile fatalities even as car
ownership has exponentially increased in the lastcentury. Safer manufacturing, seatbelts, speed limits,
driver education, and campaigns against drunk anddistracted driving have led to significantly safer
roads. Just like cars, common sense interventions for
personal firearms can produce fewer injuries anddeaths.

19

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Perceived Environmental Stress Mediates the Relationship
Between PTSD Symptoms and Coping in a NeighborhoodMatched Substance-Using Sample
Authors

Neighborhood Inventory of Environmental Typology (NIfETy) was used to objectively assess environmental stress of participant’s home address. Regression modeling was used to assess within-grouppredictors of PTSD and test for mediation in therelationships between PTSD, perceived environment,
and coping behaviors.

Sara K. Hertzel, BA , Jennifer Schroeder, PhD ,Landhing M. Moran, PhD1, Anika A. Alvanzo, MD2,
William J. Kowalczyk, PhD1, David H. Epstein, PhD1,
Kenzie L. Preston, PhD1, Karran A. Phillips, MD1
1

1

Affiliations

1. National Institute on Drug Abuse, Intramural
Research Program, Baltimore, MD
2. John Hopkins University, Division of Internal
Medicine, Baltimore, MD

Results: Among NDUs, low sense of community
partially mediated the relationship between PTSD
symptoms (p<0.01) and using mental disengagement (p<0.01). In MAUs, higher levels of perceived
crime partially mediated the relationship between
PTSD symptoms (p<0.0001) and using mental
disengagement (p<0.05), focusing on and venting
emotions (p<0.005), and using substances to cope(p<0.0001). OSUs with PTSD symptoms perceived
a significantly higher degree of crime and reported
using significantly higher levels of mental disengagement, focusing on and venting emotions, andsubstances to cope. However, perceived crime did
not predict any of the three coping behaviors ergo
no mediation was inferred.

ABSTRACT

Background: People with substance use problems
living in neighborhoods with high levels of environmental stress are disproportionately likely toexperience trauma and develop posttraumatic stressdisorder (PTSD) symptoms. We sought to evaluate
the relationships between objective and perceived
measures of environmental stress and the use of
maladaptive coping behaviors among both non-substance-using and substance-using participants withand without PTSD symptoms.

Conclusion: Perceptions of community and crime
may be more predictive of PTSD symptoms than objectively assessed measures of environmental stress.
These perceptions partially mediate PTSD symptoms and maladaptive coping behaviors.

Methods: Participants [(255 Non-Drug Users(NDUs), 168 Marijuana and/or Alcohol Users(MAUs), and 273 Opioid and/or Stimulant Users(OSUs)] completed the Addiction Severity Index,
PTSD Checklist — Civilian Version, The COPE Inventory, and the Perceived Neighborhood Scale. The

20

12th Annual Amygdala, Stress and PTSD Conference: Understanding StressMultiple Notifications of Human Remains in Families of
September 11th Decedents Associated with Depression and
Posttraumatic Stress Disorder
Authors

pants were asked how many times they were notified
of recovery of their loved one’s remains (never, once,
twice, three or more times).

Jeremy Karp, BA , Joscelyn Fisher, PhD , Shenglin
Chen, PhD1, Alexander Liu, MPH1, Enryka Christopher, BA1, Jing Zhou, MS1, Carol Fullerton, PhD1,
Robert Ursano, MD1, Stephen Cozza, MD1
1

1

Results: 38.2% of respondents were never notified ofhuman remains identification, 27.6% were notified
once, 16.2% were notified twice, and 18.1% were notified three, or more times. Multivariate logistic regressions examined the contribution of frequency of
notification of human remains to complicated grief(Inventory of Complicated Grief), depression (Patient Health Questionnaire-9), posttraumatic stressdisorder (PTSD Checklist-Civilian), and generalized
anxiety disorder (Generalized Anxiety Disorder-7).
Results indicated that those who were notified threeor more times were at risk for depression (OR =2.1; p < .05) and PTSD (OR = 3.3; p < .05), but notcomplicated grief or generalized anxiety disorder,when compared with those that had received no
notification.

Affiliations

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

ABSTRACT

Objective: During the September 11th terrorist attacks, the New York City Office of the Chief Medical
Examiner was responsible for identifying all remains
taken from Ground Zero in lower Manhattan andnotifying the families of the deceased. Previous
research has shown that when properly conducted,
confirmation of a loved one’s death (for example,
through discovery of human remains) is associated with positive mental health outcomes in the
bereaved; however no identified empirical studies
have examined the effect of multiple notifications onfamily members of those killed in a terrorist attack.

