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Author Minshew, R.; D'Andrea, W. url  doi
openurl 
  Title Implicit and explicit memory in survivors of chronic interpersonal violence Type Journal Article
  Year 2015 Publication Psychological Trauma : Theory, Research, Practice and Policy Abbreviated Journal Psychol Trauma  
  Volume 7 Issue 1 Pages 67-75  
  Keywords *Domestic Violence; Female; Humans; *Memory; Psychological Tests; Self Report; Stress Disorders, Post-Traumatic/psychology/therapy; Surveys and Questionnaires; Survivors/*psychology  
  Abstract We investigated the relationship of implicit and explicit memory to a range of symptoms in a sample of 27 women with exposure to chronic interpersonal violence (IPV). Participants viewed the first 3 letters (“stems”) of trauma-related, general threat, and neutral words; valenced words were matched with neutral words with the same stem. Free recall and a word-stem completion task were used to test explicit and implicit memory, respectively. Participants exhibited increased implicit memory for trauma-related words as compared with both general threat words and neutral “match” words. They also showed increased explicit memory for both general threat and trauma-related words. Finally, although neither implicit nor explicit memory was correlated with PTSD symptoms, implicit memory for trauma-related words was significantly correlated with symptoms associated with ongoing IPV. Interpersonal sensitivity, hostility, and alexithymia were significantly correlated with implicit, but not explicit, memory for trauma words. Somatization, dissociation, and alexithymia were negatively correlated with explicit, but not implicit, memory for general-threat words. These findings suggest that memory processes in survivors of IPV are closely related to the symptom profile associated with complex trauma. Exploring memory processes in survivors of IPV may lend unique insight into the development and maintenance of the symptom profile associated with IPV.  
  Address Department of Psychology  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor (up) Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1942-969X ISBN Medium  
  Area Expedition Conference  
  Notes PMID:25793595 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42189  
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Author Frankfurt, S.; Anders, S.L.; James, L.M.; Engdahl, B.; Winskowski, A.M. url  doi
openurl 
  Title Evaluating the dimensionality of PTSD in a sample of OIF/OEF veterans Type Journal Article
  Year 2015 Publication Psychological Trauma : Theory, Research, Practice and Policy Abbreviated Journal Psychol Trauma  
  Volume 7 Issue 5 Pages 430-436  
  Keywords  
  Abstract Both categorical and dimensional models of mental disorders, including posttraumatic stress disorder (PTSD), are useful for diagnostic and heuristic purposes; however, few empirical studies have compared categorical and dimensional models of PTSD side-by-side or compared these models to a hybrid (dimensional and categorical) model. In the present study, the dimensionality of PTSD was examined by fitting latent profile analytic, confirmatory factor analytic, and factor mixture models in 271 Operation Iraqi Freedom/Operation Enduring Freedom veterans 6 months after return from deployment. Latent profile analysis was used to identify subgroups of individuals with similar PTSD symptom profiles and predictors of subgroup membership, confirmatory factor analysis was used to identify the underlying continuous structure of PTSD in this sample, and factor mixture modeling was used to test whether a hybrid categorical and continuous model of PTSD best fit our sample. A factor mixture model consisting of a 4-factor dysphoria model of PTSD with 2 classes characterized by low and moderate symptom severity was the best-fitting model. Dissociation and deployment concerns emerged as significant predictors of membership in the moderate symptoms class. Implications for PTSD diagnostic conceptualization and treatment planning are discussed.  
