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 frequenciesUnraveling PTSD: Symptom Cluster Change During and 1 Year After Veterans’ Residential PTSD Treatment
Gross G, Spiller T, Ben-Zion Z, Rubenstein A, Pietrzak R, Duek O, Hoff R, Harpaz-Rotem I. Unraveling PTSD: Symptom Cluster Change During and 1 Year After Veterans’ Residential PTSD Treatment. Psychological Trauma Theory Research Practice And Policy 2024 PMID: 38990694, DOI: 10.1037/tra0001734.Peer-Reviewed Original ResearchPosttraumatic stress disorderPosttraumatic stress disorder symptom clustersPosttraumatic stress disorder clustersSymptom clustersIntrusive symptomsResidential treatmentTreatment of posttraumatic stress disorderPosttraumatic stress disorder symptomsResidential PTSD treatmentPTSD symptom clustersNovel treatment interventionsDifferential treatment responseReduce symptom severityDifferential patterns of changeAvoidance symptomsPTSD treatmentTreatment gainsStress disorderVeterans AffairsSymptom severityCluster CTreatment interventionsCluster BIndividual symptomsCohort of veteransEmotional 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 researchFunctional correlates of a novel 8-factor model of PTSD in U.S. military veterans: Results from the National Health and Resilience in Veterans Study
Stiltner B, Fischer I, Duek O, Polimanti R, Harpaz-Rotem I, Pietrzak R. Functional correlates of a novel 8-factor model of PTSD in U.S. military veterans: Results from the National Health and Resilience in Veterans Study. Journal Of Psychiatric Research 2024, 171: 69-74. PMID: 38244335, DOI: 10.1016/j.jpsychires.2024.01.017.Peer-Reviewed Original ResearchConceptsModels of posttraumatic stress disorderPosttraumatic stress disorderNational Health and ResilienceU.S. military veteransArousal symptomsSuicidal ideationVeterans StudyCurrent depressionSymptom clustersMilitary veteransPosttraumatic stress disorder symptom clustersPosttraumatic stress disorder symptomsPosttraumatic Stress Disorder ChecklistAnxious arousal symptomsDysphoric arousal symptomsIntrusive symptom clustersOdds of suicidal ideationFunctional correlatesMulti-faceted disorderExternalizing behavioral symptomsAssociated with lower oddsAssociated with higher oddsSymptom structureAvoidance symptomsDSM-5
2023
Effects of a dissociative drug on fronto-limbic resting-state functional connectivity in individuals with posttraumatic stress disorder: a randomized controlled pilot study
Danböck S, Duek O, Ben-Zion Z, Korem N, Amen S, Kelmendi B, Wilhelm F, Levy I, Harpaz-Rotem I. Effects of a dissociative drug on fronto-limbic resting-state functional connectivity in individuals with posttraumatic stress disorder: a randomized controlled pilot study. Psychopharmacology 2023, 241: 243-252. PMID: 37872291, PMCID: PMC10806226, DOI: 10.1007/s00213-023-06479-4.Peer-Reviewed Original ResearchResting-state functional connectivityPosttraumatic stress disorderFunctional magnetic resonance imagingMedial prefrontal cortexMPFC subregionsAnterior medial PFCFunctional connectivityStress disorderAspartate glutamate receptor antagonistPilot studyNon-competitive N-methylGlutamate receptor antagonistsEffects of ketamineDissociative drugsMagnetic resonance imagingIntravenous drug infusionReceptor antagonistSubanesthetic doseDrug infusionCorrelative findingsKetamineResonance imagingTransient decreaseDrug midazolamAmygdalaChanges in mental health among U.S. military veterans during the COVID-19 pandemic: A network analysis