Conclusions: These findings suggest a negative
impact of repeated notifications of human remains
on the families of 9/11 decedents. Further researchshould replicate these findings and future policy
decisions regarding notification of family members
about human remains after mass casualty eventsshould consider these effects.

Method: The present study sought to address thisgap in the literature by examining a sample of 421(83% female; M= 57.12 years, SD= 12.02; White
91%) families of September 11th decedents. Partici-

21

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Grief, Anxiety, and Depression Independently Predict
Cognitive Failures in Bereaved Family Members
Authors:

Results: Linear regression indicated depression (p< .0001), GA (p < .034), anxious arousal (p < .0001)
and grief (p = .0001) independently predicted
cognitive failures. It was expected that comorbid
depression and/or GA would be associated withmore cognitive failures than CG alone. To investigate, eight groups were created: high scores on three(CG, GA, and depression) measures (hiall; n=1),high scores on two measures and low scores on thethird (n=3), high scores on one measure (n=3), andlow scores on three (n=1). ANOVA was used to test
CFQ differences between groups. As expected, hiall
had the most cognitive failures. However, hiall did
not differ from the comorbid depression and CG
group, or the comorbid depression and GA group.
Thus, while CG, depression and anxiety were eachassociated with cognitive failures, comorbid depression (with either CG, anxiety, or both) contributed
to increased cognitive failures.

Alexander G. Liu, MPH1, Joscelyn E. Fisher, PhD1,Jing Zhou, MS1, Enryka Christopher, BA1, JeremyKarp, BA1, Carol S. Fullerton, PhD1, Robert J. Ursano,MD1, Stephen J. Cozza, MD1

Affiliation:

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

Abstract:

Background: Between 7-25% of bereaved individuals develop complicated grief (CG), characterized bypersistent sense of loss, bitterness, and loss of meaning in life (Newson et al., 2001; Kersting et al., 2011;
Prigerson et al., 1995). CG is also associated withmemory and attention difficulties. It is unknown
whether these difficulties generalize to cognitive failures (minor errors in thinking that interrupt physical or mental action) and whether these cognitive
failures are also affected by co-morbid anxiety anddepression.

Conclusions: Future assessments of cognitive failures in bereaved individuals, especially with comorbid depression, can elucidate how cognitive capacity
is affected in day-to-day activities, and suggest futuretargets for intervention and provide ecological validity for research about grief and cognition.

Method: The present study investigated associations
between cognitive failures and CG, generalized
anxiety (GA), anxious arousal, and depression using
participants (n=619) from the National Military
Family Bereavement Study.

22

12th Annual Amygdala, Stress and PTSD Conference: Understanding StressCommunity Strength and Disasters: Collective Efficacy
Following the 2004 Florida Hurricanes
Authors

Participants: Ages ranged from 21–72 years (median=48.5). Most were female (78%; n=462), currently
married (69%; n=407), White (83%; n=487), and
57% had at least a BA/BS degree (n=338).
Procedures: Participants completed self-report questionnaires at 9 months following 4 hurricanes and1 tropical storm in August and September 2004 andapproximately 9 months after the 2005 hurricane
season. Questionnaire items identified participants’zip codes and assessed CE at both time points. Relocation was defined by a participant’s zip code differing between the two time points. Independent-samples and paired t-tests compared CE in those who
remained in the same geographical area or relocated.
Results: In general, CE decreased from Time 1(M=7.76, SD=1.84) to Time 2 (M=7.54, SD=1.88),
t(591)=2.97, p=.0031. Among participants who did
not move, CE decreased from Time 1 (M=7.81,
SD=1.83) to Time 2 (M=7.52, SD=1.9), t(532)=3.69,
p=.0003. For those who relocated, the change in CE
from Time 1 to Time 2 was not significant, suggesting that CE level was sustained from before to after
their move.

Joshua C. Morganstein, MD1, Holly B. Herberman
Mash, PhD1, Mackenzie Franz, BA1, Leming Wang1,
Eric G. Meyer, MD1, Patcho N. Santiago, MD1,2, Carol
S. Fullerton, PhD1, Robert J. Ursano, MD1

Affiliations:

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

ABSTRACT

Background: Natural disasters produce a range ofadverse behavioral and psychological outcomes inresidents of affected communities. The impact ofdisaster exposure on community-level characteristics, including collective efficacy (CE), also influence community strength and mental health. CE,
defined as social cohesion among neighbors andwillingness to intervene for the common good, isassociated with lower levels of depressive symptoms
and post-traumatic stress disorder following natural disasters. Perception of CE may influence thedecision to relocate or remain in one’s neighborhood
following a disaster, such as a hurricane. This study
assessed the association of relocating following aseries of Florida hurricanes with CE in 592 community members.