  Address Brain Science Center, Minneapolis Veterans Affairs Medical Center  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor (up) Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1942-969X ISBN Medium  
  Area Expedition Conference  
  Notes PMID:25793318 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42190  
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Author Nicholson, A.A.; Densmore, M.; Frewen, P.A.; Theberge, J.; Neufeld, R.W.; McKinnon, M.C.; Lanius, R.A. url  doi
openurl 
  Title The Dissociative Subtype of Posttraumatic Stress Disorder: Unique Resting-State Functional Connectivity of Basolateral and Centromedial Amygdala Complexes Type Journal Article
  Year 2015 Publication Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology Abbreviated Journal Neuropsychopharmacology  
  Volume 40 Issue 10 Pages 2317-2326  
  Keywords  
  Abstract Previous studies point towards differential connectivity patterns among basolateral (BLA) and centromedial (CMA) amygdala regions in patients with posttraumatic stress disorder (PTSD) as compared with controls. Here we describe the first study to compare directly connectivity patterns of the BLA and CMA complexes between PTSD patients with and without the dissociative subtype (PTSD+DS and PTSD-DS, respectively). Amygdala connectivity to regulatory prefrontal regions and parietal regions involved in consciousness and proprioception were expected to differ between these two groups based on differential limbic regulation and behavioral symptoms. PTSD patients (n=49) with (n=13) and without (n=36) the dissociative subtype and age-matched healthy controls (n=40) underwent resting-state fMRI. Bilateral BLA and CMA connectivity patterns were compared using a seed-based approach via SPM Anatomy Toolbox. Among patients with PTSD, the PTSD+DS group exhibited greater amygdala functional connectivity to prefrontal regions involved in emotion regulation (bilateral BLA and left CMA to the middle frontal gyrus and bilateral CMA to the medial frontal gyrus) as compared with the PTSD-DS group. In addition, the PTSD+DS group showed greater amygdala connectivity to regions involved in consciousness, awareness, and proprioception-implicated in depersonalization and derealization (left BLA to superior parietal lobe and cerebellar culmen; left CMA to dorsal posterior cingulate and precuneus). Differences in amygdala complex connectivity to specific brain regions parallel the unique symptom profiles of the PTSD subgroups and point towards unique biological markers of the dissociative subtype of PTSD.  
  Address Lawson Health Research Institute, Western University, London, Ontario, Canada  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor (up) Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0893-133X ISBN Medium  
  Area Expedition Conference  
  Notes PMID:25790021 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42191  
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Author Hansen, M.; Armour, C.; Wang, L.; Elklit, A.; Bryant, R.A. url  doi
openurl 
  Title Assessing possible DSM-5 ASD subtypes in a sample of victims meeting caseness for DSM-5 ASD based on self-report following multiple forms of traumatic exposure Type Journal Article
  Year 2015 Publication Journal of Anxiety Disorders Abbreviated Journal J Anxiety Disord  
  Volume 31 Issue Pages 84-89  
  Keywords Crime Victims/*psychology; Diagnostic and Statistical Manual of Mental Disorders; Disaster Victims/*psychology; Dissociative Disorders/diagnosis; Female; Humans; Male; Rape/psychology; Self Report; Stress Disorders, Traumatic, Acute/*diagnosis/psychology; Violence/psychology; ASD subtypes; Acute stress disorder; Dsm-5; Icd-11; Latent profile analysis  
  Abstract Acute stress disorder (ASD) was introduced into the DSM-IV to recognize early traumatic responses and as a precursor of PTSD. Although the diagnostic criteria for ASD were altered and structured more similarly to the PTSD definition in DSM-5, only the PTSD diagnosis includes a dissociative subtype. Emerging research has indicated that there also appears to be a highly symptomatic subtype for ASD. However, the specific nature of the subtype is currently unclear. The present study investigates the possible presence of ASD subtypes in a mixed sample of victims meeting caseness for DSM-5 ASD based on self-report following four different types of traumatic exposure (N=472). The results of latent profile analysis revealed a 5-class solution. The highly symptomatic class was marked by high endorsement on avoidance and dissociation compared to the other classes. Findings are discussed in regard to its clinical implications including the implications for the pending the ICD-11 and the recently released DSM-5.  
