Post-traumatic stress الصدمة

فَلَمَّا ذَهَبَ عَنۡ إِبۡرَٰهِيمَ ٱلرَّوۡعُ وَجَآءَتۡهُ ٱلۡبُشۡرَىٰ يُجَٰدِلُنَا فِي قَوۡمِ لُوطٍ

Then, when the fear left Abraham and the good news came to him, he pleaded with Us for Lot’s people

وَزُرُوعࣲ وَنَخۡلࣲ طَلۡعُهَا هَضِيمࣱ‏

fields, palm trees laden with fruit

وَزُرُوعࣲ وَمَقَامࣲ كَرِيمࣲ‏

many a cornfield and noble building

وَلَمَّا بَلَغَ أَشُدَّهُۥٓ ءَاتَيۡنَٰهُ حُكۡمࣰ ا وَعِلۡمࣰ اۚ وَكَذَٰلِكَ نَجۡزِي ٱلۡمُحۡسِنِينَ

When he reached maturity, We gave him judgement and knowledge: this is how We reward those who do good

وَلَا تَقۡرَبُواْ مَالَ ٱلۡيَتِيمِ إِلَّا بِٱلَّتِي هِيَ أَحۡسَنُ حَتَّىٰ يَبۡلُغَ أَشُدَّهُۥۚ وَأَوۡفُواْ بِٱلۡعَهۡدِۖ إِنَّ ٱلۡعَهۡدَ كَانَ مَسۡـُٔولࣰ ا

Do not go near the orphan’s property, except with the best [intentions], until he reaches the age of maturity. Honour your pledges: you will be questioned about your pledges

وَلَا تَقۡرَبُواْ مَالَ ٱلۡيَتِيمِ إِلَّا بِٱلَّتِي هِيَ أَحۡسَنُ حَتَّىٰ يَبۡلُغَ أَشُدَّهُۥۚ وَأَوۡفُواْ ٱلۡكَيۡلَ وَٱلۡمِيزَانَ بِٱلۡقِسۡطِۖ لَا نُكَلِّفُ نَفۡسًا إِلَّا وُسۡعَهَاۖ وَإِذَا قُلۡتُمۡ فَٱعۡدِلُواْ وَلَوۡ كَانَ ذَا قُرۡبَىٰۖ وَبِعَهۡدِ ٱللَّهِ أَوۡفُواْۚ ذَٰلِكُمۡ وَصَّىٰكُم بِهِۦ لَعَلَّكُمۡ تَذَكَّرُونَ

Stay well away from the property of orphans, except with the best [intentions], until they come of age; give full measure and weight, according to justice’- We do not burden any soul with more than it can bear- ‘ when you speak, be just, even if it concerns a relative; keep any promises you make in God’s name. This is what He commands you to do, so that you may take heed’

And when the awe the fear departed from Abraham and the good tiding came to him of a child he began to plead with Us pleading with Our messengers concerning the matter of the people of Lot.

Then when the fear had gone away from (the mind of) Ibrahim, and the glad tidings had reached him, he began to plead with Us (Our messengers) for the people of Lut (74)Verily, Ibrahim was, without doubt, forbearing, used to invoke Allah with humility, and was repentant (75)"O Ibrahim! Forsake this. Indeed, the commandment of your Lord has gone forth. Verily, there will come a torment for them which cannot be turned back. (76) The Dispute of Ibrahim over the People of Lut Allah, the Exalted, informs of what happened after the fright of Ibrahim left him and he felt no more fear of the angels when they refused to eat. After this, they gave him the glad tidings of the birth of a son and the destruction of the people of Lut. When they told him of this, he spoke to them as Sa'id bin Jubayr narrated concerning this verse. Sa'id said: When Jibril and the other angels who were with him came to

and farms and date palms with slender delicate and tender spathes?

as well as sown fields and many a glorious residence many a splendid court

"Will you be left secure in that which you have here? (146)"In gardens and springs. (147)"And crops and date palms with soft clusters. (148)"And you hew out in the mountains, houses with great skill. (149)"So, have Taqwa of Allah, and obey me. (150)"And follow not the command of the extravagant, (151)Who make mischief in the land, and reform not. (152) A Reminder to Them of Their Circumstances and the Blessings They Enjoyed Salih preached to them, warning them that the punishment of Allah could overtake them and reminding them of the blessings that Allah had bestowed upon them, by giving them ample provision and making them safe from all kinds of dangers, giving them gardens and flowing springs, and bringing forth for them crops and fruits. وَنَخْلٍ طَلْعُهَا هَضِيمٌ (and date palms with soft clusters.) Al-'Awfi narrated from Ibn 'Abbas, "Ripe and rich." 'Ali bin Abi Talhah narrated

