Tailoring therapeutic strategies for treating posttraumatic stress disorder symptom clusters
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Tailoring therapeutic strategies for treating posttraumatic stress disorder symptom clusters Seth D Norrholm1,2, Tanja Jovanovic21Atlanta VA Medical Center, Mental Health Service Line, Decatur, GA, USA; 2Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USAAbstract: According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, posttraumatic stress disorder (PTSD) is characterized by three major symptom clusters following an event that elicited fear, helplessness, or horror. This review will examine each symptom cluster of PTSD separately, giving case study examples of patients who exhibit a preponderance of a given symptom domain. We use a translational approach in describing the underlying neurobiology that is relevant to particular symptoms and treatment options, thus showing how clinical practice can benefit from current research. By focusing on symptom clusters, we provide a more specific view of individual patient’s clinical presentations, in order to better address treatment needs. Finally, the review will also address potential genetic approaches to treatment as another form of individualized treatment.Keywords: psychophysiology, pharmacotherapy, exposure therapy, pharmacogenetics; posttraumatic stress disorder, symptom clusters
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The heterogeneity of PTSD implies the involvement of multiple neurobiological mechanisms underlying its development and maintenance.
“This heterogeneity implies the involvement of multiple neurobiological mechanisms, which underlie the development and maintenance of PTSD [for a comprehensive review, see (10)].”
From Conditioned fear associated phenotypes as robust, translational indices of trauma-, stressor-, and anxiety-related behaviors (2014) · cites this paper as [10]
PTSD symptom clusters provide useful diagnostic criteria and could be used to discern the most effective treatment, but they represent broad categories of behavior and do not easily reflect common underlying mechanisms.
“While PTSD symptom clusters provide a useful set of diagnostic criteria and could be used to discern the most effective treatment [for a comprehensive review, see Ref. (10)], they represent broad categories of behavior and do not easily reflect common underlying mechanisms.”
From Conditioned fear associated phenotypes as robust, translational indices of trauma-, stressor-, and anxiety-related behaviors (2014) · cites this paper as [10]
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- [59]Friedman M Post Traumatic and Acute Stress Disorders: The Latest Assessment and Treatment Strategies 4th ed Kansas City, MO Dean Psych Press Corporation 2006
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Impaired safety signal learning may be a biomarker of PTSD
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Self-citationBriscione, M. A., Jovanovic, T., & Norrholm, S. D. (2014) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2014.00088 · Cited by 105 · see citing works
Self-citationRaber, J., Arzy, S., Bertolus, J. B., Depue, B., Haas, H. E., Hofmann, S. G., Kangas, M., Kensinger, E., Lowry, C. A., Marusak, H. A., et al. (2019) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2019.03.015 · Cited by 62 · see citing works
Self-citationWarren, V. T., Anderson, K. M., Kwon, C., Bosshardt, L., Jovanovic, T., Bradley, B., & Norrholm, S. D. (2014) · Neurobiology of Learning and Memory · doi:10.1016/j.nlm.2013.10.014 · Cited by 62 · see citing works
Self-citationIncreased perceived self-efficacy facilitates the extinction of fear in healthy participants
Zlomuzica, A., Preusser, F., Schneider, S., & Margraf, J. (2015) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2015.00270 · Cited by 55 · see citing works
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Self-citationReid, B. O., Næss-Pleym, L. E., Bakkelund, K. E., Dale, J., Uleberg, O., & Nordstrand, A. E. (2022) · Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine · doi:10.1186/s13049-021-00991-2 · Cited by 25 · see citing works
- Authors
- Norrholm, S., & Jovanovic, T.
- Affiliations
- Atlanta VA Medical Center (US)
- Corresponding author
- Norrholm, Seth
- ORCID
- Norrholm, Seth
- Venue
- Neuropsychiatric Disease and Treatment
- Publisher
- Informa UK Limited
- Published
- 2010-08
- Volume
- 6
- Pages
- 517
- ISSN
- 1176-6328 (ISSN-L)
- PMC
- PMC2938301
- OpenAlex
- W2013386221
- Cited by
- 56
- References
- 167
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 3 · 2022: 2 · 2021: 3 · 2020: 1 · 2019: 3 · 2018: 3 · 2017: 3 · 2016: 4 · 2015: 8 · 2014: 4 · 2013: 7
- FWCI
- 5.61
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Neuropsychiatric Disease and Treatment (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Funders
- U.S. Department of Defense
- Emory University
- Atlanta Clinical and Translational Science Institute
- National Alliance for Research on Schizophrenia and Depression
- National Institutes of Health (UL1TR000454)
- National Center for Advancing Translational Sciences
- Congressionally Directed Medical Research Programs
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- post-traumatic stress disorder, PTSD symptom clusters, personalized treatment, pharmacotherapy, exposure therapy, pharmacogenetics, psychophysiology
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