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Mental Health Functioning in the Human Rights Field: Findings from an International Internet-Based Survey
Joscelyne, Amy; Knuckey, Sarah; Satterthwaite, Margaret L; Bryant, Richard A; Li, Meng; Qian, Meng; Brown, Adam D
Human rights advocates play a critical role in promoting respect for human rights world-wide, and engage in a broad range of strategies, including documentation of rights violations, monitoring, press work and report-writing, advocacy, and litigation. However, little is known about the impact of human rights work on the mental health of human rights advocates. This study examined the mental health profile of human rights advocates and risk factors associated with their psychological functioning. 346 individuals currently or previously working in the field of human rights completed an internet-based survey regarding trauma exposure, depression, posttraumatic stress disorder (PTSD), resilience and occupational burnout. PTSD was measured with the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) and depression was measured with the Patient History Questionnaire-9 (PHQ-9). These findings revealed that among human rights advocates that completed the survey, 19.4% met criteria for PTSD, 18.8% met criteria for subthreshold PTSD, and 14.7% met criteria for depression. Multiple linear regressions revealed that after controlling for symptoms of depression, PTSD symptom severity was predicted by human rights-related trauma exposure, perfectionism and negative self-appraisals about human rights work. In addition, after controlling for symptoms of PTSD, depressive symptoms were predicted by perfectionism and lower levels of self-efficacy. Survey responses also suggested high levels of resilience: 43% of responders reported minimal symptoms of PTSD. Although survey responses suggest that many human rights workers are resilient, they also suggest that human rights work is associated with elevated rates of PTSD and depression. The field of human rights would benefit from further empirical research, as well as additional education and training programs in the workplace about enhancing resilience in the context of human rights work.
PMCID:4689393
PMID: 26700305
ISSN: 1932-6203
CID: 1884272
Precuneal and amygdala spontaneous activity and functional connectivity in war-zone-related PTSD
Yan, Xiaodan; Lazar, Mariana; Shalev, Arieh Y; Neylan, Thomas C; Wolkowitz, Owen M; Brown, Adam D; Henn-Haase, Clare; Yehuda, Rachel; Flory, Janine D; Abu-Amara, Duna; Sodickson, Daniel K; Marmar, Charles R
Abnormality in the "fear circuitry" has been known as a major neural characteristic of posttraumatic stress disorder (PTSD). Recent studies also revealed decreased functional connectivity in the default mode network in PTSD. The present study aims to investigate, in war-zone-related PTSD, the spontaneous activity and functional connectivity of the amygdala and the precuneus, which are two representative brain regions of the two networks, respectively. Two groups of 52 male US Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) veterans (PTSD vs. controls), well matched on age and ethnicity, were clinically assessed and then studied in a resting state functional magnetic resonance imaging (fMRI) procedure. Functional connectivity analysis was conducted on the resting state fMRI data with the amygdala and precuneus as seeds. Compared with controls, veterans with PTSD had lower functional connectivity in the default mode network, as well as lower amygdala-frontal functional connectivity. Both the PTSD and the control group had a significant positive precuneal-amygdala functional connectivity without a significant group difference. The magnitudes of spontaneous activity of the amygdala and the precuneus were negatively correlated in the PTSD group and showed significant quadratic relationships with the amount of emotional abuse in early life trauma. These findings may improve our understanding about the relationships between fear circuitry and the default mode network in the context of war-zone-related PTSD.
PMID: 25561375
ISSN: 0165-1781
CID: 1428912
Cortisol response to an experimental stress paradigm prospectively predicts long-term distress and resilience trajectories in response to active police service
Galatzer-Levy, Isaac R; Steenkamp, Maria M; Brown, Adam D; Qian, Meng; Inslicht, Sabra; Henn-Haase, Clare; Otte, Christian; Yehuda, Rachel; Neylan, Thomas C; Marmar, Charles R
Heterogeneity in glucocorticoid response to experimental stress conditions has shown to differentiate individuals with healthy from maladaptive real-life stress responses in a number of distinct domains. However, it is not known if this heterogeneity influences the risk for developing stress related disorders or if it is a biological consequence of the stress response itself. Determining if glucocorticoid response to stress induction prospectively predicts psychological vulnerability to significant real life stressors can adjudicate this issue. To test this relationship, salivary cortisol as well as catecholamine responses to a laboratory stressor during academy training were examined as predictors of empirically identified distress trajectories through the subsequent 4 years of active duty among urban police officers routinely exposed to potentially traumatic events and routine life stressors (N = 234). During training, officers were exposed to a video vignette of police officers exposed to real-life trauma. Changes in salivary 3-methoxy-4-hydroxyphenylglycol (MHPG) and cortisol in response to this video challenge were examined as predictors of trajectory membership while controlling for age, gender, and baseline neuroendocrine levels. Officers who followed trajectories of resilience and recovery over 4 years mounted significant increases in cortisol in response to the experimental stressor, while those following a trajectory of chronic increasing distress had no significant cortisol change in response to the challenge. MHPG responses were not associated with distress trajectories. Cortisol response prospectively differentiated trajectories of distress response suggesting that a blunted cortisol response to a laboratory stressor is a risk factor for later vulnerability to distress following significant life stressors.
