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Christine Elizabeth Marx

Christine Elizabeth Marx

Professor of Psychiatry and Behavioral Sciences
Psychiatry, Child & Family Mental Health & Community Psychiatry
marx0001@mc.duke.edu
Box 3862 Med Ctr, DUMC, Durham, NC 27710
VA Medical Ctr 116 A, 508 Fulton St, Durham, NC 27705

Selected Publications

Brain levels of the neurotransmitter γ-aminobutyric acid are reduced in people with HIV-related neuropathic pain.

Journal Article Pain · September 3, 2025 Previous studies suggest a dysregulation of the inhibitory γ-aminobutyric acid (GABA) and the excitatory glutamate/glutamine (Glx) neurotransmitter systems in people living with chronic pain. Here, we test this hypothesis in people with HIV (PWH) on stable ... Full text Link to item Cite

Epigenome-wide association studies identify novel DNA methylation sites associated with PTSD: a meta-analysis of 23 military and civilian cohorts.

Journal Article Genome Med · December 18, 2024 BACKGROUND: The occurrence of post-traumatic stress disorder (PTSD) following a traumatic event is associated with biological differences that can represent the susceptibility to PTSD, the impact of trauma, or the sequelae of PTSD itself. These effects inc ... Full text Link to item Cite

Black Americans With Sickle Cell Disease (SCD) Demonstrate Accelerated Epigenetic Pace of Aging Compared to Black Americans Without SCD.

Journal Article J Gerontol A Biol Sci Med Sci · November 1, 2024 BACKGROUND: Sickle cell disease (SCD) is a chronic medical condition characterized by red blood cell sickling, vaso-occlusion, hemolytic anemia, and subsequently, end-organ damage and reduced survival. Because of this significant pathophysiology and early ... Full text Link to item Cite

Posttraumatic stress disorder, trauma, and accelerated biological aging among post-9/11 veterans.

Journal Article Transl Psychiatry · January 6, 2024 People who experience trauma and develop posttraumatic stress disorder (PTSD) are at increased risk for poor health. One mechanism that could explain this risk is accelerated biological aging, which is associated with the accumulation of chronic diseases, ... Full text Open Access Link to item Cite

Adverse Outcome Following Mild Traumatic Brain Injury Is Associated with Microstructure Alterations at the Gray and White Matter Boundary.

Journal Article J Clin Med · August 21, 2023 The gray matter/white matter (GM/WM) boundary of the brain is vulnerable to shear strain associated with mild traumatic brain injury (mTBI). It is, however, unknown whether GM/WM microstructure is associated with long-term outcomes following mTBI. The diff ... Full text Link to item Cite

White Matter Microstructure Is Associated with Serum Neuroactive Steroids and Psychological Functioning.

Journal Article J Neurotrauma · April 2023 Military service members are at increased risk for mental health issues, and comorbidity with mild traumatic brain injury (mTBI) is common. Largely overlapping symptoms between conditions suggest a shared pathophysiology. The present work investigates the ... Full text Link to item Cite

Warzone experiences and subsequent clinician suicide risk assessment in veterans

Journal Article Suicide and Life Threatening Behavior · December 1, 2021 Objective: To determine in veterans whether severity of combat exposure was predictive of subsequently receiving a suicide risk assessment (SRA), and whether this relationship was meditated by depression symptomatology. Method: We conducted an electronic m ... Full text Cite

A network analysis of risk factors for suicide in Iraq/Afghanistan-era veterans.

Journal Article J Psychiatr Res · June 2021 Suicidal ideation (SI) is a prevalent issue in the veteran population. A number of factors have been identified as risk factors for suicidal ideation (SI) in veterans, including suicide attempts, depression, posttraumatic stress disorder (PTSD), and drug u ... Full text Link to item Cite

Cannabis use disorder, anger, and violence in Iraq/Afghanistan-era veterans.