  Address School of Psychology, University of New South Wales, NSW, Australia  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor (up) Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0887-6185 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:25768397 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42192  
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Author Zaba, M.; Kirmeier, T.; Ionescu, I.A.; Wollweber, B.; Buell, D.R.; Gall-Kleebach, D.J.; Schubert, C.F.; Novak, B.; Huber, C.; Kohler, K.; Holsboer, F.; Putz, B.; Muller-Myhsok, B.; Hohne, N.; Uhr, M.; Ising, M.; Herrmann, L.; Schmidt, U. url  doi
openurl 
  Title Identification and characterization of HPA-axis reactivity endophenotypes in a cohort of female PTSD patients Type Journal Article
  Year 2015 Publication Psychoneuroendocrinology Abbreviated Journal Psychoneuroendocrinology  
  Volume 55 Issue Pages 102-115  
  Keywords Fkbp5; Gene expression; Ptsd; PTSD subtypes; Posttraumatic stress disorder; Stress reactivity; Trier Social Stress Test  
  Abstract Analysis of the function of the hypothalamic-pituitary-adrenal (HPA)-axis in patients suffering from posttraumatic stress disorder (PTSD) has hitherto produced inconsistent findings, inter alia in the Trier Social Stress Test (TSST). To address these inconsistencies, we compared a sample of 23 female PTSD patients with either early life trauma (ELT) or adult trauma (AT) or combined ELT and AT to 18 age-matched non-traumatized female healthy controls in the TSST which was preceded by intensive baseline assessments. During the TSST, we determined a variety of clinical, psychological, endocrine and cardiovascular parameters as well as expression levels of four HPA-axis related genes. Using a previously reported definition of HPA-axis responsive versus non-responsive phenotypes, we identified for the first time two clinically and biologically distinct HPA-axis reactivity subgroups of PTSD. One subgroup (“non-responders”) showed a blunted HPA-axis response and distinct clinical and biological characteristics such as a higher prevalence of trauma-related dissociative symptoms and of combined AT and ELT as well as alterations in the expression kinetics of the genes encoding for the mineralocorticoid receptor (MR) and for FK506 binding protein 51 (FKBP51). Interestingly, this non-responder subgroup largely drove the relatively diminished HPA axis response of the total cohort of PTSD patients. These findings are limited by the facts that the majority of patients was medicated, by the lack of traumatized controls and by the relatively small sample size. The here for the first time identified and characterized HPA-axis reactivity endophenotypes offer an explanation for the inconsistent reports on HPA-axis function in PTSD and, moreover, suggest that most likely other factors than HPA-axis reactivity play a decisive role in determination of PTSD core symptom severity.  
  Address Max Planck Institute of Psychiatry, Clinical Department, Kraepelinstrasse 10, 80804 Munchen, Germany. Electronic address: uschmidt@mpipsykl.mpg.de  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor (up) Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0306-4530 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:25745955 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42193  
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Author Chalavi, S.; Vissia, E.M.; Giesen, M.E.; Nijenhuis, E.R.S.; Draijer, N.; Barker, G.J.; Veltman, D.J.; Reinders, A.A.T.S. url  doi
openurl 
  Title Similar cortical but not subcortical gray matter abnormalities in women with posttraumatic stress disorder with versus without dissociative identity disorder Type Journal Article
  Year 2015 Publication Psychiatry Research Abbreviated Journal Psychiatry Res  
  Volume 231 Issue 3 Pages 308-319  
  Keywords Adolescent; Adult; Cerebral Cortex/*pathology; Comorbidity; Corpus Striatum/*pathology; Female; Gray Matter/*pathology; Hippocampus/pathology; Humans; *Life Change Events; Magnetic Resonance Imaging; Middle Aged; Multiple Personality Disorder/epidemiology/*pathology; Stress Disorders, Post-Traumatic/epidemiology/*pathology; Young Adult; Cortical surface area; Cortical thickness; Cortical volume; FreeSurfer; Neuroimaging; Subcortical volume  
  Abstract Neuroanatomical evidence on the relationship between posttraumatic stress disorder (PTSD) and dissociative disorders is still lacking. We acquired brain structural magnetic resonance imaging (MRI) scans from 17 patients with dissociative identity disorder (DID) and co-morbid PTSD (DID-PTSD) and 16 patients with PTSD but without DID (PTSD-only), and 32 healthy controls (HC), and compared their whole-brain cortical and subcortical gray matter (GM) morphological measurements. Associations between GM measurements and severity of dissociative and depersonalization/derealization symptoms or lifetime traumatizing events were evaluated in the patient groups. DID-PTSD and PTSD-only patients, compared with HC, had similarly smaller cortical GM volumes of the whole brain and of frontal, temporal and insular cortices. DID-PTSD patients additionally showed smaller hippocampal and larger pallidum volumes relative to HC, and larger putamen and pallidum volumes relative to PTSD-only. Severity of lifetime traumatizing events and volume of the hippocampus were negatively correlated. Severity of dissociative and depersonalization/derealization symptoms correlated positively with volume of the putamen and pallidum, and negatively with volume of the inferior parietal cortex. Shared abnormal brain structures in DID-PTSD and PTSD-only, small hippocampal volume in DID-PTSD, more severe lifetime traumatizing events in DID-PTSD compared with PTSD-only, and negative correlations between lifetime traumatizing events and hippocampal volume suggest a trauma-related etiology for DID. Our results provide neurobiological evidence for the side-by-side nosological classification of PTSD and DID in the DSM-5.  
