Carmen V. Russoniello

Childhood Posttraumatic Stress Disorder and Efforts to Cope After Hurricane Floyd

Abstract The authors report on the level of posttraumatic stress disorder (PTSD) experienced by fourth-grade children 6 months after Hurricane Floyd and describe the childrens efforts to cope with their stress. All of the children they studied were directly affected by the hurricane, secondary to the destruction of their school by floodwaters. The homes of 37% of these children were also flooded. Ninety-five percent of the children experienced at least mild symptoms of PTSD, and 71% had symptoms that were moderate to very severe. Children who reported that their homes were flooded were 3 times more likely to report symptoms than those whose homes were not flooded, and the girls were twice as likely as the boys to report symptoms. The high PTSD prevalence rates are comparable to findings from other studies involving violence in which 94% of the victims reported experiencing symptoms. For further analyses, the authors used symptom clusters of hyperarousal, numbing/avoidance, and reexperiencing symptoms.

Effect of Itch, Scratching and Mental Stress on Autonomic Nervous System Function in Atopic Dermatitis

Atopic dermatitis is a stress-responsive disorder that involves the autonomic nervous system. The current study used heart rate variability to examine the effect of itch, scratching and mental stress in atopic patients with moderate to severe disease. Twenty-one patients with active disease and 24 healthy volunteers participated in the study. Heart rate variability measurements were taken at 5 min intervals at rest and after each of 3 acute stress tests, which included histamine-induced itch at the forearm, scratching around the itch site, and the Trier Social Stress Test. Atopic patients displayed a higher heart rate than healthy controls in all 4 experimental settings, which was statistically significant using Cohens delta analysis. The very low frequency component of the power spectrum, indicative of sympathetic activity, showed a 200% increase after scratching in patients with atopic dermatitis. The high frequency component, reflecting parasympathetic tone, responded swiftly to itch and scratching in healthy controls, but displayed a limited adaptability in atopic dermatitis. This study supports the concept that atopic dermatitis is a stress-responsive disorder and involves autonomic nervous system dysfunction. Atopic subjects exhibited an overactive sympathetic response to itch and scratching, while the parasympathetic tone was persistently and rigidly elevated, showing a lack of adaptability in response to stress.

Acute Physical Activity on Cognitive Function: A Heart Rate Variability Examination

The purpose of this study was to examine the relationship of physical activity and cognitive function (as determined by reaction time and the trail-making test) in active versus non-active participants. Participants were divided into one of four groups: active experimental, active control, non-active experimental and non-active control. All groups completed a complex cognitive task (the trail-making test) as well as a set of reaction time tasks both before and after the experimental session. The experimental groups completed a 30-min exercise session while the control groups monitored the physical activity of the experimental group. In addition to the measures of cognitive function, heart rate variability was recorded during the pre- and post-tests. There was significant cognitive performance improvement in tasks with a higher cognitive and perceptual component. Heart rate variability data indicated that a moderate level of arousal based on sympathetic nervous system activity post exercise was associated with an increase in cognitive performance. The findings are discussed in light of the inverted-U hypothesis.

A Measurement of Electrocardiography and Photoplethesmography in Obese Children

The purpose of this study was to establish heart rate variability normative data on obese children and to comparing the accuracy of two medical technologies photoplethesmography (PPG) with electrocardiography (ECG) while measuring heart rate variability (HRV). PPG is a relatively new technique that holds promise for health care practitioners as an evaluative tool and biofeedback instrument due to its cost and easy administration. This study involved ten children who were recruited for an after-school program designed to reduce obesity. Three-five-minute recordings of HRV were collected while the children were lying in the supine position on a therapy bed. PPG was measured from a thumb sensor and ECG from sensors placed under wristbands on both wrists. The results indicate that PPG is as effective as ECG in measuring the eleven parameters of heart rate variability.