Journal Article J Psychiatr Res · June 2021 An association has been found between cannabis use disorder (CUD) and violence in several clinical populations, including veterans with posttraumatic stress disorder (PTSD), and there is evidence that CUD has been increasing among veterans since September ... Full text Link to item Cite

Gene Expression Analysis in Three Posttraumatic Stress Disorder Cohorts Implicates Inflammation and Innate Immunity Pathways and Uncovers Shared Genetic Risk With Major Depressive Disorder.

Journal Article Front Neurosci · 2021 Posttraumatic stress disorder (PTSD) is a complex psychiatric disorder that can develop following exposure to traumatic events. The Psychiatric Genomics Consortium PTSD group (PGC-PTSD) has collected over 20,000 multi-ethnic PTSD cases and controls and has ... Full text Open Access Link to item Cite

Neuroendocrine biomarkers of prolonged exposure treatment response in military-related PTSD.

Journal Article Psychoneuroendocrinology · September 2020 Posttraumatic stress disorder (PTSD) is associated with dysregulation of the neuroendocrine system, including cortisol, allopregnanolone, and pregnanolone. Preliminary evidence from animal models suggests that baseline levels of these biomarkers may predic ... Full text Link to item Cite

Contributions of posttraumatic stress disorder (PTSD) and mild TBI (mTBI) history to suicidality in the INTRuST consortium.

Journal Article Brain Inj · August 23, 2020 OBJECTIVE: Mild TBI (mTBI) and posttraumatic stress disorder (PTSD) are independent risk factors for suicidal behaviour (SB). Further, co-occurring mTBI and PTSD increase one's risk for negative health and psychiatric outcomes. However, little research has ... Full text Link to item Cite

Serum Neurosteroid Levels Are Associated With Cortical Thickness in Individuals Diagnosed With Posttraumatic Stress Disorder and History of Mild Traumatic Brain Injury.

Journal Article Clin EEG Neurosci · July 2020 Featured Publication Posttraumatic stress disorder (PTSD) co-occurring with mild traumatic brain injury (mTBI) is common in veterans. Worse clinical outcome in those with PTSD has been associated with decreased serum neurosteroid levels. Furthermore, decreased cortical thickne ... Full text Link to item Cite

Neural correlates of conceptual-level fear generalization in posttraumatic stress disorder.

Journal Article Neuropsychopharmacology · July 2020 Posttraumatic stress disorder (PTSD) may develop when mechanisms for making accurate distinctions about threat relevance have gone awry. Generalization across conceptually related objects has been hypothesized based on clinical observation in PTSD, but the ... Full text Link to item Cite

An epigenome-wide association study of posttraumatic stress disorder in US veterans implicates several new DNA methylation loci.

Journal Article Clin Epigenetics · March 14, 2020 BACKGROUND: Previous studies using candidate gene and genome-wide approaches have identified epigenetic changes in DNA methylation (DNAm) associated with posttraumatic stress disorder (PTSD). METHODS: In this study, we performed an EWAS of PTSD in a cohort ... Full text Open Access Link to item Cite

Effect of Pregnenolone vs Placebo on Self-reported Chronic Low Back Pain Among US Military Veterans: A Randomized Clinical Trial.

Journal Article JAMA Netw Open · March 2, 2020 Featured Publication IMPORTANCE: In response to the national opioid public health crisis, there is an urgent need to develop nonopioid solutions for effective pain management. Neurosteroids are endogenous molecules with pleotropic actions that show promise for safe and effecti ... Full text Link to item Cite

Amygdala Nuclei Volume and Shape in Military Veterans With Posttraumatic Stress Disorder.

Journal Article Biol Psychiatry Cogn Neurosci Neuroimaging · March 2020 BACKGROUND: The amygdala is a subcortical structure involved in socioemotional and associative fear learning processes relevant for understanding the mechanisms of posttraumatic stress disorder (PTSD). Research in animals indicates that the amygdala is a h ... Full text Link to item Cite

Combat exposure, posttraumatic stress disorder, and head injuries differentially relate to alterations in cortical thickness in military Veterans.