And indeed We tried before them Fir'awn's people, when there came to them a noble Messenger (17)Saying: "Deliver to me the servants of Allah. Verily, I am to you a Messenger worthy of all trust. (18)"And exalt not yourselves against Allah. Truly, I have come to you with a manifest authority. (19)"And truly, I seek refuge with my Lord and your Lord, lest you should stone me. (20)"But if you believe me not, then keep away from me and leave me alone. (21)So he (Musa) called upon his Lord (saying): "These are indeed the people who are criminals. (22)(Allah said): "Depart you with My servants by night. Surely, you will be pursued. (23)"And leave the sea as it is (quiet and divided). Verily, they are a host to be drowned. (24)How many of gardens and springs that they (Fir'awn's people) left behin (25)And green crops (fields) and goodly places (26)And comforts of life wherein they used to take

حَدَّثَنَا عَلِيُّ بْنُ عَبْدِ اللَّهِ، حَدَّثَنَا بِشْرُ بْنُ السَّرِيِّ، حَدَّثَنَا نَافِعُ بْنُ عُمَرَ، عَنِ ابْنِ أَبِي مُلَيْكَةَ، قَالَ قَالَتْ أَسْمَاءُ عَنِ النَّبِيِّ صلى الله عليه وسلم قَالَ ‏ "‏ أَنَا عَلَى، حَوْضِي أَنْتَظِرُ مَنْ يَرِدُ عَلَىَّ، فَيُؤْخَذُ بِنَاسٍ مِنْ دُونِي فَأَقُولُ أُمَّتِي‏.‏ فَيَقُولُ لاَ تَدْرِي، مَشَوْا عَلَى الْقَهْقَرَى ‏"‏‏.‏ قَالَ ابْنُ أَبِي مُلَيْكَةَ اللَّهُمَّ إِنَّا نَعُوذُ بِكَ أَنْ نَرْجِعَ عَلَى أَعْقَابِنَا أَوْ نُفْتَنَ‏.‏

Narrated Asma':The Prophet (ﷺ) said, "I will be at my Lake-Fount (Kauthar) waiting for whoever will come to me. Then some people will be taken away from me whereupon I will say, 'My followers!' It will be said, 'You do not know they turned Apostates as renegades (deserted their religion).'" (Ibn Abi Mulaika said, "Allah, we seek refuge with You from turning on our heels from the (Islamic) religion and from being put to trial

حَدَّثَنَا مُوسَى بْنُ إِسْمَاعِيلَ، حَدَّثَنَا أَبُو عَوَانَةَ، عَنْ مُغِيرَةَ، عَنْ أَبِي وَائِلٍ، قَالَ قَالَ عَبْدُ اللَّهِ قَالَ النَّبِيُّ صلى الله عليه وسلم ‏ "‏ أَنَا فَرَطُكُمْ عَلَى الْحَوْضِ، لَيُرْفَعَنَّ إِلَىَّ رِجَالٌ مِنْكُمْ حَتَّى إِذَا أَهْوَيْتُ لأُنَاوِلَهُمُ اخْتُلِجُوا دُونِي فَأَقُولُ أَىْ رَبِّ أَصْحَابِي‏.‏ يَقُولُ لاَ تَدْرِي مَا أَحْدَثُوا بَعْدَكَ ‏"‏‏.‏

Narrated `Abdullah:The Prophet (ﷺ) said, "I am your predecessor at the Lake-Fount (Kauthar) and some men amongst you will be brought to me, and when I will try to hand them some water, they will be pulled away from me by force whereupon I will say, 'O Lord, my companions!' Then the Almighty will say, 'You do not know what they did after you left, they introduced new things into the religion after you

أَخْبَرَنَا أَبُو عَبْدِ الرَّحْمَنِ، أَحْمَدُ بْنُ شُعَيْبٍ قَالَ أَنْبَأَنَا عَمْرُو بْنُ عَلِيٍّ، قَالَ حَدَّثَنَا أَبُو عَاصِمٍ، قَالَ حَدَّثَنَا ابْنُ أَبِي ذِئْبٍ، قَالَ حَدَّثَنِي أَسِيدُ بْنُ أَبِي أَسِيدٍ، عَنْ مُعَاذِ بْنِ عَبْدِ اللَّهِ، عَنْ أَبِيهِ، قَالَ أَصَابَنَا طَشٌّ وَظُلْمَةٌ فَانْتَظَرْنَا رَسُولَ اللَّهِ صلى الله عليه وسلم لِيُصَلِّيَ بِنَا ثُمَّ ذَكَرَ كَلاَمًا مَعْنَاهُ فَخَرَجَ رَسُولُ اللَّهِ صلى الله عليه وسلم لِيُصَلِّيَ بِنَا فَقَالَ ‏"‏ قُلْ ‏"‏ ‏.‏ فَقُلْتُ مَا أَقُولُ قَالَ ‏"‏ ‏{‏ قُلْ هُوَ اللَّهُ أَحَدٌ ‏}‏ وَالْمُعَوِّذَتَيْنِ حِينَ تُمْسِي وَحِينَ تُصْبِحُ ثَلاَثًا يَكْفِيكَ كُلَّ شَىْءٍ ‏"‏ ‏.‏

