Papers by Robert J Ursano
Journal of Psychiatric Research
Post-traumatic stress disorder (PTSD) develops after an exposure to a life-threatening event and ... more Post-traumatic stress disorder (PTSD) develops after an exposure to a life-threatening event and is characterized by intrusive memories. According to memory reconsolidation theory retrieval of memory under certain conditions leads to its labilization and subsequent re-storage which could be disrupted by drugs. Propranolol has been the most commonly investigated drug for memory reconsolidation therapy in clinical trials. Intervention with propranolol have shown mixed results in PTSD patients with some studies showing improvement in symptoms while other failing to replicate these findings. We conducted a systematic review and meta-analysis to determine the efficacy of trauma memory disruption by propranolol on PTSD symptoms and physiological responses in PTSD patients. 3224 publications were assessed for eligibility. Seven studies on effects of propranolol on PTSD symptoms and 3 studies on effects of propranolol on physiological responses were incorporated in the meta-analyses. Overall, results indicate that propranolol did not show a beneficial effect on PTSD symptoms (standardized mean difference: 1.29; 95% CI = -2.16 - 0.17). Similarly, propranolol did not influence skin conductance (standardized mean difference: 0.77; 95% CI = -1.85 - 0.31) or EMG response (standardized mean difference: 0.16; 95% CI = -0.65 - 0.33). However, propranolol significantly reduced heart rate after trauma memory recall compared to placebo (standardized mean difference: 0.67; 95% CI = -1.27 to -0.07). This study finds a lack of evidence for the efficacy of propranolol on traumatic memory disruption, in PTSD patients, to recommend its routine clinical use. However, a high level of heterogeneity, variation in propranolol dosage and inadequate sample sizes mean that these findings require cautious interpretation.
Psychological Medicine, Apr 4, 2017
Depression and Anxiety, 2019
Journal of Traumatic Stress, Nov 21, 2018
Psychological Medicine, Oct 17, 2017
Molecular Psychiatry, Mar 8, 2018
Journal of Neurotrauma, Feb 15, 2017
Journal of Nervous and Mental Disease, Feb 1, 2008
Military Medicine, Aug 1, 2004
Conn's Translational Neuroscience, 2017
This chapter provides an overview of the most up-to-date understanding of the neuroscience of pos... more This chapter provides an overview of the most up-to-date understanding of the neuroscience of posttraumatic stress disorder (PTSD). A variety of topics are covered throughout this chapter in a systematic fashion with the goal that each section can be read and understood as a stand-alone piece of a greater whole. The first section presents an overview of the neurobiology of traumatic stress from receptors to structural brain changes. After this general overview, a discussion of the various animal models of PTSD is provided. These models include fear conditioning, fear-potentiated startle, and models of unpredictable stress. This review of animal models is then followed by a discussion of biomarkers, PTSD and somatic health, neuroimaging, and treatment. Following these in-depth topics, this chapter provides some possible avenues for future research including exploration of the neuroscience of sleep and PTSD or through new technologies such as magnetoencephalography.
Journal of Traumatic Stress, Jan 31, 2017
Journal of Clinical and Experimental Neuropsychology, Jul 3, 2015
American Journal of Medical Genetics - Neuropsychiatric Genetics, Feb 22, 2017
BMC Research Notes, Mar 25, 2019
Child Abuse & Neglect, Sep 1, 1999
Molecular Psychiatry, Aug 13, 2018
Depression and Anxiety, Feb 11, 2013
Disaster Medicine and Public Health Preparedness, Sep 19, 2017
ObjectiveA series of sniper attacks in the Washington, DC, area left 10 people dead and 3 wounded... more ObjectiveA series of sniper attacks in the Washington, DC, area left 10 people dead and 3 wounded. We developed and tested a model that examined the unique and interdependent relationships of sniper-related television viewing, prior life-threatening events, and parental status to identification with attack victims.MethodsParticipants were 1238 residents of the DC area (aged 18-90 years, mean=41.7 years; 51% female; 68% white) who completed an online survey that assessed identification with sniper attack victims, amount of television viewing, and prior life-threatening events. Identification was measured by using a previously developed scale that assessed to what extent participants identified victims as similar to themselves, a friend, or a family member.ResultsThe relationship of television viewing to identification was examined by using multivariate linear regression analyses. In univariate analyses, female gender, having children, higher levels of television viewing, and past life-threatening events were independently related to greater identification. After adjustment for demographics and life-threatening events, sniper-related television viewing continued to be associated with identification (B=0.61,P≤0.001, ∆R2=0.07). Examination of the interactions of television viewing by parental status and television viewing by life-threatening event revealed significant relationships.ConclusionsAttention to events preceding and during a terrorist event could help in the recognition of those at particular risk for increased identification with attack victims. These findings also have implications for recommendations for media exposure during an event. (Disaster Med Public Health Preparedness. 2018; 12: 337–344)
Child & youth care forum, Aug 4, 2013
American journal of disaster medicine, 2018
A series of sniper attacks in the Washington, DC, area left 10 people dead and three wounded. The... more A series of sniper attacks in the Washington, DC, area left 10 people dead and three wounded. The authors examined the relationship of sniper-related television (TV) viewing, identification with victims, and peritraumatic dissociation to post-traumatic stress symptoms. Participants were 1,238 DC residents (ages 18-90, M = 41.7; 51 percent female; 68 percent White) who completed an online survey including items assessing identification, amount of TV, peritraumatic dissociation, and post-traumatic stress symptoms. Identification was measured by assessing to what extent participants identified victims as similar to themselves, a friend, or a family member. Peritraumatic dissociation and post-traumatic stress symptoms were assessed with the Peritraumatic Dissociative Experiences Questionnaire and Impact of Event Scale-Revised. Relationships of TV viewing, identification, and peritraumatic dissociation to post-traumatic stress symptoms were examined by univariable and multivariable regressions and variable interactions. Female gender and higher levels of TV viewing, identification, and peritraumatic dissociation were each related to greater post-traumatic stress symptoms. After adjusting for gender and the predictor variables, higher TV viewing was associated with post-traumatic stress symptoms (B = 0.72, p < 0.01, ΔR =0.05). Participants with greater identification (B = 0.85, p < 0.001, ΔR = 0.08) and peritraumatic dissociation (B = 1.58, p < 0.001, ΔR = 0.39) reported more post-traumatic stress symptoms. Among those with both high (B = 1.19, p < 0.001) and low TV viewing, identification was associated with post-traumatic stress symptoms. Among those reporting low TV viewing, this association was greater for those who experienced more peritraumatic dissociation (B = -0.09, p < 0.001). Trauma-related TV viewing, which may stimulate identification and peritraumatic dissociation, is an important consideration in understanding development of post-traumatic stress symptoms.
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Papers by Robert J Ursano