Journal Article Neuropsychopharmacology · February 2020 Combat-exposed Veterans are at increased risk for developing psychological distress, mood disorders, and trauma and stressor-related disorders. Trauma and mood disorders have been linked to alterations in brain volume, function, and connectivity. However, ... Full text Link to item Cite

Resilience as a translational endpoint in the treatment of PTSD.

Journal Article Mol Psychiatry · September 2019 Resilience is a neurobiological entity that shapes an individual's response to trauma. Resilience has been implicated as the principal mediator in the development of mental illness following exposure to trauma. Although animal models have traditionally def ... Full text Link to item Cite

Pain Intensity and Pain Interference in Male and Female Iraq/Afghanistan-era Veterans.

Journal Article Womens Health Issues · June 25, 2019 BACKGROUND: Chronic pain conditions are common among both male and female Iraq/Afghanistan-era veterans and can have substantial negative impacts on quality of life and function. Although in general women tend to report higher levels of pain intensity than ... Full text Link to item Cite

Relationship between traumatic brain injury history and recent suicidal ideation in Iraq/Afghanistan-era veterans.

Journal Article Psychol Serv · May 2019 This study evaluated whether a history of traumatic brain injury (TBI) was associated with increased risk for recent suicidal ideation (SI) after accounting for demographics, depression, posttraumatic stress disorder (PTSD), and sleep quality. In terms of ... Full text Link to item Cite

Posttraumatic stress disorder and traumatic brain Injury: Sex differences in veterans.

Journal Article Psychiatry Res · April 2019 Around half of Iraq and Afghanistan war veterans with traumatic brain injury (TBI) have co-occurring posttraumatic stress disorder (PTSD). Research on the differences between male and female veterans with co-occurring PTSD/TBI is sparse. This study evaluat ... Full text Link to item Cite

Associations between neuropsychiatric and health status outcomes in individuals with probable mTBI.

Journal Article Psychiatry Res · February 2019 Mild traumatic brain injury (mTBI) is a common occurrence, and may impact distal outcomes in a subgroup of individuals. Improved characterization of health outcomes and identification of factors associated with poor outcomes is needed to better understand ... Full text Link to item Cite

Neurosteroid Levels in the Orbital Frontal Cortex of Subjects with PTSD and Controls: A Preliminary Report.

Journal Article Chronic Stress (Thousand Oaks) · January 2019 BACKGROUND: Neurosteroids mediate stress signaling and have been implicated in the pathogenesis of post-traumatic stress disorder (PTSD) in both preclinical and clinical studies. Compared to controls, subjects with PTSD exhibit altered neurosteroid levels ... Full text Link to item Cite

The association of resilience on psychiatric, substance use, and physical health outcomes in combat trauma-exposed military service members and veterans.

Journal Article Eur J Psychotraumatol · 2019 Objective: Although Combat exposure is associated with a range of psychiatric outcomes, many veterans do not develop psychopathology. Resilience is a multifaceted construct associated with reduced risk of distress and psychopathology; however, few studies ... Full text Open Access Link to item Cite

Widespread Cortical Thickness Is Associated With Neuroactive Steroid Levels.

Journal Article Front Neurosci · 2019 Featured Publication BACKGROUND: Neuroactive steroids are endogenous molecules with regenerative and neuroprotective actions. Both cortical thickness and many neuroactive steroid levels decline with age and are decreased in several neuropsychiatric disorders. However, a system ... Full text Open Access Link to item Cite

Behavioral and Health Outcomes Associated With Deployment and Nondeployment Acquisition of Traumatic Brain Injury in Iraq and Afghanistan Veterans.