  Address Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Psychosis Studies, Institute of Psychiatry (IoP), Kings College London, De Crespigny Park, P.O. Box 40, London SE5 8AF, United Kingdom. Electronic address: a.a.t.s.reinders@gmail.com  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor (up) Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0165-1781 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:25670646 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42194  
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Author Tursich, M.; Ros, T.; Frewen, P.A.; Kluetsch, R.C.; Calhoun, V.D.; Lanius, R.A. url  doi
openurl 
  Title Distinct intrinsic network connectivity patterns of post-traumatic stress disorder symptom clusters Type Journal Article
  Year 2015 Publication Acta Psychiatrica Scandinavica Abbreviated Journal Acta Psychiatr Scand  
  Volume 132 Issue 1 Pages 29-38  
  Keywords adult survivors of child abuse; functional neuroimaging; multivariate analysis; post-traumatic stress disorders  
  Abstract OBJECTIVE: Post-traumatic stress disorder (PTSD) is considered a multidimensional disorder, with distinct symptom clusters including re-experiencing, avoidance/numbing, hyperarousal, and most recently depersonalization/derealization. However, the extent of differing intrinsic network connectivity underlying these symptoms has not been fully investigated. We therefore investigated the degree of association between resting connectivity of the salience (SN), default mode (DMN), and central executive (CEN) networks and PTSD symptom severity. METHOD: Using resting-state functional MRI data from PTSD participants (n = 21), we conducted multivariate analyses to test whether connectivity of extracted independent components varied as a function of re-experiencing, avoidance/numbing, hyperarousal, and depersonalization/derealization. RESULTS: Hyperarousal symptoms were associated with reduced connectivity of posterior insula/superior temporal gyrus within SN [peak Montreal Neurological Institute (MNI): -44, -8, 0, t = -4.2512, k = 40]. Depersonalization/derealization severity was associated with decreased connectivity of perigenual anterior cingulate/ventromedial prefrontal cortex within ventral anterior DMN (peak MNI: 8, 40, -4; t = -3.8501; k = 15) and altered synchrony between two DMN components and between DMN and CEN. CONCLUSION: Our results are consistent with prior research showing intrinsic network disruptions in PTSD and imply heterogeneous connectivity patterns underlying PTSD symptom dimensions. These findings suggest possible biomarkers for PTSD and its dissociative subtype.  
