2024
Prevalence, 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 ResearchCerebellar Contributions to Traumatic Autobiographical Memory in People with Post-Traumatic Stress Disorder
Blithikioti C, Duek O, Gordon C, Krystal J, Levy I, Harpaz-Rotem I, Schiller D, Perl O. Cerebellar Contributions to Traumatic Autobiographical Memory in People with Post-Traumatic Stress Disorder. The Cerebellum 2024, 1-9. PMID: 39180693, DOI: 10.1007/s12311-024-01731-9.Peer-Reviewed Original ResearchPost-traumatic stress disorderFunctional magnetic resonance imagingRight cerebellar lobule VICerebellar lobule VIAutobiographical memoryTraumatic eventsAutobiographical recallStress disorderLobule VIRe-experiencing of traumatic eventsChronic post-traumatic stress disorderDebilitating mental health conditionPTSD pathophysiologyProcessing negative emotionsNegative affective statesCerebellar Crus IIMental health conditionsCerebellar engagementRe-experiencingTrauma exposureCerebellar contributionReactivity paradigmNegative emotionsAffective statesCrus IIUnveiling 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 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 frequenciesPost-treatment alterations in white matter integrity in PTSD: Effects on symptoms and functional connectivity a secondary analysis of an RCT
Korem N, Duek O, Ben-Zion Z, Spiller T, Gordon C, Amen S, Levy I, Harpaz-Rotem I. Post-treatment alterations in white matter integrity in PTSD: Effects on symptoms and functional connectivity a secondary analysis of an RCT. Psychiatry Research Neuroimaging 2024, 343: 111864. PMID: 39111111, DOI: 10.1016/j.pscychresns.2024.111864.Peer-Reviewed Original ResearchReduced resting-state functional connectivityPost-traumatic stress disorderPost-traumatic stress disorder symptomsFunctional connectivityPost-treatment changesReducing PTSD symptom severityFollow-up changesResting-state functional connectivityIntensive exposure therapyExposure-based psychotherapyVentromedial prefrontal cortexPTSD symptom severityReduced structural connectivityFunctional connectivity patternsPost-treatmentWhite matter integrityPrefrontal cortexExposure therapyPTSD symptomsStress disorderSymptom severityUncinate fasciculusLimbic systemSecondary analysisAssociated with sustained changesUnraveling 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 veteransBarriers to Mental Health Care in US Military Veterans
Lewis C, Fischer I, Tsai J, Harpaz-Rotem I, Pietrzak R. Barriers to Mental Health Care in US Military Veterans. Psychiatric Quarterly 2024, 95: 367-383. PMID: 38940875, DOI: 10.1007/s11126-024-10078-7.Peer-Reviewed Original ResearchMental health careMental health treatmentHealth careHealth treatmentReduce barriersUS veteransNegative beliefsInstrumental barriersNational Health and ResiliencePromote engagementMental health servicesPopulation-based effortsUS military veteransNationally representative dataMultivariate logistic regressionPerceived stigmaHealth servicesSocial supportPsychiatric needsVeterans StudyPractical barriersLow purposeConclusionsNearly halfMilitary veteransCare351. High-Threshold-Low-Tolerance: A Model for the Emotionality Paradox in PTSD
Korem N, Duek O, Spiller T, Ben-Zion Z, Levy I, Harpaz-Rotem I. 351. High-Threshold-Low-Tolerance: A Model for the Emotionality Paradox in PTSD. Biological Psychiatry 2024, 95: s243. DOI: 10.1016/j.biopsych.2024.02.850.Peer-Reviewed Original ResearchSome 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 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 transitionSymptomsParticipantsDisordersFunctional 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-5Smaller total and subregional cerebellar volumes in posttraumatic stress disorder: a mega-analysis by the ENIGMA-PGC PTSD workgroup
Huggins A, Baird C, Briggs M, Laskowitz S, Hussain A, Fouda S, Haswell C, Sun D, Salminen L, Jahanshad N, Thomopoulos S, Veltman D, Frijling J, Olff M, van Zuiden M, Koch S, Nawjin L, Wang L, Zhu Y, Li G, Stein D, Ipser J, Seedat S, du Plessis S, van den Heuvel L, Suarez-Jimenez B, Zhu X, Kim Y, He X, Zilcha-Mano S, Lazarov A, Neria Y, Stevens J, Ressler K, Jovanovic T, van Rooij S, Fani N, Hudson A, Mueller S, Sierk A, Manthey A, Walter H, Daniels J, Schmahl C, Herzog J, Říha P, Rektor I, Lebois L, Kaufman M, Olson E, Baker J, Rosso I, King A, Liberzon I, Angstadt M, Davenport N, Sponheim S, Disner S, Straube T, Hofmann D, Qi R, Lu G, Baugh L, Forster G, Simons R, Simons J, Magnotta V, Fercho K, Maron-Katz A, Etkin A, Cotton A, O’Leary E, Xie H, Wang X, Quidé Y, El-Hage W, Lissek S, Berg H, Bruce S, Cisler J, Ross M, Herringa R, Grupe D, Nitschke J, Davidson R, Larson C, deRoon-Cassini T, Tomas C, Fitzgerald J, Blackford J, Olatunji B, Kremen W, Lyons M, Franz C, Gordon E, May G, Nelson S, Abdallah C, Levy I, Harpaz-Rotem I, Krystal J, Dennis E, Tate D, Cifu D, Walker W, Wilde E, Harding I, Kerestes R, Thompson P, Morey R. Smaller total and subregional cerebellar volumes in posttraumatic stress disorder: a mega-analysis by the ENIGMA-PGC PTSD workgroup. Molecular Psychiatry 2024, 29: 611-623. PMID: 38195980, PMCID: PMC11153161, DOI: 10.1038/s41380-023-02352-0.Peer-Reviewed Original 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