Journal Article Arch Phys Med Rehabil · December 2018 OBJECTIVE: To characterize behavioral and health outcomes in veterans with traumatic brain injury (TBI) acquired in nondeployment and deployment settings. DESIGN: Cross-sectional assessment evaluating TBI acquired during and outside of deployment, mental a ... Full text Link to item Cite

Psychosocial Risk Factors and Other Than Honorable Military Discharge: Providing Healthcare to Previously Ineligible Veterans.

Journal Article Mil Med · September 1, 2018 INTRODUCTION: In response to a strong focus on suicide prevention for all veterans, the Department of Veterans Affairs (VA) recently revised policy to provide emergency mental healthcare for veterans who received Other Than Honorable (OTH) discharges from ... Full text Link to item Cite

Informing Federal Policy on Firearm Restrictions for Veterans with Fiduciaries: Risk Indicators in the Post-Deployment Mental Health Study.

Journal Article Adm Policy Ment Health · July 2018 This article examines the public safety rationale for a federal policy of prohibiting gun sales to veterans with psychiatric disabilities who are assigned a fiduciary to manage their benefits from the Department of Veterans Affairs. The policy was evaluate ... Full text Link to item Cite

The Association Between Alcohol Consumption, Lifetime Alcohol Use Disorder, and Psychiatric Distress Among Male and Female Veterans.

Journal Article J Stud Alcohol Drugs · July 2018 OBJECTIVE: This study aimed to examine among veterans (a) whether alcohol consumption patterns are associated with probability of psychiatric symptoms and (b) whether an alcohol use disorder (AUD) history explains psychiatric symptoms among nondrinkers. ME ... Full text Link to item Cite

White matter abnormalities in mild traumatic brain injury with and without post-traumatic stress disorder: a subject-specific diffusion tensor imaging study.

Journal Article Brain Imaging Behav · June 2018 Mild traumatic brain injuries (mTBIs) are often associated with posttraumatic stress disorder (PTSD). In cases of chronic mTBI, accurate diagnosis can be challenging due to the overlapping symptoms this condition shares with PTSD. Furthermore, mTBIs are he ... Full text Link to item Cite

Risk factors for concurrent suicidal ideation and violent impulses in military veterans.

Journal Article Psychol Assess · April 2018 Suicide and violence are significant problems in a subset of Iraq/Afghanistan-era veterans. This study investigates how posttraumatic stress disorder (PTSD) and resilience in veterans are associated with suicidal ideation and violent impulses while control ... Full text Link to item Cite

Multi-site harmonization of diffusion MRI data in a registration framework.

Journal Article Brain Imaging Behav · February 2018 Diffusion MRI (dMRI) data acquired on different scanners varies significantly in its content throughout the brain even if the acquisition parameters are nearly identical. Thus, proper harmonization of such data sets is necessary to increase the sample size ... Full text Link to item Cite

Brain Structural Covariance Network Topology in Remitted Posttraumatic Stress Disorder.

Journal Article Front Psychiatry · 2018 Posttraumatic stress disorder (PTSD) is a prevalent, chronic disorder with high psychiatric morbidity; however, a substantial portion of affected individuals experience remission after onset. Alterations in brain network topology derived from cortical thic ... Full text Link to item Cite

Exploring resilience models in a sample of combat-exposed military service members and veterans: a comparison and commentary.

Journal Article Eur J Psychotraumatol · 2018 Background: The term resilience is applied in numerous ways in the mental health field, leading to different perspectives of what constitutes a resilient response and disparate findings regarding its prevalence following trauma. Objective: illustrate the i ... Full text Link to item Cite

Neurosteroid Levels in Patients With Bipolar Disorder and a History of Cannabis Use Disorders.

Journal Article J Clin Psychopharmacol · December 2017 PURPOSE/BACKGROUND: In animal models, levels of the neurosteroid pregnenolone increase after tetrahydrocannabinol (THC) administration and pregnenolone appears to attenuate the brain effects of THC. Given these interactions between pregnenolone and THC, we ... Full text Link to item Cite

Genome-wide association study of subcortical brain volume in PTSD cases and trauma-exposed controls.