  Address Department of Neuroscience, The University of Western Ontario, London, ON, Canada  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor (up) Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0001-690X ISBN Medium  
  Area Expedition Conference  
  Notes PMID:25572430 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42195  
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Author Armour, C.; Hansen, M. url  doi
openurl 
  Title Assessing DSM-5 latent subtypes of acute stress disorder dissociative or intrusive? Type Journal Article
  Year 2015 Publication Psychiatry Research Abbreviated Journal Psychiatry Res  
  Volume 225 Issue 3 Pages 476-483  
  Keywords Adult; Age Factors; *Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders/classification/*diagnosis/psychology; Female; Humans; Male; Middle Aged; Risk Factors; Social Support; Stress Disorders, Traumatic, Acute/classification/*diagnosis/psychology; ASD subtypes; Dissociative ASD; Intrusive ASD; Latent profile analysis; Risk factors  
  Abstract Acute Stress Disorder (ASD) was first included in the DSM-IV in 1994. It was proposed to account for traumatic responding in the early post trauma phase and to act as an identifier for later Posttraumatic Stress Disorder (PTSD). Unlike PTSD it included a number of dissociative indicators. The revised DSM-5 PTSD criterion included a dissociative-PTSD subtype. The current study assessed if a dissociative-ASD subtype may be present for DSM-5 ASD. Moreover, we assessed if a number of risk factors resulted in an increased probability of membership in symptomatic compared to a baseline ASD profile. We used data from 450 bank robbery victims. Latent profile analysis (LPA) was used to uncover latent profiles of ASD. Multinomial logistic regression was used to determine if female gender, age, social support, peritraumatic panic, somatization, and number of trauma exposures increased or decreased the probability of profile membership. Four latent profiles were uncovered and included an intrusion rather than dissociative subtype. Increased age and social support decreased the probability of individuals being grouped into the intrusion subtype whereas increased peritraumatic panic and somatization increased the probability of individuals being grouped into the intrusion subtype. Findings are discussed in regard to the ICD-11 and the DSM-5.  
  Address National Centre for Psychotraumatology, Institute for Psychology, University of Southern Denmark, Denmark  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor (up) Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0165-1781 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:25535010 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42196  
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Author Nash, W.P.; Boasso, A.M.; Steenkamp, M.M.; Larson, J.L.; Lubin, R.E.; Litz, B.T. url  doi
openurl 
  Title Posttraumatic stress in deployed Marines: prospective trajectories of early adaptation Type Journal Article
  Year 2015 Publication Journal of Abnormal Psychology Abbreviated Journal J Abnorm Psychol  
  Volume 124 Issue 1 Pages 155-171  
  Keywords  
  Abstract We examined the course of PTSD symptoms in a cohort of U.S. Marines (N = 867) recruited for the Marine Resiliency Study (MRS) from a single infantry battalion that deployed as a unit for 7 months to Afghanistan during the peak of conflict there. Data were collected via structured interviews and self-report questionnaires 1 month prior to deployment and again at 1, 5, and 8 months postdeployment. Second-order growth mixture modeling was used to disaggregate symptom trajectories; multinomial logistic regression and relative weights analysis were used to assess the role of combat exposure, prior life span trauma, social support, peritraumatic dissociation, and avoidant coping as predictors of trajectory membership. Three trajectories best fit the data: a low-stable symptom course (79%), a new-onset PTSD symptoms course (13%), and a preexisting PTSD symptoms course (8%). Comparison in a separate MRS cohort with lower levels of combat exposure yielded similar results, except for the absence of a new-onset trajectory. In the main cohort, the modal trajectory was a low-stable symptoms course that included a small but clinically meaningful increase in symptoms from predeployment to 1 month postdeployment. We found no trajectory of recovery from more severe symptoms in either cohort, suggesting that the relative change in symptoms from predeployment to 1 month postdeployment might provide the best indicator of first-year course. The best predictors of trajectory membership were peritraumatic dissociation and avoidant coping, suggesting that changes in cognition, perception, and behavior following trauma might be particularly useful indicators of first-year outcomes.  
