Papers by Suzanne Pineles
Psychological Trauma: Theory, Research, Practice, and Policy, Jun 2, 2022
PsycEXTRA Dataset, 2007
Summer 2007 Issue Clinical Science is published as a service to the members of Section III of the... more Summer 2007 Issue Clinical Science is published as a service to the members of Section III of the Division of Clinical Psychology of the American Psychological Association. The purpose is to disseminate current information relevant to the goals of our organization. Feature Articles may be submitted to the editor via e-mail. They should be approximately 16 doublespaced pages and should include an abstract of 75-to 100-words. Brief Articles may also be submitted,and should also include a 75-to 100-word abstract. All articles should be submitted as an attachment to an e-mail and formatted according to the Publication Manual of the American Psychological Association, 5th edition.
Journal of Neuroendocrinology, Dec 28, 2021
Trauma-focused psychotherapies show general efficacy in posttraumatic stress disorder (PTSD), but... more Trauma-focused psychotherapies show general efficacy in posttraumatic stress disorder (PTSD), but outcomes vary substantially among individuals with PTSD and many patients do not achieve clinically meaningful symptom improvement. Several factors may contribute to poor treatment response, including genetic or environmental (e.g., stress) effects on neurobiological factors involved in learning and memory processes critical to PTSD recovery. In this review, we discuss the relationship between deficient GABAergic neurosteroid metabolites of progesterone, allopregnanolone (Allo) and pregnanolone (PA) and PTSD symptoms in men and women or PTSD-like behavioral abnormalities observed in male rodent models of PTSD. We also review the role and molecular underpinnings of learning and memory processes relevant to PTSD recovery, including extinction, extinction retention, reconsolidation of reactivated aversive memories, and episodic non-aversive memory. We then discuss preclinical and clinical research that supports a role in these learning and memory processes for GABAergic neurosteroids and sulfated metabolites of Allo and PA that allosterically antagonize N-methyl-D-aspartate (NMDA) receptor function. Studies supporting the possible therapeutic impact of appropriately timed, acutely administered Allo or Allo analogues to facilitate extinction retention and/or block reconsolidation of aversive memories are also reviewed. Finally, we discuss important future directions for research in this area. Examining the varied and composite effects in PTSD of the several metabolites of progesterone, as well as neuroactive derivatives of other parent steroids produced in the brain and the periphery will likely enable a broadening of targets for treatment development. Defining the contributions of these neuroactive steroids to common PTSD-comorbid psychiatric and medical conditions, as well as subpopulation-specific underlying dysfunctional physiological processes such as hypothalamic-pituitary-adrenal axis and immune system dysregulation, may also enable development of more effective multi-system precision medicines to prevent and treat the broader, polymorbid sequelae of extreme and chronic stress.
Addictive Behaviors, 2019
Introduction: Trauma-exposed individuals with and without posttraumatic stress disorder (PTSD) ar... more Introduction: Trauma-exposed individuals with and without posttraumatic stress disorder (PTSD) are more likely to smoke and less successful in quit attempts than individuals without psychopathology. Contingency management (CM) techniques (i.e., incentives for abstinence) have demonstrable efficacy for smoking cessation in some populations with psychopathology, but have not been well tested in PTSD. This pilot study examined the feasibility of CM plus brief cognitive behavioral therapy (CBT) in promoting smoking cessation among trauma-exposed individuals with and without PTSD. Methods: Fifty trauma-exposed smokers (18 with PTSD) were asked to abstain from tobacco and nicotine replacement therapy for one month. During week one of cessation, CBT was provided
Anxiety, Stress, & Coping, 2019
Background and Objectives: Anxiety sensitivity (AS), as measured by the Anxiety Sensitivity Index... more Background and Objectives: Anxiety sensitivity (AS), as measured by the Anxiety Sensitivity Index (ASI), has consistently been studied as a trait-level predictor of a variety of emotional and physical health conditions, including premenstrual symptoms. The menstrual cycle influences symptom expression and stress reactivity among anxiety and stress-related disorders. However, research has yet to directly evaluate the stability of AS across the various phases of the menstrual cycle, particularly in clinical populations with high levels of AS and with documented menstrual cycle differences in symptoms such as women with posttraumatic stress disorder (PTSD). Design and Methods: The current study examined whether AS fluctuates as a function of menstrual cycle phase among a community sample of trauma-exposed women (N = 48) with and without PTSD. Participants completed the ASI, including subscales assessing sensitivity to physical, cognitive, and social symptoms of anxiety, during early follicular and midluteal menstrual cycle phases. Results: Results revealed that ASI scores remained relatively stable across the different phases of the menstrual cycle assessed; evidence for stability was particularly strong for the subscale assessing sensitivity to physical symptoms of anxiety. Conclusion: This study provides additional support for the conceptualization of AS as a stable, trait-like, cognitive risk factor.
Neurobiology of Stress, 2020
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Sleep
Introduction Prolonged Exposure (PE) therapy produces therapeutic fear extinction via imaginal ex... more Introduction Prolonged Exposure (PE) therapy produces therapeutic fear extinction via imaginal exposure to trauma memories. However, traumatic events that occurred in the distant past and the associated memories may become distorted or habituated. Posttraumatic nightmares are more recent, potentially salient, and may better support extinction learning. Physiological responses to imagery of a trauma and nightmare related to this trauma were compared to each other and to neutral imagery. Methods Twelve participants (mean age=26.16, 11 female) with PTSD (mean CAPS-5=27.83) and frequent trauma-related nightmares wrote accounts of their trauma. Participants then completed a 14-day sleep-monitoring period with diaries, actigraphy and two nights of ambulatory PSG. Participants narrated a nightmare report into an audio recorder when awoken by a nightmare or when recalled upon awakening. Two pairs of short narratives were created from the written account of the trauma and recording of a nigh...