It was narrated from Mu'adh bin 'Abdullah that his father said:"It was raining and dark, and we were waiting for the Messenger of Allah [SAW] to lead us in prayer. Then the Messenger of Allah [SAW] came out to lead us in prayer and he said: 'Say.' I said: 'What should I say?' He said: 'Say: He is Allah, (the) One and Al-Mu'awwadhatain in the evening and in the morning, three times, and that will suffice you against everything

أَخْبَرَنَا مُحَمَّدُ بْنُ عَلِيٍّ، قَالَ حَدَّثَنِي الْقَعْنَبِيُّ، عَنْ عَبْدِ الْعَزِيزِ، عَنْ عَبْدِ اللَّهِ بْنِ سُلَيْمَانَ، عَنْ مُعَاذِ بْنِ عَبْدِ اللَّهِ بْنِ خُبَيْبٍ، عَنْ أَبِيهِ، عَنْ عُقْبَةَ بْنِ عَامِرٍ الْجُهَنِيِّ، قَالَ بَيْنَا أَنَا أَقُودُ، بِرَسُولِ اللَّهِ صلى الله عليه وسلم رَاحِلَتَهُ فِي غَزْوَةٍ إِذْ قَالَ ‏"‏ يَا عُقْبَةُ قُلْ ‏"‏ ‏.‏ فَاسْتَمَعْتُ ثُمَّ قَالَ ‏"‏ يَا عُقْبَةُ قُلْ ‏"‏ ‏.‏ فَاسْتَمَعْتُ فَقَالَهَا الثَّالِثَةَ فَقُلْتُ مَا أَقُولُ فَقَالَ ‏"‏ ‏{‏ قُلْ هُوَ اللَّهُ أَحَدٌ ‏}‏ ‏"‏ ‏.‏ فَقَرَأَ السُّورَةَ حَتَّى خَتَمَهَا ثُمَّ قَرَأَ ‏{‏ قُلْ أَعُوذُ بِرَبِّ الْفَلَقِ ‏}‏ وَقَرَأْتُ مَعَهُ حَتَّى خَتَمَهَا ثُمَّ قَرَأَ ‏{‏ قُلْ أَعُوذُ بِرَبِّ النَّاسِ ‏}‏ فَقَرَأْتُ مَعَهُ حَتَّى خَتَمَهَا ثُمَّ قَالَ ‏"‏ مَا تَعَوَّذَ بِمِثْلِهِنَّ أَحَدٌ ‏"‏ ‏.‏

It was narrated that 'Uqbah bin 'Amir Al-Juhani said:"While I was leading the Messenger of Allah [SAW] on his mount on a military campaign, he said: 'O 'Uqbah, say!' I listened, then he said: 'O 'Uqbah, say!' I listened, then he said it a third time. I said: 'What should I say?' He said: 'Say: He is Allah, (the) One...' and he recited the Surah to the end. Then he recited: 'Say: I seek refuge with (Allah) the Lord of the daybreak...' and I recited it with him until the end. Then he recited: 'Say: I seek refuge with (Allah) the Lord of mankind...' and I recited it with him until the end. Then he said: 'No one ever sought refuge (with Allah) by means of anything like them

حَدَّثَنَا أَبُو بَكْرِ بْنُ أَبِي شَيْبَةَ، حَدَّثَنَا أَبُو مُعَاوِيَةَ، وَحَفْصُ بْنُ غِيَاثٍ، عَنِ الأَعْمَشِ، عَنْ أَبِي صَالِحٍ، عَنْ أَبِي هُرَيْرَةَ، قَالَ قَالَ رَسُولُ اللَّهِ ـ صلى الله عليه وسلم ـ ‏ "‏ أُمِرْتُ أَنْ أُقَاتِلَ النَّاسَ حَتَّى يَقُولُوا لاَ إِلَهَ إِلاَّ اللَّهُ فَإِذَا قَالُوهَا عَصَمُوا مِنِّي دِمَاءَهُمْ وَأَمْوَالَهُمْ إِلاَّ بِحَقِّهَا وَحِسَابُهُمْ عَلَى اللَّهِ عَزَّ وَجَلَّ ‏"‏ ‏.‏

It was narrated from Abu Hurairah that the Messenger of Allah (ﷺ) said:“I have been commanded to fight the people until they say: La ilaha illallah. If they say it, then their blood and wealth are protected from me, except for a right that is due from it, and their reckoning will be with Allah.”