Conclusions: Individual, community and event-related factors can influence CE following a disaster.
Optimizing CE prior to and following disasters
may hold promise to offer significant public healthbenefits.

23

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Regression Modeling of Post-Deployment Survey Data
Identifies Areas of Needed Resiliency Training
Authors

ployment support networks, and negative post-deployment life events would be significant predictorsof PTSD symptom severity.

Jerry E. Murphy, MS1,2, Jessica N. Busler, PhD1,2,
Brian Jantzen, BS1,2, Megan Thomas1,2, Jennifer L.
Robinson, PhD1,2, Julio A. Yanes, BS1,2, Meredith Reid,
PhD2, Jeffrey S. Katz, PhD1,2, Thomas S. Denney,
PhD2, and Michael N. Dretsch, PhD3

Methods: We collected data from previously deployed service members (n=81 [74 males], age=32.9±6.9 years). We used multiple-regression modeling to determine the best fitting model associatedwith resiliency factors predicting PTSD symptom
severity using the Deployment Risk and Resiliency
Inventory, Combat Exposure Scale, and Life Events
Checklist.

Affiliations

1. Department of Psychology, Auburn University,
Auburn, AL
2. MRI Research Center, Auburn University,
Auburn, AL
3. Walter Reed National Medical Center, Bethesda,
MD

Results: The model that best fit our data included
combat exposure, anxiety about self and family
while deployed, post-deployment support, negative
life events post-deployment, and an interaction between combat exposure and anxiety while deployed(F(5, 75) = 35.42; p <0.001; R2 = 0.70). Contrary to
our hypothesis, pre-deployment trauma exposure
variables were not significant predictors. The data
did support our hypothesis that combat exposure,anxiety while deployed, post-deployment support
networks, and negative post-deployment life eventswere significant predictors.

ABSTRACT

Background: The population lifetime exposure
rate to traumatic events is approximately 90%, with
PTSD prevalence among combat veterans at 23%.
Identifying factors differentiating those who experience trauma and develop PTSD versus those who
do not develop PTSD is a major research question.
Resiliency is a possible explanation. The U.S. Army
Comprehensive Soldier Fitness program trains
personal resiliency, but does not address other areasthat may be contributing factors (e.g., social support from one’s family or unit). As such, we sought
to examine how extraneous factors such as family
issues and social support affected PTSD severity. We
hypothesized that pre-deployment trauma exposure,combat exposure, anxiety while deployed, post-de-Conclusions: These data suggest that including
how to deal with family issues while deployed andpost-deployment resiliency training that includes
the family may have a transformative impact on
Army resiliency training.

24

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Effects of Isoflurane Anesthesia and Intravenous Morphine
Self-administration on Regional Cerebral Glucose Metabolism
in Sprague Dawley Rats: 18F-FDG PET/CT Study
Authors

Method: We investigated the effects of 1) isoflurane
anesthesia during [18F]-fluoro-deoxy-glucose (FDG)
uptake and 2) intravenous morphine self-administration (MSA) on regional glucose metabolism(BGluM) using positron emission tomography(PET) and computed tomography (CT). Jugularvein cannulated adult male Sprague-Dawley rats
self-administered either saline or morphine (0.5mg/kg/infusion, 4hrs/day) for 12 days. All animals
were scanned twice with FDG-PET/CT at a baseline(pre-self-administration) and 2 days after the lastself-administration session. After the intravenous injection of FDG, one group (n=14) was anesthetizedwith isoflurane and the other (n=16) was kept awake
during FDG uptake (45 min).

Thomas Y. Park, BS , Kevin S. Nishida, MS , Colin M.
Wilson, MS2,3, Shalini Jaiswal, MS2, Jessica Scott, MS2,
Andrew R. Hoy, PhD2,4, Reed G. Selwyn, PhD2,3,4,Bernard J. Dardzinski, PhD2,4, and Kwang H. Choi,
PhD1,51

1

Affiliations

1. Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University of the Health Sciences, Bethesda, MD
2. Center for Neuroscience and Regenerative
Medicine, Uniformed Services University of the
Health Sciences, Bethesda, MD
3. Department of Radiology, University of New
Mexico, Albuquerque, NM
4. Department of Radiology and Radiological
Sciences, Uniformed Services University of the
Health Sciences, Bethesda, MD
5. Program in Neuroscience, Uniformed Services
University of the Health Sciences, Bethesda, MD

Results: Isoflurane anesthesia, as compared to theawake condition, reduced BGluM in the olfactory,
cortex, thalamus, and basal ganglia, while increasing
BGluM in the midbrain, hypothalamus, hippocampus, and cerebellum. Morphine self-administeredanimals exhibited withdrawal signs, drug seeking,and behavioral sensitization to morphine challenge(0.5 mg/kg). At two-day withdrawal, BGluM in the
striatum was selectively increased in morphineself-administered animals as compared to that ofsaline self-administered animals.