Journal of abnormal psychology, Jan 11, 2016
The propensity to acquire and retain conditioned fear responses may contribute to the risk of dev... more The propensity to acquire and retain conditioned fear responses may contribute to the risk of developing and maintaining posttraumatic stress disorder (PTSD) following a traumatic event. There is growing evidence that the gonadal hormones estrogen and progesterone are associated with how well women retain extinction of previously conditioned fear responses. Thus, sex steroid effects may contribute to the increased prevalence of PTSD in women. For the current study, 32 nonmedicated female trauma survivors with and without PTSD completed a differential fear conditioning task both during the early follicular phase of the menstrual cycle when estradiol and progesterone levels are low, and during the midluteal phase when estradiol and progesterone levels are high. Skin conductance served as the measure of conditioned fear. Women with PTSD, compared to those without, showed impaired retention of extinction learning in the midluteal phase of the menstrual cycle. Therefore, the impact of me...
Clinical Psychological Science, 2015
Self-distancing, or viewing oneself from a third-person perspective, reduces reactivity when anal... more Self-distancing, or viewing oneself from a third-person perspective, reduces reactivity when analyzing one’s feelings. Self-distancing may have important effects among individuals with posttraumatic stress disorder (PTSD), who have heightened emotional and physiological reactivity to trauma memories, but the effects of self-distancing in this group are unclear. We randomly assigned 48 veterans diagnosed with PTSD to analyze their trauma-related feelings from an immersed (first-person) or distanced (third-person) perspective, and measured physiological and subjective emotional reactivity. Self-distancing during trauma analysis protected against increases in physiological reactivity, such that participants in the immersed condition showed a significant increase in heart rate and skin conductance responses not seen in the distanced condition. However, self-distancing had no effect on self-reported emotional reactivity. Our findings suggest that the effects of self-distancing on subject...
Journal of Traumatic Stress, 2015
Psychiatry Research, 2013
Journal of Traumatic Stress, 2009
Sex differences and pretrauma functioning have been understudied in examinations of posttraumatic... more Sex differences and pretrauma functioning have been understudied in examinations of posttraumatic stress symptoms (PSS) and health. This study examined relationships between sexual harassment and assault in the military (MST), PSS, and perceived physical health when accounting for pre-MST PSS, pre-MST health, and current depression. Relationships were examined separately in 226 female and 91 male Marines endorsing recent MST (past 6 months). MST predicted increased PSS for women and especially men. For men, higher levels of MST were associated with worse perceived physical health, whereas for women, lower levels of MST were associated with worse perceived health. For men with MST, there was some evidence for the association being partially mediated by PSS, but no mediation was found in women.
Journal of Abnormal Psychology, 2011
Behaviour Research and Therapy, 2009
Attentional biases to trauma-related stimuli have been widely demonstrated in individuals with po... more Attentional biases to trauma-related stimuli have been widely demonstrated in individuals with posttraumatic stress disorder (PTSD). However, the majority of these studies used methods not suited to differentiating difficulty disengaging attention from threatening stimuli (interference) from facilitated detection of threat. In the current study, a visual search task (VST) with a lexical decision component was used to differentiate between attentional interference and facilitation. Forty-six sexual assault survivors with High PTSD or Low PTSD symptoms completed the VST with three types of stimuli (trauma-related, general threat-related, and semantically-related neutral words), to examine the specificity of attentional biases associated with PTSD symptoms. High PTSD participants showed increased interference to trauma-related words relative to Low PTSD participants. Furthermore, the increased attentional interference in High PTSD participants was specific to trauma-related stimuli. No evidence was found for facilitated detection of threatening stimuli in PTSD. These results provide additional support for attentional biases in PTSD relating to attentional interference with trauma-related cues rather than facilitated detection of threat. The implications for this pattern of results are discussed in relation to anxiety disorders that are characterized by rumination and/or intrusions (e.g., PTSD, GAD) rather than those more circumscribed to fight or flight response (e.g., phobias).
Current Psychiatry Reports
Journal of Traumatic Stress
Seminars in Reproductive Medicine
The literature on the reproductive health and healthcare of women Veterans has increased dramatic... more The literature on the reproductive health and healthcare of women Veterans has increased dramatically, though there are important gaps. This article aims to synthesize recent literature on reproductive health and healthcare of women Veterans. We updated a literature search to identify manuscripts published between 2008 and July 1, 2017. We excluded studies that were not original research, only included active-duty women, or had few women Veterans in their sample. Manuscripts were reviewed using a standardized abstraction form. We identified 52 manuscripts. Nearly half (48%) of the new manuscripts addressed contraception and preconception care (n = 15) or pregnancy (n = 10). The pregnancy and family planning literature showed that (1) contraceptive use and unintended pregnancy among women Veterans using VA healthcare is similar to that of the general population; (2) demand for VA maternity care is increasing; and (3) women Veterans using VA maternity care are a high-risk population f...
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Papers by Suzanne Pineles