حَدَّثَنَا سُوَيْدُ بْنُ سَعِيدٍ، حَدَّثَنَا عَلِيُّ بْنُ مُسْهِرٍ، عَنِ الأَعْمَشِ، عَنْ أَبِي سُفْيَانَ، عَنْ جَابِرٍ، قَالَ قَالَ رَسُولُ اللَّهِ ـ صلى الله عليه وسلم ـ ‏ "‏ أُمِرْتُ أَنْ أُقَاتِلَ النَّاسَ حَتَّى يَقُولُوا لاَ إِلَهَ إِلاَّ اللَّهُ فَإِذَا قَالُوا لاَ إِلَهَ إِلاَّ اللَّهُ عَصَمُوا مِنِّي دِمَاءَهُمْ وَأَمْوَالَهُمْ إِلاَّ بِحَقِّهَا وَحِسَابُهُمْ عَلَى اللَّهِ ‏"‏ ‏.‏

It was narrated from Jabir that the Messenger of Allah (ﷺ) said:“I have been commanded to fight the people until they say: La ilaha illallah. If they say: La ilaha illallah, then their blood and wealth are protected from me, except for a right that is due from it, and their reckoning will be with Allah.”

والمجاهدة بالنفس هي الشجاعة التي ترجع إلى استعمال قوة الغضب على شرط العقل وحد الاعتدال فقد وصف الله تعالى الصحابة فقال أشداء على الكفار رحماء بينهم إشارة إلى أن للشدة موضعا وللرحمة موضعا فليس الكمال في الشدة بكل حال ولا في الرحمة بكل حال فهذا بيان معنى الخلق وحسنه وقبحه وبيان أركانه وثمراته وفروعه

جزى الله يوم الروع خيرا % فإنه أرانا على علاته أم ثابت

والأول يسمى إلهاما ونفثا في الروع

أي لذلك الماء الذي غمر الأرض ومن عليها فصل وأما الوهل فهو بتحريك الهاء وأصله الفزع والروع يقال وهل يوهل وهو وهل ومستوهل قال القطامي يصف إبلا

ومنها البهت والروعة التي تحصل عند مواجهة الحبيب أو عند سماع ذكره ولا سيما إذا رآه فجأة أو طلع عليه بغتة كما قال الشاعر

وإنما كان الوهل من أسماء الحب لما فيه من الروع ومنه يقال جمال رائع فإن قيل ما سبب روعة الجمال ولأي شيء إذا رأى المحب محبوبه فجأة يرتاع لذلك ويصفر لونه ويبهت قال الشاعر

Cognitive Behavioral Treatment for Acute Posttrauma Distress: A Randomized, Controlled Proof-of-Concept Study Among Hospitalized Adults With Burns.: Objective: (1) To evaluate the feasibility of conducting a randomized controlled trial (RCT) of the Safety, Meaning, Activation and Resilience Training (SMART) intervention vs nondirective supportive psychotherapy (NDSP) in an acutely hospitalized adult survivor of burn injury sample; and (2) to assess the preliminary effect of SMART on acute stress disorder (ASD), posttraumatic stress disorder (PTSD), and major depressive disorder (MDD) symptom reduction as secondary prevention. Design: Proof-o

Treatment of acute stress disorder: a randomized controlled trial.: Context: Recent trauma survivors with acute stress disorder (ASD) are likely to subsequently develop chronic posttraumatic stress disorder (PTSD). Cognitive behavioral therapy for ASD may prevent PTSD, but trauma survivors may not tolerate exposure-based therapy in the acute phase. There is a need to compare nonexposure therapy techniques with prolonged exposure for ASD. Objective: To determine the efficacy of exposure therapy or trauma-focused cognitive restructuring in preventing chronic PTSD

Cortisol augmentation of a psychological treatment for warfighters with posttraumatic stress disorder: Randomized trial showing improved treatment retention and outcome.: Background: Prolonged exposure (PE) therapy for post-traumatic stress disorder (PTSD) in military veterans has established efficacy, but is ineffective for a substantial number of patients. PE is also associated with high dropout rates. We hypothesized that hydrocortisone augmentation would enhance symptom improvement and reduce drop-out rates by diminishing the distressing effects of traumatic memories retrieved during imaginal exposure. We also hypothesized that in responders, hydrocortisone a

The culture, mental health and psychosocial wellbeing of Rohingya refugees: a systematic review.: Aims: Despite the magnitude and protracted nature of the Rohingya refugee situation, there is limited information on the culture, mental health and psychosocial wellbeing of this group. This paper, drawing on a report commissioned by the United Nations High Commissioner for Refugees (UNHCR), aims to provide a comprehensive synthesis of the literature on mental health and psychosocial wellbeing of Rohingya refugees, including an examination of associated cultural factors. The ultimate objective i