ABSTRACT

Background: Over the past decade of military operations in Iraq and Afghanistan, more than 50,000
U.S. service members have been wounded in action.
A previous study found that 44% of 2,597 active
duty soldiers who had been deployed to Iraq and Afghanistan experienced chronic pain, lasting at least
three months (Toblin, Quartana et al. 2014). Therefore, efficient pain management and prevention of
opioid drug misuse represent a major challenge inthe military community. Despite these epidemiological findings, biological factors that are associatedwith opiate abuse are not well characterized.

Conclusions: Increased BGluM in the striatum
following chronic MSA may have functional significance in opiate abuse. The current findings demonstrate the utility of combining an intravenous drug
self-administration paradigm and a non-invasive
brain imaging technique to better understand biological mechanisms associated with opiate abuse.
25

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Effect of Intravenous Ketamine on Corticosterone and BrainDerived Neurotrophic Factor in Sprague-Dawley Rats
Authors

were separated into 4 groups (n=12/group). Group 1(SAL) = no FC + 2h saline infusion. Group 2 (KET)= no FC + IV ketamine bolus & 2h infusion. Group
3 (FC) = FC and saline infusion. Group 4 (FC/KET)= FC + IV ketamine bolus + 2h infusion. Fear-Conditioning: Rats underwent 3 pairings of a 20s tone
(75dB) that co-terminated with footshock (0.8mA
x 0.5s). Drug: Rats received an IV ketamine bolus (5mg/kg) and a 2h IV ketamine infusion (20 mg/kg/h).
Plasma: CORT and BDNF concentrations were measured at 2h and 4h after FC using enzyme-linked
immunosorbent assay (ELISA).

KD Radford, PhD(c), CRNA1, TY Park, BS2, LA
Osborne, PhD, CRNA1,3, & KH Choi, PhD1,2

Affiliations

1. Graduate School of Nursing, Uniformed Services
University of the Health Sciences, Bethesda, MD
2. Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University of the Health Sciences, Bethesda, MD
3. Nurse Anesthesia Program, Oregon Health andSciences University, Portland, OR

ABSTRACT

Results: IV ketamine infusion significantly increased
CORT levels compared to SAL at the 2h time point.
There were no differences in CORT levels between
SAL and FC groups at 2h and no difference in
CORT between all groups at 4h. Ketamine decreased
peripheral BDNF concentrations in ketamine treatedrats at 4h.

Background: Corticosterone (CORT) and brain-derived neurotrophic factor (BDNF) mediate stressand memory. Alterations of CORT and BDNF
following trauma are implicated in post-traumaticstress disorder (PTSD). Since ketamine is administered in the immediate period after injury, its impact
on PTSD is of interest. Currently, the short-term
effects of intravenous (IV) ketamine infusion on
CORT and BDNF using a rat fear-conditioning (FC)model are unknown. Aim: To characterize plasma
CORT at 2 and 4h and plasma BDNF at 4h following
IV ketamine infusion after FC.

Implications: High-dose steroid administration immediately following trauma may be associated with
reduced incidence of PTSD. On the other hand, reduced production of BDNF may be associated with
impaired memory formation. Our results suggestthat a high-dose ketamine infusion may offer protective effects for the development of stress relateddisorders following a fear triggering event.

Methods/Design: Male Sprague-Dawley rats
(300±25g) with indwelling jugular vein catheters2612th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Heterogeneity of the DSM-5 PTSD Diagnostic Criteria:
A Quantitative Analysis
Authors

Results: Preliminary analyses revealed several
important results. First, disjoint PTSD combinations were rare for the lenient rule and absent forthe stringent rule. Second, coherence was higher forthe stringent rule. Third, coherence was higher for
DSM-IV PTSD using the lenient rule but higher for
DSM-5 using the stringent rule. Last, coherence for
DSM-5 using the stringent rule was comparable tocoherence for MDD, with an average shared proportion of symptoms of about two-thirds.

Meredith A. Reid, PhD1, Frank W. Weathers, PhD1,
Thomas S. Denney, PhD1, Jessica M. Petri, MS1, andLindsay B. Kramer, MS1

Affiliations

1. Auburn University, Auburn, AL

ABSTRACT

Background: The diagnostic criteria for PTSD havebeen criticized for permitting extremely high levelsof heterogeneity. In DSM-IV, PTSD had one of thehighest number of possible diagnostic combinations
and disjoint combinations (those sharing no symptoms), and these both increased eight-fold in DSM-5.
However, observed coherence (homogeneity) for
DSM-IV in empirical samples is substantially higher
than theoretical levels.

