2024
Unveiling the Structure in Mental Disorder Presentations
Spiller T, Duek O, Helmer M, Murray J, Fielstein E, Pietrzak R, von Känel R, Harpaz-Rotem I. Unveiling the Structure in Mental Disorder Presentations. JAMA Psychiatry 2024, 81: 1101-1107. PMID: 39110437, PMCID: PMC11307158, DOI: 10.1001/jamapsychiatry.2024.2047.Peer-Reviewed Original ResearchSymptom combinationsNational Institute of Mental Health Data ArchivePosttraumatic stress disorderDiagnostic criteriaHeterogeneity of symptomsSecondary data analysisCross-sectional studyRevision of diagnostic criteriaSymptom-based definitionsDSM criteriaStress disorderSymptom heterogeneityDisorder presentationsClinical populationsMain OutcomesAssess symptomsGroup of individualsParticipantsSymptomsNational InstituteDisordersIndividualsSchizophreniaAnxietyIndividual frequenciesPrevalence, Correlates, and Burden of Subthreshold PTSD in US Veterans.
Fischer I, Na P, Harpaz-Rotem I, Marx B, Pietrzak R. Prevalence, Correlates, and Burden of Subthreshold PTSD in US Veterans. The Journal Of Clinical Psychiatry 2024, 85 PMID: 39480145, DOI: 10.4088/jcp.24m15465.Peer-Reviewed Original ResearchConceptsSubthreshold posttraumatic stress disorderPosttraumatic stress disorderPosttraumatic stress disorder symptom clustersLifetime psychiatric disordersUS veteransUS military veteransSymptom-related distressStress disorderPsychiatric disordersSymptom clustersTreating veteransCriterion AMilitary veteransTraumatic eventsCognitive functionWorking case definitionMental healthCriterion FFunctional impairmentVeteransNationally representative sampleFunctional correlatesDisordersElevated oddsGreater oddsAmygdala Cannabinoid 1 Receptor, Pain Response, and Emotional Numbing in Trauma-Exposed Individuals
Korem N, Hillmer A, D’Souza D, Nia A, Levy I, Pietrzak R, Harpaz-Rotem I. Amygdala Cannabinoid 1 Receptor, Pain Response, and Emotional Numbing in Trauma-Exposed Individuals. JAMA Network Open 2024, 7: e2432387. PMID: 39250156, PMCID: PMC11385051, DOI: 10.1001/jamanetworkopen.2024.32387.Peer-Reviewed Original ResearchEmotional State Transitions in Trauma-Exposed Individuals With and Without Posttraumatic Stress Disorder
Korem N, Duek O, Spiller T, Ben-Zion Z, Levy I, Harpaz-Rotem I. Emotional State Transitions in Trauma-Exposed Individuals With and Without Posttraumatic Stress Disorder. JAMA Network Open 2024, 7: e246813. PMID: 38625701, PMCID: PMC11022112, DOI: 10.1001/jamanetworkopen.2024.6813.Peer-Reviewed Original ResearchPosttraumatic stress disorderTrauma-exposed individualsEmotional numbing symptomsTrauma-exposed controlsNegative emotional statesNumbing symptomsEmotional numbingDSM-5Valence ratingsStress disorderEmotional statesTrauma-exposed control groupPTSD experiencesPosttraumatic stress disorder symptomsPosttraumatic Stress Disorder ChecklistDSM-5 criteriaAge-related associationsStimulus valencePCL-5Emotional responsesEmotional state transitionEmotional transitionSymptomsParticipantsDisordersSome Closure on Exposure—Realigning the Perspective on Trauma Treatment and Finding a Pathway Forward: Reply to Brown (2024) and Najavits (2024)
Rubenstein A, Doran J, Duek O, Harpaz-Rotem I. Some Closure on Exposure—Realigning the Perspective on Trauma Treatment and Finding a Pathway Forward: Reply to Brown (2024) and Najavits (2024). American Psychologist 2024, 79: 350-351. PMID: 38635198, DOI: 10.1037/amp0001314.Peer-Reviewed Original ResearchTo Expose or Not to Expose: A Comprehensive Perspective on Treatment for Posttraumatic Stress Disorder