Journal Article Transl Psychiatry · November 30, 2017 Depending on the traumatic event, a significant fraction of trauma survivors subsequently develop PTSD. The additional variability in PTSD risk is expected to arise from genetic susceptibility. Unfortunately, several genome-wide association studies (GWAS) ... Full text Link to item Cite

Sleep quality in returning veterans: The influence of mild traumatic brain injury.

Journal Article Rehabil Psychol · November 2017 OBJECTIVE: Sleep disturbance is a key behavioral health concern among Iraq and Afghanistan era veterans and is a frequent complaint among veterans with a history of mild traumatic brain injury (mTBI). Currently, it is unclear whether sleep disturbance is a ... Full text Link to item Cite

Self-Reported Pain in Male and Female Iraq/Afghanistan-Era Veterans: Associations with Psychiatric Symptoms and Functioning.

Journal Article Pain Med · September 1, 2017 OBJECTIVE: To examine pain symptoms and co-occurring psychiatric and functional indices in male and female Iraq/Afghanistan-era veterans. DESIGN: Self-reported data collection and interviews of Iraq/Afghanistan-era veterans who participated in a multisite ... Full text Link to item Cite

The Post-Deployment Mental Health (PDMH) study and repository: A multi-site study of US Afghanistan and Iraq era veterans.

Journal Article Int J Methods Psychiatr Res · September 2017 The United States (US) Department of Veterans Affairs (VA) Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC) Post-Deployment Mental Health (PDMH) multi-site study examines post-deployment mental health in US military Afghanistan ... Full text Link to item Cite

Analysis of recruitment strategies: Enrolling veterans with PTSD into a clinical trial

Journal Article Military Psychology · September 1, 2017 This analysis evaluated the efficacy of a variety of recruitment methods employed in a medication trial in a veteran population. Recruitment and demographic data were collected over the course of a randomized controlled trial (RCT) assessing the efficacy o ... Full text Cite

A randomized controlled trial of ganaxolone in posttraumatic stress disorder.

Journal Article Psychopharmacology (Berl) · August 2017 Preclinical and clinical research supports a role for neuroactive steroids in the pathophysiology of posttraumatic stress disorder (PTSD). We investigated ganaxolone (a synthetic 3β-methylated derivative of allopregnanolone, a GABAergic neuroactive steroid ... Full text Link to item Cite

Neuroactive steroids and PTSD treatment.

Journal Article Neurosci Lett · May 10, 2017 This review highlights early efforts to translate pre-clinical and clinical findings regarding the role of neuroactive steroids in stress adaptation and PTSD into new therapeutics for PTSD. Numerous studies have demonstrated PTSD-related alterations in res ... Full text Link to item Cite

Stress-Related Mental Health Symptoms in Coast Guard: Incidence, Vulnerability, and Neurocognitive Performance.

Journal Article Front Psychol · 2017 U.S. Coast Guard (CG) personnel face occupational stressors (e.g., search and rescue) which compound daily life stressors encountered by civilians. However, the degree CG personnel express stress-related mental health symptoms of posttraumatic stress disor ... Full text Link to item Cite

Inter-site and inter-scanner diffusion MRI data harmonization.

Journal Article Neuroimage · July 15, 2016 We propose a novel method to harmonize diffusion MRI data acquired from multiple sites and scanners, which is imperative for joint analysis of the data to significantly increase sample size and statistical power of neuroimaging studies. Our method incorpor ... Full text Open Access Link to item Cite

Sexual revictimization among Iraq and Afghanistan war era veterans.

Journal Article Psychiatry Res · June 30, 2016 Research in both civilian and military populations has demonstrated that females who experience childhood sexual abuse (CSA) are more likely to experience sexual assault in adulthood than females who did not experience CSA. Among veteran samples, however, ... Full text Link to item Cite

Allopregnanolone Levels Are Inversely Associated with Self-Reported Pain Symptoms in U.S. Iraq and Afghanistan-Era Veterans: Implications for Biomarkers and Therapeutics.