Conclusions: We demonstrate empirically that
DSM-5 PTSD criteria yield moderate coherence,comparable to that for MDD and substantially higher than theoretical levels. Although DSM-5 is moreheterogeneous than DSM-IV as predicted, requiring
a severity cutoff score considerably decreases heterogeneity. Future work will include two additional
samples with combined N=4000+.

Methods: We examined coherence of DSM-IV and
DSM-5 PTSD and major depressive disorder (MDD)
in trauma-exposed undergraduates (N=302). PTSD
diagnosis was based on a lenient (symptoms only) or
stringent rule (symptoms plus a moderate cutoff on
total severity score).

27

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Aberrant Default Mode Connectivity Associated with
Combat-Related Posttraumatic Stress Disorder
Authors

TR=600ms, TE=30ms, FA=55˚, multiband factor=2,
slice gap=1mm, voxel size=3×3×4mm, 1000 volumes). Standard preprocessing was applied, and data
were motion corrected and scrubbed. Functional
connectivity and graph theory metrics were derived
using ‘conn’, an open-source toolbox for Matlab. For
functional connectivity analyses, we used a seed-tovoxel approach, with seeds being the anterior andposterior cingulate cortices (ACC/PCC). Data were
thresholded at pvoxel-level>0.05 and FDR-correctedpcluster-level>0.05.

Jennifer L. Robinson, PhD1,2,3,4, MAJ Jerry E. Murphy,
MS1,2, Julio Yanes, BA1,2, MAJ (Ret.) Brian Jantzen,
BA1, Jessica N. Busler, PhD1,2, Meredith A. Reid,
PhD2,3,4, Thomas S. Denney, PhD2,3,4, Jeffrey S. Katz,
PhD1,2,3,4, Michael N. Dretsch, PhD5

Affiliations

1. Department of Psychology, Auburn University,
Auburn, AL
2. Auburn University MRI Research Center, Auburn
University, Auburn, AL
3. Alabama Advanced Imaging Consortium,
Auburn University, Auburn, AL
4. Department of Electrical and Computer
Engineering, Auburn University, Auburn, AL
5. Walter Reed National Military Medical Center,
Bethesda, MD

Results: Analyses revealed increased connectivity of
the ACC and PCC with bilateral anterior paracingulate cortex in combat-veterans without PTSD
compared to those with PTSD. The reverse contrast(combat-veterans with PTSD > combat-veterans
without PTSD) revealed increased connectivity between the ACC and the precuneous, PCC, left hippocampus and parahippocampus, and portions of theright prefrontal cortex. PCC connectivity differences
emerged with combat-PTSD being associated withincreased connectivity to bilateral temporal cortices,bilateral middle/posterior paracingulate, and sensory
processing regions throughout the parietal lobe.

ABSTRACT

Background: Posttraumatic stress disorder (PTSD)
is estimated to effect at least 20% of returning Iraq/
Afghanistan war veterans. As a result, several studies
have sought to identify potential biomarkers andneural signatures associated with the condition.
Here, we contribute to the literature by examining
neural functional connectivity and graph theory
metric differences between combat-veterans withand without PTSD during resting state functional
magnetic resonance imaging (fMRI) acquisition.

Conclusions: Supporting results from previous
studies, we identified disruptions to critical neuralhubs involved in the default mode network. We did
not find support for specific deficits using graphtheory metrics, but encourage the use of this novel
analytic technique in future datasets. Results suggestthat specific functional connectivity differences may
differentiate those combat veterans with and without
PTSD.

Method: Thirty-eight participants (23 combat-veterans without PTSD/15 combat-veterans with
PTSD) underwent fMRI on a Siemens 3T scannerat the Auburn University MRI Research Center(T2*-weighted multiband echo planar imaging,28

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Use of Neuromodulation Techniques in the Treatmentof Post-Traumatic Stress Disorder
Authors

November 2016 on the topics of transcranial magnetic stimulation (TMS), cranial electrotherapy
stimulation (CES), vagal nerve stimulation (VNS),
deep brain stimulation (DBS), and electroconvulsive
therapy (ECT) in the treatment of PTSD.