Rubenstein A, Duek O, Doran J, Harpaz-Rotem I. To Expose or Not to Expose: A Comprehensive Perspective on Treatment for Posttraumatic Stress Disorder. American Psychologist 2024, 79: 331-343. PMID: 38635195, PMCID: PMC11034887, DOI: 10.1037/amp0001121.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderTreating posttraumatic stress disorderNon-trauma-focused treatmentsExposure therapyStress disorderTreatment of posttraumatic stress disorderNon-trauma-focused therapiesPosttraumatic stress disorder diagnosisSelf-directed exposureTrauma-focused psychotherapyPsychotherapy factorsTrauma memoriesTrauma-focusedBehavioral paradigmsSymptom remissionHigh dropout ratesTherapy processTherapy contextProlonged exposurePsychotherapyDropout ratesIncreased patient autonomyResearch literatureDisordersClinical researchWhat Happens Next? Maintenance of Gains After Discharge From VA Residential PTSD Treatment
Grau P, Harpaz-Rotem I, Ilgen M, Ganoczy D, Sripada R. What Happens Next? Maintenance of Gains After Discharge From VA Residential PTSD Treatment. The Journal Of Nervous And Mental Disease 2024, 212: 197-204. PMID: 38536046, DOI: 10.1097/nmd.0000000000001749.Peer-Reviewed Original ResearchConceptsMaintenance of gainsResidential PTSD treatmentPosttraumatic stress disorderPTSD treatmentStress disorderResidential treatmentSymptom reboundDepartment of Veterans AffairsCohort of veteransSignificant respondersTreatment responseNational cohort of veteransVeteransAssociated with maintenanceResponse profilesPain severityVeterans AffairsGreater pain severitySessionsAssociated with decreased oddsPsychotherapyAssociated with increased oddsSeverityDisordersRespondents
2023
Structural Neuroimaging of Hippocampus and Amygdala Subregions in Posttraumatic Stress Disorder: A Scoping Review
Ben-Zion Z, Korem N, Fine N, Katz S, Siddhanta M, Funaro M, Duek O, Spiller T, Danböck S, Levy I, Harpaz-Rotem I. Structural Neuroimaging of Hippocampus and Amygdala Subregions in Posttraumatic Stress Disorder: A Scoping Review. Biological Psychiatry Global Open Science 2023, 4: 120-134. PMID: 38298789, PMCID: PMC10829655, DOI: 10.1016/j.bpsgos.2023.07.001.Peer-Reviewed Original ResearchPost-traumatic stress disorderAmygdala subregionsStress disorderKey limbic regionsEtiology of PTSDPosttraumatic stress disorderDentate gyrusLimbic regionsSubiculum volumeSubregion volumesHippocampal subregionsDisorder pathogenesisStructural neuroimagingAutomatic segmentation softwareAmygdalar subregionsHippocampusNucleus volumeScoping ReviewPathogenesisCurrent literatureDisordersSegmentation softwareMethodological limitationsPost-traumatic psychopathologyReview
2022
Distinguishing emotional numbing symptoms of posttraumatic stress disorder from major depressive disorder
Duek O, Seidemann R, Pietrzak R, Harpaz-Rotem I. Distinguishing emotional numbing symptoms of posttraumatic stress disorder from major depressive disorder. Journal Of Affective Disorders 2022, 324: 294-299. PMID: 36586605, DOI: 10.1016/j.jad.2022.12.105.Peer-Reviewed Original ResearchConceptsEmotional numbing symptomsPosttraumatic stress disorderNumbing symptomsEmotional numbingStress disorderSymptom clustersTrauma-exposed individualsGreater PTSD severityMajor depressive disorderContext of traumaUnique variancePTSD symptomsPTSD phenotypePTSD severityDifferent symptom clustersWorse treatment outcomesDepressive disorderCore aspectsNumbingDistinct contributionsMDD symptomsDSM-IIIFunctional impairmentDisordersTreatment outcomesMapping the availability of translated versions of posttraumatic stress disorder screening questionnaires for adults: A scoping review
