Objective: To detect the changes of gray matter volume (GMV) and their correlation with severity of symptom in patients with post-traumatic stress disorder (PTSD) who were defined with updated DSM-5 diagnostic criteria. Method: 71 participants were assigned into PTSD group (n = 35) or trauma-exposed control (TEC) group (n = 36) with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Voxel-based morphometry analysis was used to detect alterations in GMV in the PTSD group. Results: We found that the PTSD group had larger GMV in the left middle temporal gyrus (MTG) and in the right dorsal medial prefrontal cortex (dmPFC), and smaller GMV in the region of the right temporal pole (TP) than the TEC group. We also found that PTSD Checklist for DSM-5 (PCL-5) scores correlated positively with the left MTG and right dmPFC GMV, and negatively with left TP GMV. These correlations were consistent with the findings of the between-group comparisons. Conclusions: GMV alterations in the MTG, dmPFC, and TP are detected in the group comparisons and correlated with symptom severity when classifying PTSD individuals according to DSM-5 diagnostic criteria within an earthquake-exposed population.

Post-traumatic stress disorder (PTSD) is characterized by difficulty down-regulating emotional responses towards trauma-reminders. The neuropeptide oxytocin may enhance treatment response in PTSD, by dampening excessive fear and improving fear regulation. However, oxytocin effects on (neural correlates of) cognitive emotion regulation abilities have never been investigated in PTSD patients. Therefore, we investigated behavioral and neural effects of intranasal oxytocin administration (40IU) on distraction as emotion regulation strategy in male and female police officers with and without PTSD (n = 76), using a randomized placebo-controlled cross-over fMRI study. The distraction condition consisted of a working memory task while negative affective pictures were presented. Under placebo, male PTSD patients showed decreased right striatal activity during distraction compared to male trauma-exposed controls, which was unaffected by oxytocin. After oxytocin administration, left thalamus activity during distraction was enhanced in all participants, independent of PTSD status or sex. Although left thalamus activity during distraction did not differ between PTSD patients and controls under placebo, it was negatively correlated with error rates within PTSD patients. Furthermore, oxytocin administration increased functional connectivity between the left thalamus and amygdala in PTSD patients and male trauma-exposed controls. Upregulation of thalamus activity during distraction by oxytocin may enhance cognitive emotion regulation abilities during psychotherapy in PTSD, although this should still be investigated in a clinical setting. Our findings open an important research avenue into oxytocin effects on cognitive emotion regulation in PTSD and other psychiatric disorders characterized by deficient emotion regulation abilities. Registered in the Netherlands Trial Registry, registration number: NTR3516.

Mental health research among asylum seekers and refugees has largely focused on effects of pre-migration trauma on post-migration wellbeing. While emerging literature highlights the importance of post-migration factors, we do not yet understand how addressing these factors may influence change in psychological distress. This study uses archival clinical data to identify post-migration correlates of reductions in distress among torture survivors, after accounting for pre-migration trauma. Depression (Patient Health Questionnaire-9) and Post Traumatic Stress Disorder (PTSD; Harvard Trauma Questionnaire) were measured among torture survivors following 6 months of interdisciplinary treatment (N = 323). Relationships between pre-, post-migration factors, and changes in symptom levels from intake to six months follow-up, were evaluated using regression analyses. Average levels of depression and PTSD significantly reduced after six months of treatment. Higher exposure to pre-migration trauma, female gender, and change to a more secure visa status were associated with reduced distress. Accessing more social services and not reporting chronic pain were associated with reduced PTSD. Stable housing and employment significantly moderated the relationship between lower chronic pain and reduced PTSD. Although effect sizes were small, results emphasize the importance of post-migration factors on wellbeing among torture survivors and are a first step towards identifying key treatment targets.

Resilience following traumatic events has been studied using numerous methodologies. One approach involves quantifying lower-than-expected levels of a negative outcome following trauma exposure. Resilience research has examined personality and coping-related factors. One malleable factor is psychological flexibility, or the context-dependent ability/willingness to contact the present moment, including emotional distress, in order to engage in valued actions. Among 254 war Veterans who participated in a longitudinal study, we operationalized resilience as lower-than-expected PTSD symptoms and PTSD-related functional impairment one-year following an initial post-deployment assessment based on lifetime exposure to childhood trauma, combat trauma, and sexual trauma during military service. We evaluated the contribution of personality factors, self-reported trait resilience, and psychological flexibility, measured using the Acceptance and Action Questionnaire-II, to PTSD-related resilience after accounting for lifetime and current PTSD symptom severity and depression symptom severity. In hierarchical regression analyses, neither specific personality factors nor self-reported resilience predicted PTSD-related resilience at follow-up after accounting for PTSD and depression symptoms. In the final step, psychological flexibility predicted unique variance and was the only significant predictor of PTSD-related resilience aside from baseline PTSD symptom severity. Findings indicate that psychological flexibility is a predictor of resilience that is distinct from psychiatric symptoms, personality, and self-reported resilience. Trauma survivors may benefit from interventions that bolster psychological flexibility.

Cerebral blood flow (CBF) is known to have marked developmental sex differences. We investigated whether gender differences exert modulatory effect on mild traumatic brain injury (mTBI) from both neuropsychological testing and brain CBF changes using a longitudinal design from acute stage to subacute 1 month post-injury. Our results supported that cognitive information processing speed (IPS), as one of core cognitive impairments following mTBI, were at least partially independent from other self-reported syndromes, such as post concussive symptom and posttraumatic stress disorder, and that it can be selectively impaired in specific male mTBI individuals. The gender difference of this cognitive domain in healthy control attenuated following mTBI and only male patients showed impaired language fluency accompanying with increased CBF changes compared with male controls. The increased CBF in the posterior parietal cortex (PPC) can predict much worse cognitive IPS performance in male patients. In contrast, female patients with mTBI displayed no impairments on any neuropsychological performance, and female sex may be a protective factor against neuropsychological impairments. Moreover, the significant interaction effect of time and gender exhibited in the left inferior frontal cortex (Broca's area). Simple effect test suggested gender differences in this area was mainly derived from the patients group at later subacute but not acute phase, for the reduced CBF at subacute mainly in the male patients. Thus, the current findings suggest that regional CBF may provide an objective biomarker for tracking gender modulatory effect on mTBI and its potentially pathological recovery process.

Immigrant African gay and bisexual men (GBM) are at risk for substance use and adverse mental health outcomes due to negative experiences in home and host countries. Little is known about correlates of substance use and mental health outcomes in this population. We explored pre- and post-migratory factors associated with substance use and depression in recently migrated African GBM. Participants (N = 70) were recruited between July and November 2015 in NYC. Eligible participants were administered a structured questionnaire. Correlates of substance use and depression were identified using bivariate and multivariable analyses. Factors independently associated with current substance use were age, openness about sexual orientation, homophobic experiences in home country, forced sex in home country, current housing instability, and internalized homophobia. Factors independently associated with depression were post-traumatic stress disorder symptoms and alcohol use. Substance use and depression were associated with negative experiences in home and host country.