Chloe J. A. Shea, MS1, Gary H. Wynn, MD2,3

Affiliations

1. School of Medicine, Uniformed Services
University of the Health Sciences, Bethesda, MD
2. Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University, Bethesda, MD
3. Neuroscience Program, Uniformed Services
University of the Health Sciences, Bethesda, MD

Results: TMS has some evidence of efficacy in PTSD
treatment, has few side effects, and does not require
anesthesia or surgery. While CES is frequently usedby military and VA hospitals, and per patient reports
has positive side effects, there are no controlled studies to its effects. However, CES has an excellent safety
profile. VNS, DBS, and ECT, by contrast, all havestrong evidence for their roles in other disorders, but
their specific use for PTSD has not yet been determined. Current research for VNS and DBS is limited
to pilot and animal studies, and these modalities
are higher risk to patients than TMS or CES as theyrequire surgery.

ABSTRACT

Background: Post-traumatic stress disorder (PTSD)
is characterized by the presence of intrusive, avoidant, and hyperarousal symptoms, and negative alterations of mood and cognition, following a traumatic
exposure. Symptoms must last more than thirty days
and be accompanied by social and occupational
impairment. PTSD has an estimated lifetime prevalence of 7% among adult Americans with a higher
prevalence in combat veterans and victims of sexualassault. Only two FDA-approved clinical treatments
exist and treatment resistance remains a significant
problem. Neuromodulation, the process of stimulating or inhibiting nerve conduction, presents a
unique opportunity to treat PTSD.

Conclusions: Neuromodulation techniques arepromising treatment modalities for patients with
PTSD. With the exception of TMS, evidence iscurrently limited. Due to their higher safety profile,
CES and TMS have high potential for primary care
distribution. VNS, DBS, and ECT should be considered for patients with severe refractory PTSD.

Methods: A literature search was conducted on
PubMed for English articles published through29

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Neurophysiology of Aggression in PTSD

Authors

chronous activity of populations of neurons associated with attention and sleep. Procedures included
1) implanting microelectrodes in VMH and MeA for
stimulation and in HC and LS for recording fEPSPs
and alpha/theta waves, 2) evoking rat attack using
the resident/intruder paradigm and theta patterned
electrical stimulation in VMH/MeA, 3) recording
fEPSPs in response to a continuous probe stimulus
along with alpha/theta waves, and 4) recording video
of attack behavior simultaneous with recorded fEPSPs and alpha/theta waves.

Stanley E. Smerin, PhD1, He Li, MD, PhD1

Affiliations

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

ABSTRACT

Background: Traumatic stress in many PTSD
patients leads to explosive anger and, all too often,
violence. Herein a rat model of fight and flight isutilized toward finding Where in the brain violence foments and How. Where? Areas tested are
the ventromedial hypothalamus (VMH), medial
amygdala (MeA), and lateral septum (LS), previously
implicated in attack, and the hippocampus (HC),since flashbacks and nightmares are fundamental to
PTSD. A first step toward How is to associate synaptic transmission in and between these regions withbehavioral attack.

Results: 1) Theta patterned stimulation in VMH/
MeA evoked attack in Resident rats challenged
with an Intruder rat. In one rat the attacks were
delayed by a week, consistent with the delayed onsetof symptoms as can occur in PTSD. 2) During theattack, the fEPSP flattened out in HC and LS, thenbounced back afterwards. 3) Alpha waves became
prominent during standoff such as preceded attack.
Very similar alpha waves were also recorded during
sleep.

Methods: Synaptic transmission can be assessed in
the behaving rat by recording (1) the magnitude of
evoked excitatory postsynaptic field potentials (fEPSPs) and (2) alpha and theta “brain waves” (endogenous electric field oscillations of 5-8 Hz (theta) and
8–12 Hz (alpha)) which represent rhythmic syn-

Implications: 1) VMH and MeA are key in evoking
attack. 2) HC and LS are active leading up to andfollowing attack, possibly processing “cognitive”
information later assimilated during sleep.

30

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Accelerated Resolution Therapy: Short-Term Trauma-focused
Therapy for Operational Military Environments
Authors

Method: The presenter has over 10,000 beneficiaries in his area of responsibility. 1-2 hours of ART
was incorporated into his daily clinic schedule. ART
was used to treat post-traumatic stress disorder andother trauma-related symptoms.

Olli Toukolehto, MD1

Affiliations

1. Fort Belvoir Community Hospital, Virginia

ABSTRACT

Results: Approximately 150 sessions of ART were
provided, averaging 1–2 hours of ART on most
weekdays. On average, patients receiving ART
returned for 0-3 follow up ART sessions after the
initial session, depending on number of traumas
and symptom severity. An estimated 75% of ART
patients endorsed significant subjective benefit from
ART, an estimated 20% had a neutral-mild clinicalresponse, and approximately 5% were unable totolerate or complete the therapy. No serious adverse
reactions occurred during ART sessions.