Hoffman J, Ben-Zion Z, Arévalo A, Duek O, Greene T, Hall B, Harpaz-Rotem I, Liddell B, Locher C, Morina N, Nickerson A, Pfaltz M, Schick M, Schnyder U, Seedat S, Shatri F, Sit H, von Känel R, Spiller T. Mapping the availability of translated versions of posttraumatic stress disorder screening questionnaires for adults: A scoping review. European Journal Of Psychotraumatology 2022, 13: 2143019. PMID: 38872602, PMCID: PMC9724641, DOI: 10.1080/20008066.2022.2143019.Peer-Reviewed Original ResearchPosttraumatic stress disorderScreening QuestionnaireStress disorderBackward translation procedureStudy team membersPTSD screeningPeer-reviewed studiesLow-income countriesUsed questionnairesAPA PsycInfoCitation searchesAdultsDifferent questionnairesQuestionnaireDisordersTranslation procedureSmall proportionReviewEMBASEMEDLINEPsycINFOQualitative evaluationPost-traumatic Stress Disorder
Merians A, Spiller T, Harpaz-Rotem I, Krystal J, Pietrzak R. Post-traumatic Stress Disorder. Medical Clinics Of North America 2022, 107: 85-99. PMID: 36402502, DOI: 10.1016/j.mcna.2022.04.003.Peer-Reviewed Original ResearchConceptsPost-traumatic stress disorderStress disorderCognitive processing therapyCognitive behavioral therapyEye movement desensitizationEvidence-based psychotherapiesTraumatic eventsBehavioral therapyNegative alterationsFirst-line pharmacologic treatmentStructured interviewsFirst-line treatmentNonpsychiatric settingsLarge bodyPharmacologic treatmentReuptake inhibitorsCognitionDisordersArousalTherapeutic interventionsMoodPsychotherapyAvoidanceTherapyInterventionPerceived Purpose in Life, Mental Health, and Suicidality in Older U.S. Military Veterans: Results From the National Health and Resilience in Veterans Study
Fischer IC, Tsai J, Harpaz-Rotem I, McCutcheon VE, Schulenberg SE, Pietrzak RH. Perceived Purpose in Life, Mental Health, and Suicidality in Older U.S. Military Veterans: Results From the National Health and Resilience in Veterans Study. American Journal Of Geriatric Psychiatry 2022, 31: 87-93. PMID: 36253289, DOI: 10.1016/j.jagp.2022.09.010.Peer-Reviewed Original ResearchConceptsMental disordersNational HealthU.S. veteransVeterans StudyHigher PILSubstance use disordersOlder U.S. veteransU.S. military veteransMajor depressiveSelf-report assessmentsLower oddsCurrent prevalenceUse disordersMost veteransSuicide attemptsMental healthGeneralized anxietySuicidalityDisordersMilitary veteransVeteransPosttraumatic stressHealthOddsRepresentative sampleComparative effectiveness of group v. individual trauma-focused treatment for posttraumatic stress disorder in veterans
Spiller TR, Duek O, Buta E, Gross G, Smith NB, Harpaz-Rotem I. Comparative effectiveness of group v. individual trauma-focused treatment for posttraumatic stress disorder in veterans. Psychological Medicine 2022, 53: 4561-4568. PMID: 35959560, PMCID: PMC10388318, DOI: 10.1017/s0033291722001441.Peer-Reviewed Original ResearchConceptsGroup cognitive processing therapyCognitive processing therapyPosttraumatic stress disorderIndividual cognitive processing therapyPTSD symptom severitySymptom severityStress disorderReal-world effectivenessComparative effectiveness studiesResidential treatmentEffective treatmentComparative effectivenessVeterans AffairsEffectiveness studiesPTSD ChecklistPTSD severityGroup therapySeverityVeteransTreatmentDSM-5Group V.TherapyDisordersSmall reduction
2021
The Reward System and Post-Traumatic Stress Disorder: Does Trauma Affect the Way We Interact With Positive Stimuli?
