Augmentation of Extinction and Inhibitory Learning in Anxiety and Trauma-Related Disorders.

Although the fear response is an adaptive response to threatening situations, a number of psychiatric disorders feature prominent fear-related symptoms caused, in part, by failures of extinction and inhibitory learning. The translational nature of fear conditioning paradigms has enabled us to develop a nuanced understanding of extinction and inhibitory learning based on the molecular substrates to systems neural circuitry and psychological mechanisms. This knowledge has facilitated the development of novel interventions that may augment extinction and inhibitory learning. These interventions include nonpharmacological techniques, such as behavioral methods to implement during psychotherapy, as well as device-based stimulation techniques that enhance or reduce activity in different regions of the brain. There is also emerging support for a number of psychopharmacological interventions that may augment extinction and inhibitory learning specifically if administered in conjunction with exposure-based psychotherapy. This growing body of research may offer promising novel techniques to address debilitating transdiagnostic fear-related symptoms.

Harnessing Electroceuticals to Treat Disorders Arising From Traumatic Stress: Theoretical Considerations Using A Psychosensory Model.

Traumatically encoded memories can last a lifetime. These memories, either by purposeful or inadvertent re-activation, cause the release of stress hormones and generate a persistent and inescapable allostatic load on the body, brain and mind. This leads to a maladaptive response, as the ability to return to pre-event homeostasis is no longer possible. The consequence of this response is that it increases risk for further traumatization and other disorders. Remarkably, recent research has shown that these memories become labile and subject to disruption upon recall. In this paper we outline conditions needed for an event to be encoded as a trauma and describe a method that abrogates the release stress hormones when cued by these memories of the event. Critical to this process is the AMPA receptor (so named for its specific agonist, AMPA, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid, a compound that acts as glutamate, its natural substrate). It is hypothesized that traumatic encoding requires increasing the number and permanence of AMPA receptors on the lateral nucleus of the amygdala by a process called synaptic potentiation. Depotentiation, that is removal of these AMPA receptors, is required for de-encoding. We speculate that the generation of oscillatory intracellular calcium waves is necessary for this to occur. Electromagnetic fields, acting as electroceuticals, interact with voltage-gated calcium channels on depolarized post-synaptic membranes to produce these intracellular calcium oscillations of varying frequency. These oscillatory calcium waves are decoded by intracellular calmodulin which, depending on the frequency, either act to potentiate or depotentiate AMPA receptors. This article describes the theory and practical application of a psychosensory approach called Event Havening that generates an electromagnetic field to synaptically depotentiate these encoded AMPA receptors and eliminate the effects of traumatic encoding.

Traumatic stress, neural self and the spiritual mind.

According to recent findings stressful experiences may influence various physiological disturbances and also neuroanatomical changes and some studies also show that psychotherapy and meditation may influence brain functions. Traumatic stress is frequently related to a dissociative response that disintegrates conscious experience. In this context, self-reflection is an essential principle in the process of posttraumatic growth related to spiritual experiences and meditation states that enable mental integration and create the novel integrated self. According to recent findings there is no widely accepted evidence about specific neural mechanisms of processes related to mental integration linked to the spiritual experiences and meditation. Nevertheless there is growing evidence that these integrative experiences are related to various alterations in the brain's physiology and morphology. These findings provide a new paradigm for understanding of mental disorders and emphasize the fundamental role of mental integration and integrated self in the therapy of psychiatric disorders.

Supporting the need for an integrated system of care for youth with co-occurring traumatic stress and substance abuse problems.

Adolescents are at high risk for violence exposure and initiation of drug use. Co-occurring substance use and trauma exposure are associated with increased risk of mental health disorders, school underachievement, and involvement with multiple systems of care. Coordination and integration of systems of care are of utmost importance for these vulnerable youth. This study delineates the negative sequelae and increased service utilization patterns of adolescents with a history of trauma, substance abuse, and co-occurring trauma and substance abuse to support the need for integrated mental health and substance abuse services for youth. Data from two national sources, the National Child Traumatic Stress Network and Center for Substance Abuse Treatment demonstrate the increased clinical severity (measured by reports of emotional and behavioral problems), dysfunction, and service utilization patterns for youth with co-occurring trauma exposure and substance abuse. We conclude with recommendations for an integrated system of care that includes trauma-informed mental health treatment and substance abuse services aimed at reducing the morbidity and relapse probability of this high-risk group.

Stress and health: psychological, behavioral, and biological determinants.

Stressors have a major influence upon mood, our sense of well-being, behavior, and health. Acute stress responses in young, healthy individuals may be adaptive and typically do not impose a health burden. However, if the threat is unremitting, particularly in older or unhealthy individuals, the long-term effects of stressors can damage health. The relationship between psychosocial stressors and disease is affected by the nature, number, and persistence of the stressors as well as by the individual's biological vulnerability (i.e., genetics, constitutional factors), psychosocial resources, and learned patterns of coping. Psychosocial interventions have proven useful for treating stress-related disorders and may influence the course of chronic diseases.