Neural patterns differentiate traumatic from sad autobiographical memories in PTSD
Perl O, Duek O, Kulkarni K, Gordon C, Krystal J, Levy I, Harpaz-Rotem I, Schiller D. Neural patterns differentiate traumatic from sad autobiographical memories in PTSD. Nature Neuroscience 2023, 26: 2226-2236. PMID: 38036701, DOI: 10.1038/s41593-023-01483-5.Peer-Reviewed Original ResearchConceptsPost-traumatic stress disorderTraumatic memoriesAutobiographical memoryNeural patternsIntersubject representational similarity analysisSimilar neural representationsRepresentational similarity analysisPosterior cingulate cortexTrauma memoriesMnemonic featuresNegative memoriesMultivoxel patternsNeural representationCognitive stateHippocampal representationsCognitive entitiesStress disorderCingulate cortexNeural activityTraumatic narrativesIndividual symptom severitySemantic representationMemory typesOwn memoryMemoryExamining the association between posttraumatic stress disorder and disruptions in cortical networks identified using data-driven methods
Yang J, Huggins A, Sun D, Baird C, Haswell C, Frijling J, Olff M, van Zuiden M, Koch S, Nawijn L, Veltman D, Suarez-Jimenez B, Zhu X, Neria Y, Hudson A, Mueller S, Baker J, Lebois L, Kaufman M, Qi R, Lu G, Říha P, Rektor I, Dennis E, Ching C, Thomopoulos S, Salminen L, Jahanshad N, Thompson P, Stein D, Koopowitz S, Ipser J, Seedat S, du Plessis S, van den Heuvel L, Wang L, Zhu Y, Li G, Sierk A, Manthey A, Walter H, Daniels J, Schmahl C, Herzog J, Liberzon I, King A, Angstadt M, Davenport N, Sponheim S, Disner S, Straube T, Hofmann D, Grupe D, Nitschke J, Davidson R, Larson C, deRoon-Cassini T, Blackford J, Olatunji B, Gordon E, May G, Nelson S, Abdallah C, Levy I, Harpaz-Rotem I, Krystal J, Morey R, Sotiras A. Examining the association between posttraumatic stress disorder and disruptions in cortical networks identified using data-driven methods. Neuropsychopharmacology 2023, 49: 609-619. PMID: 38017161, PMCID: PMC10789873, DOI: 10.1038/s41386-023-01763-5.Peer-Reviewed Original ResearchPosttraumatic stress disorderStructural covariance networksCortical thicknessPTSD diagnosisInsular cortexPTSD patientsCingulate cortexSymptom severityBilateral superior frontal cortexStress disorderGreater cortical thicknessLower cortical thicknessChildhood trauma severitySuperior frontal cortexRegression analysisAnterior cingulate cortexTrauma-exposed controlsPosterior cingulate cortexPrefrontal regulatory regionsPTSD symptom severityComorbid depressionMotor cortexHealthy controlsFrontal cortexAlcohol abuseEvaluating a novel 8-factor dimensional 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. Evaluating a novel 8-factor dimensional model of PTSD in U.S. military veterans: Results from the National Health and Resilience in Veterans Study. Journal Of Affective Disorders 2023, 346: 303-307. PMID: 37979626, DOI: 10.1016/j.jad.2023.11.041.Peer-Reviewed Original ResearchConceptsIndex traumaPTSD symptomsNational HealthPosttraumatic stress disorder (PTSD) symptomsVeterans StudyMilitary veteransTrauma-exposed populationsClinician-administered interviewU.S. military veteransConfirmatory factor analysisDSM-5 modelStrong significant associationTrauma exposureIntrusive symptomsDisorder symptomsCombat exposureHigh riskU.S. veteransDSM-5Significant associationSymptomsInterpersonal violenceFactor analysisPTSDScarce researchClinical Outcomes of Veterans Affairs Residential PTSD Treatment for PTSD and Depressive Symptoms: 1-Year Follow-Up Outcomes and Gender Differences
Gross G, Spiller T, Carretta R, Sippel L, Smith N, Harpaz-Rotem I. Clinical Outcomes of Veterans Affairs Residential PTSD Treatment for PTSD and Depressive Symptoms: 1-Year Follow-Up Outcomes and Gender Differences. Psychological Trauma Theory Research Practice And Policy 2023, 15: 1406-1415. PMID: 37199985, DOI: 10.1037/tra0001494.Peer-Reviewed Original ResearchPosttraumatic stress disorderResidential Rehabilitation Treatment ProgramDepressive symptomsWomen veteransTime pointsTreatment gainsRehabilitation treatment programResidential treatmentDepressive symptom severityGreater symptom reductionFirst national investigationLong-term effectivenessResidential PTSD treatmentClinical outcomesYear postdischargeUp OutcomesSymptom reductionPTSD treatmentSymptom changeSymptom severitySymptomsTreatment programStress disorderPTSD symptomsLinear mixed modelsEffects 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 increase