Background: The treatment of post-traumatic stressdisorder (PTSD) and other trauma-related symptoms are difficult to treat in operational military
settings due to limited resources, time, and mission
requirements. Current evidence-based therapies
including cognitive processing therapy (CPT), prolonged exposure therapy (PE), and eye movement
desensitization and reprocessing (EMDR) require
weekly sessions for two to three months; thus, they
are typically not suitable for operational settings.
In 2014, Military Medicine published an article
on Accelerated Resolution Therapy (ART), which
described it as a short-term trauma-focused therapy
that may require only 2–5 hours of treatment per
patient. Based on these findings, ART could be considered as a potential therapy modality suitable for
operational military settings. ART was subsequently
tested in such a setting by an outpatient psychiatrist
at the Adult Behavioral Health Clinic, Camp Humphreys, Republic of Korea, from October 2015–
October 2016.

Conclusions: Given these results ART should beconsidered as a potential treatment for PTSD andtrauma-related symptoms particularly in settings
with resource limitations such as operational
military environments.

31

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Decomposition of Daily Variation in the PosttraumaticStress and Depression Symptoms in U.S. Military Service
Members: Trait, State and Error
Authors

nested within (level-2) subjects. For each outcome,analyses were conducted with two steps. The firststep was to test the first-order autoregression assumption, AR(1), against compound symmetry, CS,
about within-person variation. In the second step, amodified AR(1) model, AR(1) + measurement error,
was further specified which decomposes the error
term into two parts, one for autocorrelation and theother for measurement error. Model fit was compared across models specifying CS, AR(1), and themodified AR(1) for the within-subject covariancestructure.

Jing Wang, PhD , Quinn M. Biggs, PhD, MPH , Carol
S. Fullerton, PhD1, Gary H. Wynn, MD1, Deborah
Probe, MA1, Nicole Dacuyan, BS1, Mackenzie Franz,
BA1, Russell B. Carr, MD1, 2, Robert J. Ursano, MD1
1

1

Affiliations

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

ABSTRACT

Background: Rates of posttraumatic stress disorderand depression are high in US military service members. Little is known about how posttraumatic stressand depression symptoms are experienced throughout the day. Using ecological momentary assessment(EMA) methodology, this study assessed individual
daily variation of Posttraumatic Stress Symptoms(PTSS) and depression symptoms in current andformer US military service members.

Results: For both outcomes, the model with AR(1)covariance structure provided a much better fit to
the data when compared to a CS structure, and themodel with the modified AR(1) error structure further improved model fit. The between-subject variation, or “trait-like” differences, consisted of 76.8%
of total variation in PTSS and 77.4% in depression
symptoms. The “state-like” component consisted of
14.3% in PTSS and 16.3% in depression symptoms.
The measurement error variance consisted of 8.9%
in PTSS and 6.2% in depression symptoms.

Method: Forty participants completed symptom
assessments four times per day for 15 consecutive
days. PTSS were assessed with eighteen items fromthe PCL-5. Depression symptoms were assessed with
six items from the PHQ-9. Linear mixed models
were used to explore the within-individual covariance structure that (level-1) daily diary assessment

Conclusions: Exploring appropriate error covariance structure in mixed models is useful to better
understand between- and within-individual variation of posttraumatic stress and depression symptoms in EMA studies.

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12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Dissociable Meta-Analytic Networks Contribute to
Post-Traumatic Stress Disorder
Authors

brain regions into sub-networks using fractional
similarity network analysis (FSNA), revealing regions that exhibited co-occurring diagnosis-relatedchanges across studies. Finally, we established which
psychological processes were associated with these
sub-networks using paradigm classification analysis.

Julio A. Yanes, BA1, Meredith Reid, PhD1, Jennifer L.
Robinson1

Affiliations

1. Auburn University, Auburn, AL

ABSTRACT

Background: From a neurobiological perspective,
post-traumatic stress disorder (PTSD) is among thebetter-understood psychiatric conditions. However,enhanced understanding has not produced reliablebiomarkers that may serve as diagnostic criteria.
Here, we sought to establish which brain regions
show consistent PTSD-related functional changes
across neuroimaging studies within a meta-analysis
framework. To provide enhanced interpretation, weused auxiliary analyses to fractionate impacted brain
regions into sub-networks and determine which
psychological processes those sub-networks may
subserve.