Seidemann R, Duek O, Jia R, Levy I, Harpaz-Rotem I. The Reward System and Post-Traumatic Stress Disorder: Does Trauma Affect the Way We Interact With Positive Stimuli? Chronic Stress 2021, 5: 2470547021996006. PMID: 33718742, PMCID: PMC7917421, DOI: 10.1177/2470547021996006.Peer-Reviewed Original ResearchPost-traumatic stress disorderStress disorderReward systemSelf-reported dataFear learningPositive stimuliMajority of researchImportant constructDisordersPrevalent disorderCurrent reviewComplex relationshipTraumaAnhedoniaFearFunctioningStimuliEthologyResearchLearningRelationshipConstructsPossible hindranceSufficient insightClinical observationsCannabinoid Receptor 1 rs1049353 Variant, Childhood Abuse, and the Heterogeneity of PTSD Symptoms: Results From the National Health and Resilience in Veterans Study
Korem N, Duek O, Xu K, Harpaz-Rotem I, Pietrzak RH. Cannabinoid Receptor 1 rs1049353 Variant, Childhood Abuse, and the Heterogeneity of PTSD Symptoms: Results From the National Health and Resilience in Veterans Study. Chronic Stress 2021, 5: 24705470211011075. PMID: 33997583, PMCID: PMC8107935, DOI: 10.1177/24705470211011075.Peer-Reviewed Original ResearchPosttraumatic stress disorderOverall PTSD symptomsAnxious arousal symptomsPTSD symptomsNational HealthChildhood abuseVeterans StudySymptom clustersArousal symptomsAllele carrier statusArousal symptom clustersMultivariable analysisEndocannabinoid systemAllele carriersPTSD symptom clustersGene-environment studiesGreater severityG homozygotesU.S. veteransSymptomsStress disorderCarrier statusReceptor geneDisordersSignificant main effect
2018
Latent typologies of DSM-5 PTSD symptoms in U.S. military veterans
Byrne SP, Harpaz-Rotem I, Tsai J, Southwick SM, Pietrzak RH. Latent typologies of DSM-5 PTSD symptoms in U.S. military veterans. Psychiatry Research 2018, 273: 266-273. PMID: 30658212, DOI: 10.1016/j.psychres.2018.12.094.Peer-Reviewed Original ResearchConceptsHigh symptom classPosttraumatic stress disorderSymptom classUse disordersLifetime historyDSM-5 PTSD symptomsPTSD symptomsLatent class analysisDrug use disordersNicotine use disorderDSM-5 posttraumatic stress disorderDSM-5 criteriaU.S. military veteransMajor depressiveCognitive impairmentU.S. veteransSymptomsPersonalized approachHigher symptomsStress disorderGeneralized anxietyMilitary veteransThree-class solutionDisordersVeterans
2017
Smaller Hippocampal Volume in Posttraumatic Stress Disorder: A Multisite ENIGMA-PGC Study: Subcortical Volumetry Results From Posttraumatic Stress Disorder Consortia
Logue MW, van Rooij SJH, Dennis EL, Davis SL, Hayes JP, Stevens JS, Densmore M, Haswell CC, Ipser J, Koch SBJ, Korgaonkar M, Lebois LAM, Peverill M, Baker JT, Boedhoe PSW, Frijling JL, Gruber SA, Harpaz-Rotem I, Jahanshad N, Koopowitz S, Levy I, Nawijn L, O’Connor L, Olff M, Salat DH, Sheridan MA, Spielberg JM, van Zuiden M, Winternitz SR, Wolff JD, Wolf EJ, Wang X, Wrocklage K, Abdallah CG, Bryant RA, Geuze E, Jovanovic T, Kaufman ML, King AP, Krystal JH, Lagopoulos J, Bennett M, Lanius R, Liberzon I, McGlinchey RE, McLaughlin KA, Milberg WP, Miller MW, Ressler KJ, Veltman DJ, Stein DJ, Thomaes K, Thompson PM, Morey RA. Smaller Hippocampal Volume in Posttraumatic Stress Disorder: A Multisite ENIGMA-PGC Study: Subcortical Volumetry Results From Posttraumatic Stress Disorder Consortia. Biological Psychiatry 2017, 83: 244-253. PMID: 29217296, PMCID: PMC5951719, DOI: 10.1016/j.biopsych.2017.09.006.