Prefrontal responses to Stroop tasks in subjects with post-traumatic stress disorder assessed by functional near infrared spectroscopy.

Studies on posttraumatic stress disorder (PTSD) showing attentional deficits have implicated abnormal activities in the frontal lobe. In this study, we utilized multichannel functional near-infrared spectroscopy (fNIRS) to investigate selective attention-related hemodynamic activity in the prefrontal cortex among 15 combat-exposed war-zone veterans with PTSD and 13 age- and gender-matched healthy controls. While performing the incongruent Stroop task, healthy controls showed significant activations in the left lateral prefrontal cortex (LPFC) compared to baseline readings. This observation is consistent with previously reported results. In comparison, subjects with PTSD failed to activate left LPFC during the same Stroop task. Our observations may implicate that subjects with PTSD experienced difficulty in overcoming Stroop interference. We also observed significant negative correlation between task reaction times and hemodynamic responses from left LPFC during the incongruent Stroop task in the PTSD group. Regarding the methodology used in this study, we have learned that an appropriate design of Stroop paradigms is important for meeting an optimal cognitive load which can lead to better brain image contrasts in response to Stroop interference between healthy versus PTSD subjects. Overall, the feasibility of fNIRS for studying and mapping neural correlates of selective attention and interference in subjects with PTSD is reported.

Prefrontal responses to digit span memory phases in patients with post-traumatic stress disorder (PTSD): a functional near infrared spectroscopy study.

Neuroimaging studies of post-traumatic stress disorder (PTSD)-related memory impairments have consistently implicated abnormal activities in the frontal and parietal lobes. However, most studies have used block designs and could not dissociate the multiple phases of working memory. In this study, the involvement of the prefrontal cortex in working memory phases was assessed among veterans with PTSD and age-/gender-matched healthy controls. Multichannel functional near infrared spectroscopy (fNIRS) was utilized to measure prefrontal cortex hemodynamic activations during memory of neutral (i.e., not trauma-related) forward and backward digit span tasks. An event-related experimental design was utilized to dissociate the different phases (i.e., encoding, maintenance and retrieval) of working memory. The healthy controls showed robust hemodynamic activations during the encoding and retrieval processes. In contrast, the veterans with PTSD were found to have activations during the encoding process, but followed by distinct deactivations during the retrieval process. The PTSD participants, but not the controls, appeared to suppress prefrontal activity during memory retrieval. This deactivation was more pronounced in the right dorsolateral prefrontal cortex during the retrieval phase. These deactivations in PTSD patients might implicate an active inhibition of dorsolateral prefrontal neural activity during retrieval of working memory.

Veterans' informal caregivers in the "sandwich generation": a systematic review toward a resilience model.

Social work theory advanced the formulation of the construct of the sandwich generation to apply to the emerging generational cohort of caregivers, most often middle-aged women, who were caring for maturing children and aging parents simultaneously. This systematic review extends that focus by synthesizing the literature on sandwich generation caregivers for the general aging population with dementia and for veterans with dementia and polytrauma. It develops potential protective mechanisms based on empirical literature to support an intervention resilience model for social work practitioners. This theoretical model addresses adaptive coping of sandwich- generation families facing ongoing challenges related to caregiving demands.

Assessing resilience: a review of measures across the life course.

Through this systematic review the authors analyze scales used to measure resilience in individuals across the life course. The scales were obtained according to a priori inclusion criteria through searches using electronic databases, cited references, and requests to human services researchers currently engaged in research utilizing a resiliency theory framework. Eleven measurement tools meeting study inclusion criteria were located within the existing literature. Currently validated instruments measure specific populations and vary in length and format. The need for an analytical approach to measuring resilience is long overdue. This assessment is intended to aid social work practitioners working with populations that have faced adversity.

Veterans Administration health care policies as a protective mechanism supporting an expected life trajectory after military service.

Changes in the American military since the end of military conscription, as well as the increasing number of service-connected disabilities, suggest the need for increased consideration of the effects of health policies when assessing the impact of military service on young Americans' life course. This study analyzes data from the most recent National Survey of Veterans to investigate the health status, health benefits, and health care utilization of 2,773 Gulf War veterans, in association with resumption of their civilian life trajectory. Findings suggest that this sample of veterans may have poorer health status than previous veteran cohorts and did not fully utilize veterans' health care benefits to which they were entitled. This article examines whether veterans may usefully be considered a group at risk for health disparities, in that they have greater health risks and potentially poorer health status and access than mainstream Americans.

A systematic review of effectiveness of complementary and adjunct therapies and interventions involving equines.

OBJECTIVE: This systematic review examines the empirical literature in an emerging body of evidence for the effectiveness of biopsychosocial interventions involving equines across populations with chronic illness or health challenges. METHOD: Selected quantitative studies published in peer-reviewed journals were reviewed for inclusion; the gray literature and white papers were also explored. Population, Intervention, Comparison, and Outcome (PICO) criteria and Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) were applied to all studies. Fourteen full reports meeting a priori inclusion criteria were extracted from 103 studies accessed through 16 electronic databases and a hand search. Data were synthesized in relation to three research questions informing evidence-based practice. RESULTS: No randomized clinical trials were located. Two studies provided a moderate level of evidence for effectiveness. Nine studies demonstrated statistically significant positive effects. Three studies did not find significant psychosocial effects for the target group, although one found significant positive effects for the comparison group. CONCLUSION: In the aggregate, the evidence is promising in support of the effectiveness of complementary and adjunct interventions employing equines in the treatment of health challenges. Future studies are needed that utilize rigorous and creative designs, especially longitudinal studies and comparisons with established effective treatments.

Mental health risk and social ecological variables associated with educational attainment for gulf war veterans: implications for veterans returning to civilian life.

This study examines how post-secondary educational attainment among young veterans of the first gulf war affects their mental health status. The all-volunteer military attracts recruits by offering them veterans' educational benefits. Education should help veterans adjust to civilian life. Few studies have shown whether education following military service helps improve veterans' mental health, however. Viewing resiliency, life span and life course, and social geography theories through the lens of social ecology, it is hypothesized that selected contextual factors in the personal, interpersonal, and organizational domains could mediate or moderate the relationship between education and veterans' mental health. Informational social networks showed an association with obtaining mental illness treatment. Recent treatment for post-traumatic stress disorder (PTSD) showed an association with use of veterans' educational benefits. Residing with a small nuclear family in conjunction with having higher levels of health and educational benefits and a higher family income was associated with higher educational attainment.