Behav. Sci.2015, 5(1), 27-40; doi:10.3390/bs5010027 - published 23 December 2014 Show/Hide Abstract
Abstract: There is increasing awareness of the impact of post-traumatic stress disorder (PTSD) on physical health, particularly cardiovascular disease. We review the literature on the role of trauma in the development of cardiovascular risk factors and disease, aftermath of a cardiac event, and risk for recurrence in cardiac patients. We explore possible mechanisms to explain these relationships, as well as appropriate assessment and treatment strategies for this population. Our main conclusion is that screening and referral for appropriate treatments are important given the high prevalence rates of PTSD in cardiac populations and the associated impact on morbidity and mortality.
Behav. Sci.2015, 5(1), 1-26; doi:10.3390/bs5010001 - published 23 December 2014 Show/Hide Abstract
Abstract: This paper provides an attempt to conceive of music in terms of a sounding environment. Starting from a definition of music as a collection of vibrational events, it introduces the distinction between discrete-symbolic representations as against analog-continuous representations of the sounds. The former makes it possible to conceive of music in terms of a Humboldt system, the latter in terms of an experiential approach. Both approaches, further, are not opposed to each other, but are complementary to some extent. There is, however, a distinction to be drawn between the bottom-up approach to auditory processing of environmental sounds and music, which is continuous and proceeding in real time, as against the top-down approach, which is proceeding at a level of mental representation by applying discrete symbolic labels to vibrational events. The distinction is discussed against the background of phylogenetic and ontogenetic claims, with a major focus on the innate auditory capabilities of the fetus and neonate and the gradual evolution from mere sensory perception of sound to sense-making and musical meaning. The latter, finally, is elaborated on the basis of the operational concepts of affordance and functional tone, thus bringing together some older contributions from ecology and biosemiotics.
Behav. Sci.2014, 4(4), 511-527; doi:10.3390/bs4040511 - published 8 December 2014 Show/Hide Abstract
Abstract: Patients with posttraumatic stress disorder (PTSD) who fail to respond to established treatments are at risk for chronic disability and distress. Although treatment-resistant PTSD (TR-PTSD) is a common clinical problem, there is currently no standard method for evaluating previous treatment outcomes. Development of a tool that could quantify the degree of resistance to previously provided treatments would inform research in patients with PTSD. We conducted a systematic review of PTSD treatment trials to identify medication and psychotherapy interventions proven to be efficacious for PTSD. We then developed a semi-structured clinician interview called the Emory Treatment Resistance Interview for PTSD (E-TRIP). The E-TRIP includes clinician-administered questions to assess the adequacy and benefit derived from past treatment trials. For each adequately delivered treatment to which the patient failed to respond, a score is assigned depending on the strength of evidence supporting the treatment’s efficacy. The E-TRIP provides a comprehensive assessment of prior PTSD treatments that should prove valuable for researchers studying TR-PTSD and evaluating the efficacy of new treatments for patients with PTSD. The E-TRIP is not intended to guide treatment; rather, the tool quantifies the level of treatment resistance in patients with PTSD in order to standardize TR-PTSD in the research domain.
Behav. Sci.2014, 4(4), 487-510; doi:10.3390/bs4040487 - published 1 December 2014 Show/Hide Abstract
Abstract: Using three spatial network measures of “space syntax”, this correlational study describes four interaction-related behaviors among three groups of users in relation to visibility and accessibility of spaces in four adult intensive care units (ICUs) of different size, geometry, and specialty. Systematic field observations of interaction-related behaviors show significant differences in spatial distribution of interaction-related behaviors in the ICUs. Despite differences in unit characteristics and interaction-related behaviors, the study finds that when nurses and physicians “interact while sitting” they prefer spaces that help maintain a high level of environmental awareness; that when nurses “walk” and “interact while walking” they avoid spaces with better global access and visibility; and that everyone in ICUs “walk” more in spaces with higher control over neighboring spaces. It is argued that such consistent behavioral patterns occur due to the structural similarities of spatial networks over and above the more general functional similarities of ICUs.
Behav. Sci.2014, 4(4), 471-486; doi:10.3390/bs4040471 - published 1 December 2014 Show/Hide Abstract
Abstract: This exploratory study intends to characterize the neuropsychological profile in persons with post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) using objective measures of cognitive performance. A neuropsychological battery of tests for attention, memory and executive functions was administered to four groups: PTSD (n = 25), mTBI (n = 19), subjects with two formal diagnoses: Post-traumatic Stress Disorder and Mild Traumatic Brain Injury (mTBI/PTSD) (n = 6) and controls (n = 25). Confounding variables, such as medical, developmental or neurological antecedents, were controlled and measures of co-morbid conditions, such as depression and anxiety, were considered. The PTSD and mTBI/PTSD groups reported more anxiety and depressive symptoms. They also presented more cognitive deficits than the mTBI group. Since the two PTSD groups differ in severity of PTSD symptoms but not in severity of depression and anxiety symptoms, the PTSD condition could not be considered as the unique factor affecting the results. The findings underline the importance of controlling for confounding medical and psychological co-morbidities in the evaluation and treatment of PTSD populations, especially when a concomitant mTBI is also suspected.