The Impact of Event Scale: Revised

LaBar and Cabeza review the powerful effects of emotion on memory. These influences are mediated by the amygdala and its interactions with medial temporal and prefrontal regions, and affect memory from the encoding and consolidation stages through to long-term retrieval.

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Cognitive neuroscience of emotional memory

Post-traumatic stress disorder (PTSD) is the only major mental disorder for which a cause is considered to be known: that is, an event that involves threat to the physical integrity of oneself or others and induces a response of intense fear, helplessness or horror. Although PTSD is still largely regarded as a psychological phenomenon, over the past three decades the growth of the biological PTSD literature has been explosive, and thousands of references now exist. Ultimately, the impact of an environmental event, such as a psychological trauma, must be understood at organic, cellular and molecular levels. This Review attempts to present the current state of this understanding on the basis of psychophysiological, structural and functional neuroimaging, and endocrinological, genetic and molecular biological studies in humans and in animal models.

Biological studies of post-traumatic stress disorder

Recent decades have witnessed tremendous advances in the neuroscience of emotion, learning and memory, and in animal models for understanding depression and anxiety. This review focuses on new rationally designed psychiatric treatments derived from preclinical human and animal studies. Nonpharmacological treatments that affect disrupted emotion circuits include vagal nerve stimulation, rapid transcranial magnetic stimulation and deep brain stimulation, all borrowed from neurological interventions that attempt to target known pathological foci. Other approaches include drugs that are given in relation to specific learning events to enhance or disrupt endogenous emotional learning processes. Imaging data suggest that common regions of brain activation are targeted with pharmacological and somatic treatments as well as with the emotional learning in psychotherapy. Although many of these approaches are experimental, the rapidly developing understanding of emotional circuit regulation is likely to provide exciting and powerful future treatments for debilitating mood and anxiety disorders.

Targeting abnormal neural circuits in mood and anxiety disorders: from the laboratory to the clinic

Humans exhibit a remarkable degree of resilience in the face of extreme stress, with most resisting the development of neuropsychiatric disorders. Over the past 5 years, there has been increasing interest in the active, adaptive coping mechanisms of resilience; however, in humans, most published work focuses on correlative neuroendocrine markers that are associated with a resilient phenotype. In this review, we highlight a growing literature in rodents that is starting to complement the human work by identifying the active behavioral, neural, molecular and hormonal basis of resilience. The therapeutic implications of these findings are important and can pave the way for an innovative approach to drug development for a range of stress-related syndromes.

Neurobiology of Resilience

Pilot study of secondary prevention of posttraumatic stress disorder with propranolol

Background Despite many studies addressing potential impact of helicopter transport on trauma mortality, debate as to the efficacy of air transport continues.Methods This retrospective study combined trauma registry data from five urban Level I adult and pediatric centers. Logistic regression assess

https://www.lifeflightmaine.org/Documents/EMS-and-Hospitals/Research/Trauma/Blunt-Trauma-Mortality-01-2002.aspx

Helicopter transport and blunt trauma mortality: a multicenter trial

Background Because of concerns about masking important physical findings, there is controversy surrounding whether it is safe to provide analgesia to patients with undifferentiated abdominal pain. The purpose of this study was to address the effects of analgesia on the physical examination and diagnostic accuracy for patients with abdominal pain. Study design The study was a prospective, double-blind clinical trial in which adult Emergency Department (ED) patients with undifferentiated abdominal pain were randomized to receive placebo (control group, n=36) or morphine sulphate (MS group, n=38). Diagnostic and physical examination assessments were recorded before and after a 60-minute period during which study medication was titrated. Diagnostic accuracy and physical examination changes were compared between groups using univariate statistical analyses. Results There were no differences between control and MS groups with respect to changes in physical or diagnostic accuracy. The overall likelihood of change in severity of tenderness was similar in MS (37.7%) as compared with control (35.3%) patients (risk ratio [RR] 1.07, 95% confidence interval [CI] 0.64–1.78). MS patients were no more likely than controls to have a change in pain location (34.0% versus 41.2%, RR 0.82, 95% CI 0.50–1.36). Diagnostic accuracy did not differ between MS and control groups (64.2% versus 66.7%, RR 0.96, 95% CI 0.73–1.27). There were no differences between groups with respect to likelihood of any change occurring in the diagnostic list (37.7% versus 31.4%, RR 1.20, 95% CI 0.71–2.05). Correlation with clinical course and final diagnosis revealed no instance of masking of physical examination findings. Conclusions Results of this study support a practice of early provision of analgesia to patients with undifferentiated abdominal pain.

https://www.journalacs.org/article/S1072-7515(02)01480-1/pdf

Farah Cheema

Papers

Pilot study of secondary prevention of posttraumatic stress disorder with propranolol

Helicopter transport and blunt trauma mortality: a multicenter trial

Effects of morphine analgesia on diagnostic accuracy in emergency department patients with abdominal pain: a prospective, randomized trial ☆

Nontrauma helicopter emergency medical services transport: annotated review of selected outcomes-related literature.