PMCID:5759781
PMID: 24952936
ISSN: 0022-3956
CID: 1050852
rTMS as a Treatment for Anorexia Nervosa [Letter]
Bainbridge, Katie; Brown, Adam
PMID: 24269202
ISSN: 1935-861x
CID: 781752
Episodic and semantic components of autobiographical memories and imagined future events in post-traumatic stress disorder
Brown, Adam D; Addis, Donna Rose; Romano, Tracy A; Marmar, Charles R; Bryant, Richard A; Hirst, William; Schacter, Daniel L
Individuals with post-traumatic stress disorder (PTSD) tend to retrieve autobiographical memories with less episodic specificity, referred to as overgeneralised autobiographical memory. In line with evidence that autobiographical memory overlaps with one's capacity to imagine the future, recent work has also shown that individuals with PTSD also imagine themselves in the future with less episodic specificity. To date most studies quantify episodic specificity by the presence of a distinct event. However, this method does not distinguish between the numbers of internal (episodic) and external (semantic) details, which can provide additional insights into remembering the past and imagining the future. This study employed the Autobiographical Interview (AI) coding scheme to the autobiographical memory and imagined future event narratives generated by combat veterans with and without PTSD. Responses were coded for the number of internal and external details. Compared to combat veterans without PTSD, those with PTSD generated more external than internal details when recalling past or imagining future events, and fewer internal details were associated with greater symptom severity. The potential mechanisms underlying these bidirectional deficits and clinical implications are discussed.
PMID: 24712772
ISSN: 0965-8211
CID: 964082
Cognitive reserve and emotional stimuli in older individuals: level of education moderates the age-related positivity effect
Bruno, Davide; Brown, Adam D; Kapucu, Aycan; Marmar, Charles R; Pomara, Nunzio
Background/Study Context: A frequently observed age-related effect is a preference in older individuals for positive stimuli. The cognitive control model proposes that this positivity effect may be mediated by executive functions. We propose that cognitive reserve, operationally defined as years of education, which tempers cognitive decline and has been linked to executive functions, should also influence the age-related positivity effect, especially as age advances. Methods: An emotional free recall test was administered to a group of 84 cognitively intact individuals aged 60 to 88, who varied in years of education. As part of a larger test battery, data were obtained on measures of executive functioning and depression. Results: Multiple regression and moderation analyses were performed, controlling for general cognitive function, severity of depressive symptoms, and executive function. In our data, years of education appeared to moderate the effect of age on the positivity effect; age was negatively associated with recall of positive words in participants with fewer years of education, whereas a nonsignificant positive correlation was observed between age and positivity in participants with more education. Conclusion: Cognitive reserve appears to play a role in explaining individual differences in the positivity effect in healthy older individuals. Future studies should investigate whether cognitive reserve is also implicated in the ability to process a wide range of emotional stimuli and whether greater reserve is reflected in improved emotional regulation.
PMID: 24625047
ISSN: 0361-073x
CID: 865662
Spontaneous brain activity in combat related PTSD
Yan, Xiaodan; Brown, Adam D; Lazar, Mariana; Cressman, Victoria L; Henn-Haase, Clare; Neylan, Thomas C; Shalev, Arieh; Wolkowitz, Owen M; Hamilton, Steven P; Yehuda, Rachel; Sodickson, Daniel K; Weiner, Michael W; Marmar, Charles R
Posttraumatic stress disorder (PTSD) is a prevalent psychiatric disorder, especially in combat veterans. Existing functional neuroimaging studies have provided important insights into the neural mechanisms of PTSD using various experimental paradigms involving trauma recollection or other forms of emotion provocation. However it is not clear whether the abnormal brain activity is specific to the mental processes related to the experimental tasks or reflects general patterns across different brain states. Thus, studying intrinsic spontaneous brain activity without the influence of external tasks may provide valuable alternative perspectives to further understand the neural characteristics of PTSD. The present study evaluated the magnitudes of spontaneous brain activity of male US veterans with or without PTSD, with the two groups matched on age, gender, and ethnicity. Amplitudes of low frequency fluctuation (ALFF), a data driven analysis method, were calculated on each voxel of the resting state fMRI data to measure the magnitudes of spontaneous brain activity. Results revealed that PTSD subjects showed increased spontaneous activity in the amygdala, ventral anterior cingulate cortex, insula, and orbital frontal cortex, as well as decreased spontaneous activity in the precuneus, dorsal lateral prefrontal cortex and thalamus. Within the PTSD group, larger magnitudes of spontaneous activity in the thalamus, precuneus and dorsal lateral prefrontal cortex were associated with lower re-experiencing symptoms. Comparing our results with previous functional neuroimaging findings, increased activity of the amygdala and anterior insula and decreased activity of the thalamus are consistent patterns across emotion provocation states and the resting state.