Spiller T, Na P, Merians A, Duek O, Ben-Zion Z, Tsai J, von Känel R, Harpaz-Rotem I, Pietrzak R. Changes in mental health among U.S. military veterans during the COVID-19 pandemic: A network analysis. Journal Of Psychiatric Research 2023, 165: 352-359. PMID: 37595331, DOI: 10.1016/j.jpsychires.2023.08.003.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderSymptoms of PTSDTraumatic eventsPosttraumatic growthU.S. military veteransPTSD symptomsSuicidal ideationMental healthMilitary veteransIncrease of symptomsPopulation-based sampleCOVID-19 pandemicFirst yearStress disorderMost veteransSymptomsFirst monthPsychopathological symptomsGeneral resilienceGroup levelAnxietyVeteransIndividual reactionsDepressionSubtle increaseNot all traumas are created equal: Phenotypic heterogeneity of PTSD symptoms in relation to index traumas in U.S. military veterans
Kachadourian L, Duek O, Tsai J, Harpaz-Rotem I, Pietrzak R. Not all traumas are created equal: Phenotypic heterogeneity of PTSD symptoms in relation to index traumas in U.S. military veterans. Journal Of Affective Disorders 2023, 340: 728-731. PMID: 37572698, PMCID: PMC10754253, DOI: 10.1016/j.jad.2023.08.012.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderU.S. military veteransMilitary veteransIndex traumaPTSD symptomsDysphoric arousal symptomsIllness/injuryGreater overall severityIndex traumatic eventClinical presentationNational HealthDiagnostic criteriaTreatment approachesGreater severityOverall severityVeterans StudyInterpersonal violenceStress disorderTraumaArousal symptomsSymptomsVeteransPhenotypic heterogeneityTraumatic eventsSeverityStructural 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 psychopathologyReviewCorrelates of avoidance coping in trauma-exposed U.S. military veterans: Results from the National Health and Resilience in Veterans Study
Korem N, Ben-Zion Z, Spiller T, Duek O, Harpaz-Rotem I, Pietrzak R. Correlates of avoidance coping in trauma-exposed U.S. military veterans: Results from the National Health and Resilience in Veterans Study. Journal Of Affective Disorders 2023, 339: 89-97. PMID: 37437721, DOI: 10.1016/j.jad.2023.07.036.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderAvoidance copingTraumatic eventsU.S. military veteransEmotional stabilityNegative affect symptomsEmotional neglectSexual abuseAffect symptomsMilitary veteransAvoidant coping strategiesGreater emotional stabilityPhysical health outcomesPsychosocial risk factorsConsolidated memoryStress disorderCoping strategiesAdverse childhood experiencesStressful experiencesCopingVeterans StudyChildhood experiencesStrong feelingsNetwork analytic approachConscientiousnessComparative effectiveness of evidence-based psychotherapies for PTSD delivered in VA residential PTSD treatment
Sippel L, Gross G, Spiller T, Duek O, Smith N, Hoff R, Harpaz-Rotem I. Comparative effectiveness of evidence-based psychotherapies for PTSD delivered in VA residential PTSD treatment. Psychological Medicine 2023, 53: 6859-6866. PMID: 36971021, DOI: 10.1017/s0033291723000375.Peer-Reviewed Original ResearchResidential Rehabilitation Treatment ProgramPosttraumatic stress disorderCognitive processing therapyComparative effectivenessProlonged exposureFirst-line treatmentSevere posttraumatic stress disorderRehabilitation treatment programSelf-reported posttraumatic stress disorderDepressive symptom outcomesDepressive symptom severityEvidence-based psychotherapiesElectronic medical recordsResidential PTSD treatmentSymptomatic patientsComorbid conditionsMedical recordsPE groupSymptom outcomesIndividual cognitive processing therapyDepressive symptomsPTSD treatmentSymptom severityTreatment programProgram evaluation dataThe Functional Significance of a Novel Conceptualization of Intrusion Symptoms of PTSD