Results: We identified 44 studies, representing datafrom 707 patients and 758 controls. Specifically,
sub-network 1 (amygdala, hippocampus, and DLPFC) represented distributed increased activation
associated with inducing emotions and processing
emotional content. Also, sub-network 2 (insula,
cingulate, and occipital lobe) and sub-network 3(occipital lobe and cuneus) represented distributed
increased activation linked with monitoring environmental cues and subsequent evaluation. Finally,
sub-network 4 (PCC, DMPFC, and DLPFC) and
sub-network 5 (ACC, VMPFC, and VLPFC) represented distributed decreased activation associatedwith decision-making, response inhibition, andeffortful and sustained attention.

Methods: We identified published neuroimaging
studies that reported functional brain differences
between patients with PTSD and (a) patients withtrauma exposure without PTSD and/or (b) controls(groups were collapsed) as whole-brain coordinatesin stereotaxic space. First, we assessed statisticalconvergence across activation increases (PTSD>Controls) and decreases (PTSD<Controls)(pcluster-cor<0.001: pvoxel-wise<0.05). We then parsed impacted
rectedConclusions: Our results indicate that PTSD is associated with several region-specific changes across thebrain. Deeper understanding of the neural systems
that may be impacted by PTSD is important forestablishing reliable biomarkers that are specific andsensitive, capable of serving as diagnostic criteria
and therapeutic targets.

33

12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

Association Between Leukocyte Telomere Length and Hostility in
Soldiers Deployed During the Iraq and Afghanistan Wars
Authors

items include: feeling easily annoyed or irritated, temper outbursts that you could not control,and getting into frequent arguments; the HI items
include: having urges to beat, injure, or harm someone else and having urges to break or smash things.
Participants rated each item by indicating how muchthat problem had bothered or distressed them (0=”not at all” to 4=”extremely”) in the past month.
The LTL was assessed using quantitative polymerase
chain reaction methods. Regression analyses wereconducted to determine the association of hostility
and telomere length.

Lei Zhang, MD1, Xian-Zhang Hu, PhD, MD1, David
M. Benedek, MD1, Carol S. Fullerton, PhD1, Robert
D. Forsten, MD2, James A. Naifeh, PhD1, Xiaoxia Li,
BS1, Hongyan Wu, MPH1, Tsz Hin H. Ng, MPH1,
Pablo Aliaga, MA1, Tzu-Cheg Kao, PhD3, Dale Russell, PhD1, Gary Wynn, MD1, Robert J. Ursano, MD1

Affiliations

1. Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University of the Health Sciences
2. US Army Pacific Command (USARPAC)
3. Division of Epidemiology and Biostatistics,
Department of Preventive Medicine andBiometrics, Uniformed Services University of the
Health Sciences

Results: Univariate regression showed that the totalof score of hostility was negatively associated withLTL (CI= -0.06 to -0.002, Beta= -0.095, p <0.039).
Also, univariate regression reviled the significant
correlation between LTL and scores of both hostility impulse (CI= -0.108 to -0.009, Beta= -0.106, p<
0.021) and hostility control (CI= -0.071 to -0.002,
Beta= -0.095, p<0.004), indicating that the association between hostility and LTL may be associatedwith controlling anger or impulses,. Multiple regression analyses showed that the HC could not enter
the equation, while the HI was still negative correlated with the T/S ratio (P=0.021), indicating that LTL
was affected by hostility impulse.

ABSTRACT

Background: Hostility is a common form of emotionally charged angry behavior. The association
between telomere and greater levels of hostility
has been observed in the civilian population. To
investigate the relationships between hostility andleukocyte telomere length (LTL) in military service
members, we conducted a study in subjects (n=474)
from the US Army service members.

Conclusion: Our data indicate that prevention andtreatment efforts designed to reduce hostility may
help mitigate risk for accelerated cellular aging.

Method: Hostility was measured with five items
from the Brief Symptom Inventory (BSI). The items
for hostility are divided into two clusters: controlling
anger (HC) and impulsive hostility (HI). The HC34

12th Annual Amygdala, Stress and PTSD Conference: Understanding StressContinuing 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 up to 4.75 continuing educationcredits for Physicians, Psychologists, Social Workers,

and Nurses. The credits are available through live inperson attendance and as a webinar. Select your desired option at http://amygdalaptsdconference.org/
continuing-education.

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12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

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12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

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12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

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12th Annual Amygdala, Stress and PTSD Conference: Understanding Stress

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12th Annual Amygdala, Stress and PTSD Conference: Understanding StressCenter for the Study of Traumatic Stress
Department of Psychiatry
Uniformed Services University
4301 Jones Bridge Road, Bethesda, MD 20814
contact@amygdalaptsdconference.org
www.CSTSonline.org
www.facebook.com/USU.CSTS
www.twitter.com/CSTS_USU
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