The prevalence of posttraumatic stress disorder in pregnancy and after birth: A systematic review and meta-analysis.: Background: Previous reviews have provided preliminary insights into risk factors and possible prevalence of Post-traumatic Stress Disorder (PTSD) postpartum with no attempt to examine prenatal PTSD. This study aimed to assess the prevalence of PTSD during pregnancy and after birth, and the course of PTSD over this time. Methods: PsychINFO, PubMed, Scopus and Web of Science were searched using PTSD terms crossed with perinatal terms. Studies were included if they reported the prevalence of PTSD

Efficacy of group psychotherapy for posttraumatic stress disorder: Systematic review and meta-analysis of randomized controlled trials.: Objective: The present meta-analysis evaluates the efficacy of group psychotherapy for post-traumatic stress disorder (PTSD) in adults directly compared to no treatment or active treatments examined in randomized controlled trials (RCTs). Method: Electronic databases were searched for eligible studies. Effects on PTSD symptoms, depression, and anxiety were extracted. Between- and within-group effect sizes (Hedges' g) were calculated using a random-effects model. Data were adjusted to account for

Stress, glucocorticoids and memory: implications for treating fear-related disorders.

Glucocorticoid stress hormones are crucially involved in modulating mnemonic processing of emotionally arousing experiences. They enhance the consolidation of new memories, including those that extinguish older memories, but impair the retrieval of information stored in long-term memory. As strong aversive memories lie at the core of several fear-related disorders, including post-traumatic stress disorder and phobias, the memory-modulating properties of glucocorticoids have recently become of considerable translational interest. Clinical trials have provided the first evidence that glucocorticoid-based pharmacotherapies aimed at attenuating aversive memories might be helpful in the treatment of fear-related disorders. Here, we review important advances in the understanding of how glucocorticoids mediate stress effects on memory processes, and discuss the translational potential of these …

matched on Stress Disorders, Post-Traumatic (mesh), post-traumatic stress (text)

Infertility and Perinatal Loss: When the Bough Breaks.

Infertility and perinatal loss are common, and associated with lower quality of life, marital discord, complicated grief, major depressive disorder, anxiety disorders, and post-traumatic stress disorder. Young women, who lack social supports, have experienced recurrent pregnancy loss or a history of trauma and / or preexisting psychiatric illness are at a higher risk of experiencing psychiatric illnesses or symptoms after a perinatal loss or during infertility. It is especially important to detect, assess, and treat depression, anxiety, or other psychiatric symptoms because infertility or perinatal loss may be caused or perpetuated by such symptoms. Screening, psychoeducation, provision of resources and referrals, and an opportunity to discuss their loss and plan for future pregnancies can facilitate addressing mental health concerns that arise. Women at risk of or who are currently expe…

matched on Stress Disorders, Post-Traumatic (mesh), post-traumatic stress (text)

Induction and Expression of Fear Sensitization Caused by Acute Traumatic Stress.

Fear promotes adaptive responses to threats. However, when the level of fear is not proportional to the level of threat, maladaptive fear-related behaviors characteristic of anxiety disorders result. Post-traumatic stress disorder develops in response to a traumatic event, and patients often show sensitized reactions to mild stressors associated with the trauma. Stress-enhanced fear learning (SEFL) is a rodent model of this sensitized responding, in which exposure to a 15-shock stressor nonassociatively enhances subsequent fear conditioning training with only a single trial. We examined the role of corticosterone (CORT) in SEFL. Administration of the CORT synthesis blocker metyrapone prior to the stressor, but not at time points after, attenuated SEFL. Moreover, CORT co-administered with metyrapone rescued SEFL. However, CORT alone without the stressor was not sufficient to produce SEFL.…

matched on Stress Disorders, Post-Traumatic (mesh), post-traumatic stress (text)

Psychological Distress After Orthopedic Trauma: Prevalence in Patients and Implications for Rehabilitation.

Orthopedic trauma is an unforeseen life-changing event. Serious injuries include multiple fractures and amputation. Physical rehabilitation has traditionally focused on addressing functional deficits after traumatic injury, but important psychological factors also can dramatically affect acute and long-term recovery. This review presents the effects of orthopedic trauma on psychological distress, potential interventions for distress reduction after trauma, and implications for participation in rehabilitation. Survivors commonly experience post-traumatic stress syndrome, depression, and anxiety, all of which interfere with functional gains and quality of life. More than 50% of survivors have psychological distress that can last decades after the physical injury has been treated. Early identification of patients with distress can help care teams provide the resources and support to offset …

matched on Stress Disorders, Post-Traumatic (mesh), post-traumatic stress (text)

Mental health interventions for traumatized asylum seekers and refugees: What do we know about their efficacy?