Training for Optimal Performance Biofeedback Program: A Cooperative Program Between East Carolina University and the United States Marine Corps Wounded Warrior Battalion East

Abstract The signature wounds of the Iraq War are traumatic brain injury and post traumatic stress disorder (PSTD). Due to an emergent need to address the symptoms of these wounds in returning Marines and navy corpsmen, a memorandum of understanding between the U.S. Marine Corps and East Carolina Universitys Psychophysiology Lab and Biofeedback Clinic was signed and training services were begun in February 2008. The Training for Optimal Performance program involves a biofeedback circuit-training method in which marines and navy corpsmen participate in a graded exposure protocol that includes virtual reality, cognitive retraining, neurofeedback, heart rate variability, and relationship and resiliency training. Preliminary results indicate that this approach is effective in ameliorating symptoms of traumatic brain injury and PTSD.

A Systematic Review of the Biopsychosocial–Spiritual Health of Active Duty Women

Women make up approximately 15% of today’s active duty (AD) military. Not only are more women volunteering for military service now than ever before in America’s history, but due to recent policy changes, they are also allowed to apply for more jobs. Therefore, since the number of women in the military is continuing to rise and there are more job opportunities for women in the military, it is important to understand the unique health effects they experience that differ from civilian women and AD males. Although there is current literature on the biological, psychological, social, and spiritual health of veteran women, few researchers have explored the biopsychosocial–spiritual effects of military service on AD women. Thus, the purpose of this systematic review was to explore the existing research on the biopsychosocial–spiritual health factors associated with military service in AD women. The results of this study indicated that there is more data on the biological health compared to the psychological and social health of AD women. There is even less research demonstrating the interconnectedness among biological, psychological, social, and spiritual health with AD women. Future research recommendations and policy implications are provided.

Stories in Games for Health: More Pros or Cons?

There has been a debate about whether entertainment videogames should incorporate story or narrative. A concern has been whether story cut scenes break game immersion, and thereby minimize the fun of gameplay. Alternatively, games for health (G4H) have an agenda that goes beyond just having fun. The possible role of story in G4H has not been thoroughly addressed. We have assembled a group of experts who have worked with stories in G4H, and asked some pointed questions.

Zombies vs. Anxiety: An Augmentation Study of Prescribed Video Game Play Compared to Medication in Reducing Anxiety Symptoms:

Objective. Anxiety is a typical reaction to stress and when uncontrolled, clinical anxiety disorders may develop. Traditional anxiety interventions have established efficacy; however, they are often costly and stigmatizing. This study examined prescribed casual video game (CVG) play added to an SSRI prescription in reducing symptoms of anxiety compared to a two-medication treatment group. Materials and methods. We used data from a larger study examining depression and CVGs. The Quick Inventory of Depressive Symptomology screened participants for depression using a score of ≥ 5 (mild depression). Participants chose to participate in the alternative (n = 30) or traditional (n = 24) group. Alternative group participants were prescribed CVG play four times per week for 30-45 minutes over a one-month period. Traditional intervention group participants were prescribed a second medication. The State-Trait Anxiety Inventory was used to test hypotheses. Results. Repeated-measures ANOVA demonstrated a significant decrease in state anxiety scores after the one-month prescription and a medium to large effect for the alternative group. Trait anxiety results did not demonstrate significance; however, the group had a medium effect size. Conclusion. Clinicians should consider these non-stigmatizing and low-cost CVGs as a feasible intervention for patients who wish not to take additional medication.

Contextualizing Military Health and Trauma: Recommendations for Integrated Care and Couple-Centered Interventions

Military personnel and their family members are currently facing risks to their health and well-being, yet interventions such as prevention and treatment remain unsuccessful for many families. For instance, almost one-quarter of a million returning troops have been diagnosed with post-traumatic stress disorder (PTSD); however, the estimated prevalence of PTSD is grossly underestimated due to ineffective assessment. Further, only half of military PTSD sufferers are finding relief in their treatment. Through this literature review, assessment, prevention, and treatment recommendations to improve health outcomes for military personnel are provided by expanding previous medical models and incorporating biopsychorelational principles and data.