  Address VA Boston Healthcare System  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor (up) Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0021-843X ISBN Medium  
  Area Expedition Conference  
  Notes PMID:25419860 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42197  
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Author Auxemery, Y. url  doi
openurl 
  Title [Clinical forms of post-traumatic depression] Type Journal Article
  Year 2015 Publication L'Encephale Abbreviated Journal Encephale  
  Volume 41 Issue 4 Pages 346-354  
  Keywords Deuil post-traumatique; Deuil traumatique; Depression masquee; Depression post-traumatique; Depression traumatique; Post-concussive syndrome; Posttraumatic depression; Posttraumatic grief; Psychic trauma; Psychopathologie; Psychopathology; Psychopharmacologie; Psychopharmacology; Syndrome post-commotionnel; Traumatic depression; Traumatic grief; Traumatisme psychique  
  Abstract INTRODUCTION: As a result of determinants specific to the psychopathological structure of the psychological trauma, psycho-traumatised patients very rarely solicit the health care system directly with a request for treatment centred on their trauma. The medical profession is consulted for non-specific symptoms and complications, which are mainly somatoform, addictions and depressive disorders. After a few epidemiological reminders followed by a discussion concerning contemporary depressive and post-traumatic nosographic features, we define, through our clinical experience collated with the data in the literature, different clinical and etiopathogenic contexts of post-traumatic depression in order to control their therapeutic treatment. CLINICAL FINDINGS: Burnout post-traumatic depression in response to re-experiencing is the most common: it is a reactive psycho-physiological burnout in response to the emotional distress re-experienced during flashbacks, insomnia, a constant feeling of insecurity and the deleterious consequences of this symptomatology in terms of social adaptation. A common genetic predisposition affecting serotoninergic regulation seems to be a vulnerability marker of both depressive and psychotraumatic symptoms. In this case, SSRI will be effective on sadness. In addition, these antidepressants have been widely prescribed for the first-line treatment of depressive and psychotraumatic symptoms. However, this pharmacological class is often insufficient in relieving autonomic hyperactivity such as re-experiencing which are mediated more by noradrenergic hyperactivity. SNRI such as venlafaxine can be used as a first-line treatment. Post-traumatic depression with psychotic features congruent with mood is dominated by a feeling of incurability; the subject blames himself and feels guilty about the traumatic event and its consequences. Symptoms of denial of identity are sometimes observed: confined by an intense depersonalization, the psycho-traumatised subject evokes that he is “no longer himself” and that his mind “is disconnected”. Confronted with the psychological emptiness of the traumatic scene, the psycho-traumatised subject remains devoid of thought as if their mind has left him. In addition to antidepressant therapy, an atypical antipsychotic drug must be prescribed to relieve the melancholic symptoms as well as the concomitant psychotraumatic symptoms. Post-traumatic depression masked by peripheral physical injuries is the result of accidents combining psychological and physical impairment. The physical pain resulting from the accident regularly recalls the drama in the same way as traumatic re-experiencing. Depression masked by this somatic suffering is difficult to diagnose, but the repeated somatic complaints at the forefront of the request for treatment, the breakdown of self-esteem as well as the level of subjective strain due to pain and dysesthesia are all indications. The psychotherapy will focus on the symbolic reconstruction of the organs that have been damaged or destroyed, with the aim of healing the extensive narcissistic impairment. Post-concussive depression is diagnosed following a head trauma, however severe. It is sometimes assigned to neurological lesions and at other times recognised as the expression of a purely psychological reaction. Antidepressant therapy, or possibly trial therapy, is often indicated. The terms traumatic grief and post-traumatic grief are often used synonymously in publications: a conceptual opposition must however been recalled. If the traumatic grief is the result of the loss of an object that holds much psychological importance for the individual, the subject has not however been traumatised by this event and is not suffering and will not suffer from re-experiencing. The therapy will include methods used in the psychotherapeutic treatment of grief; antidepressants are often insufficient. Differently, post-traumatic grief takes shape when the loss of another is concomitant with the confrontation with the reality of the death witnessed in a moment of peri-traumatic dissociation. This grief is often observed following the discovery of the body of a close friend or family member who has committed suicide, or when part of a family has been decimated by an accident whilst the survivors watch their close relations die pending the arrival of the emergency services, or when a military comrade is wounded in combat in front of his partner. The mourning process cannot really begin until the flashbacks cease. CONCLUSIONS: Clinical depression or even melancholia, possibly masked by somatic or post-concussive complaints, is often the initial mode of contact with the health care system for the psycho-traumatised subject. The different clinical and etiopathogenic contexts of post-traumatic depression that we have developed in this work use specific therapies which need to be clarified by further research based on this nosography.  
  Address Service medical de psychologie clinique appliquee a l'aeronautique, hopital d'instruction des Armees Percy, 101, avenue Henri-Barbusse, BP406, 92141 Clamart, France. Electronic address: yann.auxemery@hotmail.fr  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language French Summary Language Original Title Formes cliniques des depressions post-traumatiques  
  Series Editor (up) Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0013-7006 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:25238908 Approved no  
  Call Number UU @ jana.mullerova @ Serial 42198  
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