Background: The prevalence of trauma-related problems among refugees and asylum seekers is extremely high due to adverse experiences associated with forced migration. Although the literature presents a considerable number of guidelines and theoretical frameworks for working with traumatized refugees and asylum seekers, the efficacy, feasibility and applicability of these interventions have little empirical evidence. Aims: The purpose of this article is to critically review the literature to provide a rationale for developing culturally sensitive, evidence-based interventions for refugees and asylum seekers. Methods: A literature review integrating research findings on interventions designed especially for traumatized asylum seekers and refugees was conducted. Retained studies had to use some quantitative measurements of post-traumatic stress and to have pre- and post-measurements to eval…

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Neuroinflammatory pathways in anxiety, posttraumatic stress, and obsessive compulsive disorders.

As prevalence of anxiety, posttraumatic stress, and obsessive compulsive disorders continue to rise worldwide, increasing focus has been placed on immune mediated theories in understanding the underlying mechanisms of these disorders. Associations between the dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and these disorders have been recognized in the scientific literature, specifically in regard to cortisol levels, as well as changes in pro- and anti-inflammatory cytokines. The present commentary will systematically assess the scientific literature within the past decade in regard to the psychoneuroimmunology of anxiety, posttraumatic stress, and obsessive compulsive disorders. Understanding the mechanisms of these disorders is essential in order to determine efficacious and targeted treatment strategies, which may lead to substantial improvements in overall functioning…

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Clinical applications of cortisol measurements in hair.

Cortisol measurements in blood, saliva and urine are frequently used to examine the hypothalamus-pituitary-adrenal (HPA) axis in clinical practice and in research. However, cortisol levels are subject to variations due to acute stress, the diurnal rhythm and pulsatile secretion. Cortisol measurements in body fluids are not always a reflection of long-term cortisol exposure. The analysis of cortisol in scalp hair is a relatively novel method to measure cumulative cortisol exposure over months up to years. Over the past years, hair cortisol concentrations (HCC) have been examined in association with a large number of somatic and mental health conditions. HCC can be used to evaluate disturbances of the HPA axis, including Cushing's syndrome, and to evaluate hydrocortisone treatment. Using HCC, retrospective timelines of cortisol exposure can be created which can be of value in diagnosing cy…

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Glucocorticoid receptor gene (NR3C1) methylation processes as mediators of early adversity in stress-related disorders causality: A critical review.

Early life stress (ELS) is a known risk factor for suffering psychopathology in adulthood. The hypothalamic-pituitary-adrenal (HPA) axis has been described to be deregulated in both individuals who experienced early psychosocial stress and in patients with a wide range of psychiatric disorders. The NR3C1 gene codes for the glucocorticoid receptor, a key element involved in several steps of HPA axis modulation. In this review, we gather existing evidence linking NR3C1 methylation pattern with either ELS or psychopathology. We summarize that several types of ELS have been frequently associated with NR3C1 hypermethylation whereas hypomethylation has been continuously found to be associated with post-traumatic stress disorder. In light of the reported findings, the main concerns of ongoing research in this field are the lack of methodological consensus and selection of CpG sites. Further stu…

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Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders.

Background: Anxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated. Methods: These guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980-2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines. Results: These guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Secti…

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Bereavement: course, consequences, and care.

This paper discusses each of several potential consequences of bereavement. First, we describe ordinary grief, followed by a discussion of grief gone awry, or complicated grief (CG). Then, we cover other potential adverse outcomes of bereavement, each of which may contribute to, but are not identical with, CG: general medical comorbidity, mood disorders, post-traumatic stress disorder, anxiety, and substance use.

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The role of sleep in emotional brain function.

Rapidly emerging evidence continues to describe an intimate and causal relationship between sleep and emotional brain function. These findings are mirrored by long-standing clinical observations demonstrating that nearly all mood and anxiety disorders co-occur with one or more sleep abnormalities. This review aims to (a) provide a synthesis of recent findings describing the emotional brain and behavioral benefits triggered by sleep, and conversely, the detrimental impairments following a lack of sleep; (b) outline a proposed framework in which sleep, and specifically rapid-eye movement (REM) sleep, supports a process of affective brain homeostasis, optimally preparing the organism for next-day social and emotional functioning; and (c) describe how this hypothesized framework can explain the prevalent relationships between sleep and psychiatric disorders, with a particular focus on posttr…

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From the neurobiology of extinction to improved clinical treatments.

The neural circuitry underlying the fear response is extremely well conserved across mammalian species, which has allowed for the rapid translation of research findings in rodent models of fear to therapeutic interventions in human populations. Many aspects of exposure-based psychotherapy treatments in humans, which are widely used in the treatment of PTSD, panic disorder, phobias, and other anxiety disorders, are closely paralleled by extinction training in rodent fear conditioning models. Here, we discuss how the neural circuitry of fear learning and extinction in rodent animal models may be used to understand the underlying neural circuitry of fear-related disorders, such as PTSD in humans. We examine the factors that contribute to the pathology and development of PTSD. Next, we will review how fear is measured in animal models using classical Pavlovian fear conditioning paradigms, as…

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Pregnancy loss.