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderStress disorderTrauma-exposed control subjectsCurrent posttraumatic stress disorderSmaller hippocampal volumesControl subjectsSmaller hippocampiHippocampal volumeClinical dataAmygdala volumeAmygdala findingsSmaller amygdalaConsortium studySubcortical structuresNeuroimaging studiesLargest neuroimaging studyENIGMA consortiumBrain responsesNeurobiological underpinningsPsychiatric Genomics ConsortiumDisordersSubjectsWorking GroupSignificance levelHippocampusSynaptic Loss and the Pathophysiology of PTSD: Implications for Ketamine as a Prototype Novel Therapeutic
Krystal JH, Abdallah CG, Averill LA, Kelmendi B, Harpaz-Rotem I, Sanacora G, Southwick SM, Duman RS. Synaptic Loss and the Pathophysiology of PTSD: Implications for Ketamine as a Prototype Novel Therapeutic. Current Psychiatry Reports 2017, 19: 74. PMID: 28844076, PMCID: PMC5904792, DOI: 10.1007/s11920-017-0829-z.Peer-Reviewed Original ResearchConceptsSynaptic connectivityRapid-acting treatmentPathophysiology of PTSDPotential clinical importanceTreatment of PTSDSynaptic lossPurpose of ReviewStudiesDisconnection syndromeClinical importanceNovel pharmacotherapeuticsNovel therapeuticsPTSD symptomsRecent FindingsHerePTSDPathophysiologyKetamineTreatmentDisordersTherapeutic applicationsStress-related lossesSyndromeSymptomsPharmacotherapeuticsOxytocin and Stress-related Disorders: Neurobiological Mechanisms and Treatment Opportunities
Sippel LM, Allington CE, Pietrzak RH, Harpaz-Rotem I, Mayes LC, Olff M. Oxytocin and Stress-related Disorders: Neurobiological Mechanisms and Treatment Opportunities. Chronic Stress 2017, 1: 2470547016687996. PMID: 28649672, PMCID: PMC5482285, DOI: 10.1177/2470547016687996.Peer-Reviewed Original ResearchStress-related disordersStress-related psychiatric disordersNeurobiological mechanismsPosttraumatic stress disorderCritical moderating variablePsychiatric disordersStress disorderNeurohormone oxytocinClinical populationsEndogenous oxytocinModerating variableHeterogeneous findingsHealthy samplesOverview of evidenceSingle-dose studyMajor depressive disorderPromising findingsOxytocinDisordersDepressive disorderDosing schedulesNovel pharmacotherapiesMultidose studyReliable biomarkersTreatment opportunitiesFear extinction and memory reconsolidation as critical components in behavioral treatment for posttraumatic stress disorder and potential augmentation of these processes
Smith NB, Doran JM, Sippel LM, Harpaz-Rotem I. Fear extinction and memory reconsolidation as critical components in behavioral treatment for posttraumatic stress disorder and potential augmentation of these processes. Neuroscience Letters 2017, 649: 170-175. PMID: 28065842, DOI: 10.1016/j.neulet.2017.01.006.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderReconsolidation processPTSD psychotherapyStress disorderBehavioral treatmentExposure-based treatmentsCritical brain regionsFear extinctionMemory reconsolidationTraumatic memoriesImportant future directionsPTSD populationsPTSD therapyNeurobiological mechanismsPrefrontal cortexReconsolidationBrain regionsPsychotherapyProcess of extinctionMemoryPotential avenuesFuture directionsBehavioral modificationExtinctionDisorders