PMID: 23643995
ISSN: 0304-3940
CID: 335862
Positive and Negative Emotion Prospectively Predict Trajectories of Resilience and Distress Among High-Exposure Police Officers
Galatzer-Levy, Isaac R; Brown, Adam D; Henn-Haase, Clare; Metzler, Thomas J; Neylan, Thomas C; Marmar, Charles R
Responses to both potentially traumatic events and other significant life stressors have been shown to conform to discrete patterns of response such as resilience, anticipatory stress, initial distress with gradual recovery, and chronic distress. The etiology of these trajectories is still unclear. Individual differences in levels of negative and positive emotion are believed to play a role in determining risk and resilience following traumatic exposure. In the current investigation, we followed police officers prospectively from academy training through 48 months of active duty, assessing levels of distress every 12 months. Using latent class growth analysis, we identified 4 trajectories closely conforming to prototypical patterns. Furthermore, we found that lower levels of self-reported negative emotion during academy training prospectively predicted membership in the resilient trajectory compared with the more symptomatic trajectories following the initiation of active duty, whereas higher levels of positive emotion during academy training differentiated resilience from a trajectory that was equivalently low on distress during academy training but consistently grew in distress through 4 years of active duty. These findings emerging from a prospective longitudinal design provide evidence that resilience is predicted by both lower levels of negative emotion and higher levels of positive emotion prior to active duty stressor exposure. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
PMCID:3974969
PMID: 23339621
ISSN: 1528-3542
CID: 215412
Overgeneralized autobiographical memory and future thinking in combat veterans with posttraumatic stress disorder
Brown, AD; Root, JC; Romano, TA; Chang, LJ; Bryant, RA; Hirst, W
BACKGROUND: Studies show that individuals with Posttraumatic Stress Disorder (PTSD) tend to recall autobiographical memories with decreased episodic specificity. A growing body of research has demonstrated that the mechanisms involved in recalling autobiographical memories overlap considerably with those involved in imagining the future. Although shared autobiographical deficits in remembering the past and imagining the future have been observed in other clinical populations, this has yet to be examined in PTSD. This study examined whether, compared to combat trauma-exposed individuals without PTSD, those with combat-related PTSD would be more likely to generate overgeneralized autobiographical memories and imagined future events. METHOD: Operation Enduring/Iraqi Freedom (OEF/OIF) veterans with and without PTSD were presented with neutral word cues and were instructed to generate memories or imagine future autobiographical events. Responses were digitally recorded and were coded for level of episodic specificity and content related to combat trauma. RESULTS: Individuals with PTSD were more likely to generate overgeneral autobiographical memories and future events than individuals without PTSD, and were more likely to incorporate content associated with combat when remembering the past or thinking about the future. LIMITATION: Limitations of the study include a cross-sectional design, precluding causality; the lack of a non-trauma exposed group, relatively small sample, and almost all-male gender of participants, limiting the generalizability to other populations. CONCLUSION: These findings suggest that individuals with PTSD show similar deficits when generating personal past and future events, which may represent a previously unexamined mechanism involved in the maintenance of PTSD symptoms.
PMID: 22200095
ISSN: 0005-7916
CID: 162625
Remembering President Barack Obama's inauguration and the landing of US Airways Flight 1549: A comparison of the predictors of autobiographical and event memory
Koppel, Jonathan; Brown, Adam D; Stone, Charles B; Coman, Alin; Hirst, William
We examined and compared the predictors of autobiographical memory (AM) consistency and event memory accuracy across two publicly documented yet disparate public events: the inauguration of Barack Obama as the 44th president of the United States on January 20th 2009, and the emergency landing of US Airways Flight 1549, off the coast of Manhattan, on January 15th 2009. We tracked autobiographical and event memories for both events, with assessments taking place within 2(1/2) weeks of both events (Survey 1), and again between 3(1/2) and 4 months after both events (Survey 2). In a series of stepwise regressions we found that the psychological variables of recalled emotional intensity and personal importance/centrality predicted AM consistency and event memory accuracy for the inauguration. Conversely, the rehearsal variables of covert rehearsal and media attention predicted, respectively, AM consistency and event memory accuracy for the plane landing. We conclude from these findings that different factors may underlie autobiographical and event memory for personally and culturally significant events (e.g., the inauguration), relative to noteworthy, yet less culturally significant, events (e.g., the plane landing).
PMID: 23301921
ISSN: 0965-8211
CID: 335812