Women who lose desired pregnancies by miscarriage, stillbirth, or genetic termination are at risk of suffering from grief, anxiety, guilt and self-blame that may even present in subsequent pregnancies. It is important to find effective means of helping women deal with these losses. The approach to stillbirth has shifted from immediately removing the child from the mother to encouraging the parents to view and hold the baby. This approach has been questioned as possibly causing persistent anxiety and post-traumatic stress disorder. Women who miscarry are currently encouraged to find ways to memorialise the lost fetus. Couples who decide to terminate a pregnancy after discovering a defect may deal not only with sadness but also guilt. Immediate crisis intervention and follow-up care should be available, recognising that individual women may experience different reactions and their specific…

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Health consequences of sexual violence against women.

Sexual violence can lead to a multitude of health consequences, including physical, reproductive and psychological. Some may be fatal, whereas others, such as unhealthy behaviours, may occur indirectly as a result of the violence. In total, these result in a significant health burden and should be considered by service providers, government authorities and non-governmental agencies. For women who present early, immediate care should be provided with plans for follow up. Mental-health interventions are important, as women who are sexually assaulted have the highest burden of post-traumatic stress disorder. Cognitive- behavioural therapy has been found to be effective for preventing and treating post-traumatic stress disorder, but psychological debriefing for preventing post-traumatic stress disorder is not recommended. Implementing a routine screening and intervention programme in obstetr…

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Childhood maltreatment and psychopathology: A case for ecophenotypic variants as clinically and neurobiologically distinct subtypes.

Objective: Childhood maltreatment increases risk for psychopathology. For some highly prevalent disorders (major depression, substance abuse, anxiety disorders, and posttraumatic stress disorder) a substantial subset of individuals have a history of maltreatment and a substantial subset do not. The authors examined the evidence to assess whether those with a history of maltreatment represent a clinically and biologically distinct subtype. Method: The authors reviewed the literature on maltreatment as a risk factor for these disorders and on the clinical differences between individuals with and without a history of maltreatment who share the same diagnoses. Neurobiological findings in maltreated individuals were reviewed and compared with findings reported for these disorders. Results: Maltreated individuals with depressive, anxiety, and substance use disorders have an earlier age at onse…

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On mind wandering, attention, brain networks, and meditation.

Human attention selectively focuses on aspects of experience that are threatening, pleasant, or novel. The physical threats of the ancient times have largely been replaced by chronic psychological worries and hurts. The mind gets drawn to these worries and hurts, mostly in the domain of the past and future, leading to mind wandering. In the brain, a network of neurons called the default mode network has been associated with mind wandering. Abnormal activity in the default mode network may predispose to depression, anxiety, attention deficit, and posttraumatic stress disorder. Several studies show that meditation can reverse some of these abnormalities, producing salutary functional and structural changes in the brain. This narrative review presents a mechanistic understanding of meditation in the context of recent advances in neurosciences about mind wandering, attention, and the brain n…

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The contextual brain: implications for fear conditioning, extinction and psychopathology.

Contexts surround and imbue meaning to events; they are essential for recollecting the past, interpreting the present and anticipating the future. Indeed, the brain's capacity to contextualize information permits enormous cognitive and behavioural flexibility. Studies of Pavlovian fear conditioning and extinction in rodents and humans suggest that a neural circuit including the hippocampus, amygdala and medial prefrontal cortex is involved in the learning and memory processes that enable context-dependent behaviour. Dysfunction in this network may be involved in several forms of psychopathology, including post-traumatic stress disorder, schizophrenia and substance abuse disorders.

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Sex differences in anxiety and emotional behavior.

Research has elucidated causal links between stress exposure and the development of anxiety disorders, but due to the limited use of female or sex-comparative animal models, little is known about the mechanisms underlying sex differences in those disorders. This is despite an overwhelming wealth of evidence from the clinical literature that the prevalence of anxiety disorders is about twice as high in women compared to men, in addition to gender differences in severity and treatment efficacy. We here review human gender differences in generalized anxiety disorder, panic disorder, posttraumatic stress disorder and anxiety-relevant biological functions, discuss the limitations of classic conflict anxiety tests to measure naturally occurring sex differences in anxiety-like behaviors, describe sex-dependent manifestation of anxiety states after gestational, neonatal, or adolescent stressors,…

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Implications of memory modulation for post-traumatic stress and fear disorders.

Post-traumatic stress disorder, panic disorder and phobia manifest in ways that are consistent with an uncontrollable state of fear. Their development involves heredity, previous sensitizing experiences, association of aversive events with previous neutral stimuli, and inability to inhibit or extinguish fear after it is chronic and disabling. We highlight recent progress in fear learning and memory, differential susceptibility to disorders of fear, and how these findings are being applied to the understanding, treatment and possible prevention of fear disorders. Promising advances are being translated from basic science to the clinic, including approaches to distinguish risk versus resilience before trauma exposure, methods to interfere with fear development during memory consolidation after a trauma, and techniques to inhibit fear reconsolidation and to enhance extinction of chronic fea…

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The hippocampal-prefrontal pathway: the weak link in psychiatric disorders?