Spiller T, Gross G, Duek O, Pietrzak R, Harpaz-Rotem I. The Functional Significance of a Novel Conceptualization of Intrusion Symptoms of PTSD. European Psychiatry 2023, 66: s476-s477. PMCID: PMC10434546, DOI: 10.1192/j.eurpsy.2023.1020.Peer-Reviewed Original ResearchPosttraumatic stress disorderIntrusion symptomsResidential treatment programEmotional functioningFactors of PTSDSymptoms of PTSDSymptom clustersDistinct underlying processesDisclosure of interestSelf-report formCore defining featuresStructural equation modellingPhysical functioningGood model fitStress disorderPTSD ChecklistIntrusion factorCorresponding subscalesPreliminary empirical evidenceInitial supportDSM-5Equation modellingTreatment programSuperior fitBiological underpinningsClinical significance of novel 8-factor model of DSM-5 PTSD in national VA PTSD residential treatment data: Internally- v. externally-cued intrusions
Gross G, Spiller T, Duek O, Pietrzak R, Harpaz-Rotem I. Clinical significance of novel 8-factor model of DSM-5 PTSD in national VA PTSD residential treatment data: Internally- v. externally-cued intrusions. Journal Of Affective Disorders 2023, 328: 255-260. PMID: 36806596, DOI: 10.1016/j.jad.2023.02.046.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderPTSD symptomsDysphoric arousalDSM-5 posttraumatic stress disorderDSM-5 PTSD symptomsDistinct underlying processesSelf-report measuresGeneralized anxiety symptomsSuperior model fitPhysical health functioningCore defining featuresStructural equation modelingWorse emotional functioningAnxious arousalSymptoms of depressionNegative affectIntrusion symptomsGreater avoidanceEmotional functioningStress disorderAnxiety symptomsPTSD ChecklistIntrusion factorCross-sectional designGeneralized anxietyUnderlying Hippocampal Mechanism of Posttraumatic Stress Disorder Treatment Outcome: Evidence From Two Clinical Trials
Zilcha-Mano S, Duek O, Suarez-Jimenez B, Zhu X, Lazarov A, Helpman L, Korem N, Malka M, Harpaz-Rotem I, Neria Y. Underlying Hippocampal Mechanism of Posttraumatic Stress Disorder Treatment Outcome: Evidence From Two Clinical Trials. Biological Psychiatry Global Open Science 2023, 3: 867-874. PMID: 37881552, PMCID: PMC10593870, DOI: 10.1016/j.bpsgos.2023.01.005.Peer-Reviewed Original ResearchPosttraumatic stress disorderRight hippocampal volumeHippocampal volumeSymptom reductionPosttreatment magnetic resonance imagingPosttraumatic stress disorder treatment outcomeLarger hippocampal volumesDisorder treatment outcomesPTSD symptom reductionMagnetic resonance imagingGreater PTSD symptom reductionBetter prognosisClinical trialsTreatment outcomesDepressive symptomsTherapeutic outcomesPTSD treatmentResonance imagingTreatment studiesClinical targetsStress disorderPTSD symptomsSmall sample sizeHippocampal mechanismsTreatment
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 evaluationComparative 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 reductionEmotional numbing in PTSD is associated with lower amygdala reactivity to pain
Korem N, Duek O, Ben-Zion Z, Kaczkurkin AN, Lissek S, Orederu T, Schiller D, Harpaz-Rotem I, Levy I. Emotional numbing in PTSD is associated with lower amygdala reactivity to pain. Neuropsychopharmacology 2022, 47: 1913-1921. PMID: 35945274, PMCID: PMC9485255, DOI: 10.1038/s41386-022-01405-2.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderAmygdala reactivityLower amygdala reactivityHigher pain responseLower amygdala activationAltered pain perceptionAmygdala activationProcessing of painAmygdala responseEmotional numbingPain correlateMild painPain processingPain thresholdPain responsePain perceptionPainControl groupPTSD groupStress disorderRobust reductionAmygdala activityCombat controlsAmygdalaEmotional numbing symptomsExploration of a Novel Model of Intrusive Symptoms in Posttraumatic Stress Disorder Among US Veterans
Duek O, Spiller TR, Rubenstein A, Pietrzak RH, Harpaz-Rotem I. Exploration of a Novel Model of Intrusive Symptoms in Posttraumatic Stress Disorder Among US Veterans. JAMA Network Open 2022, 5: e223555. PMID: 35311966, PMCID: PMC8938717, DOI: 10.1001/jamanetworkopen.2022.3555.Peer-Reviewed Original ResearchConceptsCross-sectional studyPosttraumatic stress disorderPosttraumatic stress disorder modelUS veteransStress disorderIntrusive symptoms