While the hippocampal formation and the prefrontal cortex each have a well-established role in cognitive and mnemonic processes, the extent and manner in which these structures interact to achieve these functions has not been fully delineated. Recent research in rodents compellingly supports the idea that the projection of neurons extending from the CA1 region of the hippocampus and from the subiculum to the prefrontal cortex, referred to here as the H-PFC pathway, is critically involved in aspects of cognition related to executive function and to emotional regulation. Concurrently, it is becoming evident that persons suffering from schizophrenia, depression, and post-traumatic stress disorder display structural anomalies and aberrant functional coupling within the hippocampal-prefrontal circuit. Considering that these disorders involve varying degrees of cognitive impairment and emotion…

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The challenge of quality care for family caregivers in pediatric cancer care.

Objectives: To discuss the needs and potential interventions for parental caregivers of children with cancer. Data sources: Published articles between 2002 and 2012. Conclusion: In general, parents do adjust and cope with their child's cancer, but a significant majority experience post-traumatic stress symptoms. Families also report that the shift to parenting a child with cancer is very disruptive to identity and family structure and can cause negative outcomes for mothers, father, and siblings. There is growing evidence of post-traumatic growth and resilience in parents of children with cancer. Recent studies have suggested that targeted interventions may relieve distress. Implications for nursing practice: Nurses can support families in the difficult transition to having a child with cancer and may be able to intervene to reduce long-term distress in families.

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Conceptualizing mindfulness and acceptance as components of psychological resilience to trauma.

Mindfulness- and acceptance-based conceptualizations of PTSD implicate experiential avoidance and non-mindful behavior in the etiology and maintenance of the disorder. If experiential avoidance is associated with vulnerability to PTSD, then a mindful and accepting orientation toward experience may confer psychological resilience following exposure to trauma. This article examines how mindfulness- and acceptance-based theories of psychopathology relate to risk of and resilience to PTSD. Research is reviewed dealing with the impact of experiential avoidance, avoidant coping, dissociation, acceptance, and mindfulness on PTSD symptom severity and posttraumatic functioning. This review suggests that trait mindfulness and acceptance are associated with greater psychological adjustment following exposure to trauma, while experiential avoidance, persistent dissociation, and coping strategies inv…

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Psychotherapies for comorbid anxiety in bipolar spectrum disorders.

Background: Comorbid anxiety disorders are highly prevalent in bipolar disorder and have been shown to have serious negative impacts on the course of illness. The pharmacological treatment of anxiety can interact with the bipolar disorder and has not been proven effective. As such, many have recommended the psychological treatment of anxiety. This paper reviews the literature on psychological treatments for anxiety comorbid to bipolar disorder. Method: The Medline, PsychInfo and Web of Science databases were thoroughly examined for relevant treatment studies. Results: Despite frequent recommendations in the literature, surprisingly few have studied the psychological treatment of comorbid anxiety in bipolar disorders. Nevertheless, preliminary results suggest that comorbid anxiety disorders can be effectively treated in a bipolar clientele using cognitive-behavioral therapy, mindfulness-b…

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The pharmacologic treatment of anxiety disorders: a review of progress.

Anxiety disorders, as a group, are among the most common mental health conditions and frequently cause significant functional impairment. Both psychotherapeutic and pharmacologic techniques are recognized to be effective management strategies. This review provides a discussion of the major classes of psychotropic medications investigated in clinical trials of the following anxiety disorders: panic disorder, social anxiety disorder, generalized anxiety disorder, posttraumatic stress disorder, and obsessive-compulsive disorder. Findings suggest that both selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are useful first-line agents for most of the anxiety disorders, particularly given the frequent comorbidity with mood disorders. Highly serotonergic agents are preferred for obsessive-compulsive disorder. Other antidepressants, such as tricyclic antide…

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Women's perceptions and experiences of a traumatic birth: a meta-ethnography.

Aim: This study presents the findings a meta-ethnographic study reporting women's perceptions and experiences of traumatic birth. Background: Childbirth is viewed by many as a life transition that can bring a sense of accomplishment. However, for some women, birth is experienced as a traumatic event with a minority experiencing post-traumatic stress. A traumatic birth experience can have a significant impact on the physical and emotional well-being of a woman, her infant and family. Data source: The CINAHL, MEDLINE, Scopus and PubMed databases were searched for the period January 1994 to October 2009 using the keywords birth trauma, traumatic birth, qualitative research, birth narrative and birth stories. Review methods: A meta-ethnographic approach was used. Quality appraisal was carried out. An index paper served as a guide in identifying particular findings and comparing them with oth…

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