Journal Article Pain Med · January 2016 BACKGROUND AND OBJECTIVES: Pain symptoms are common among Iraq/Afghanistan-era veterans, many of whom continue to experience persistent pain symptoms despite multiple pharmacological interventions. Preclinical data suggest that neurosteroids such as allopr ... Full text Open Access Link to item Cite

Potential neurobiological benefits of exercise in chronic pain and posttraumatic stress disorder: Pilot study.

Journal Article J Rehabil Res Dev · 2016 This pilot study assessed the effects of cardiopulmonary exercise testing and cardiorespiratory fitness on plasma neuropeptide Y (NPY), allopregnanolone and pregnanolone (ALLO), cortisol, and dehydroepiandrosterone (DHEA), and their association with pain s ... Full text Link to item Cite

An exploratory pilot investigation of neurosteroids and self-reported pain in female Iraq/Afghanistan-era Veterans.

Journal Article J Rehabil Res Dev · 2016 Female Veterans are the most rapidly growing segment of new users of the Veterans Health Administration (VHA), and a significant proportion of female Veterans receiving treatment from VHA primary care providers report persistent pain symptoms. Currently, a ... Full text Link to item Cite

Brain and Serum Androsterone Is Elevated in Response to Stress in Rats with Mild Traumatic Brain Injury.

Journal Article Front Neurosci · 2016 Exposure to lateral fluid percussion (LFP) injury consistent with mild traumatic brain injury (mTBI) persistently attenuates acoustic startle responses (ASRs) in rats. Here, we examined whether the experience of head trauma affects stress reactivity. Male ... Full text Link to item Cite

Fear learning circuitry is biased toward generalization of fear associations in posttraumatic stress disorder.

Journal Article Transl Psychiatry · December 15, 2015 Fear conditioning is an established model for investigating posttraumatic stress disorder (PTSD). However, symptom triggers may vaguely resemble the initial traumatic event, differing on a variety of sensory and affective dimensions. We extended the fear-c ... Full text Open Access Link to item Cite

Functional correlates of military sexual assault in male veterans.

Journal Article Psychol Serv · November 2015 Despite research findings that similar numbers of male and female veterans are affected by military sexual trauma (MST), there has been considerably less research on the effects of MST specific to male veterans. The aim of the present study was to provide ... Full text Link to item Cite

Effect of genetic variation in the nicotinic receptor genes on risk for posttraumatic stress disorder.

Journal Article Psychiatry Res · September 30, 2015 The present study examined the association between genetic variation in the nicotinic receptor gene family (CHRNA2, CHRNA3, CHRNA4, CHRNA5, CHRNA6, CHRNA7, CHRNA9, CHRNA10, CHRNB2, CHRNB3, CHRNB4) and the occurrence of posttraumatic stress disorder (PTSD). ... Full text Link to item Cite

DHEA metabolism to the neurosteroid androsterone: a possible mechanism of DHEA's antidepressant action.

Journal Article Psychopharmacology (Berl) · September 2015 BACKGROUND: Alterations in neurosteroid secretion have been implicated in the efficacy of antidepressants. In a previous study, the adrenal androgen DHEA, a precursor of the neurosteroid androsterone, produced antidepressant and libido-enhancing effects in ... Full text Link to item Cite

Drug use and childhood-, military- and post-military trauma exposure among women and men veterans.

Journal Article Drug Alcohol Depend · July 1, 2015 BACKGROUND: The current study was undertaken to examine whether posttraumatic stress symptoms (PTSS) and depressive symptoms mediated the association between trauma exposure (combat-related trauma and non-combat traumas occurring before, during, and after ... Full text Link to item Cite

A pilot randomized placebo-controlled trial of adjunctive aripiprazole for chronic PTSD in US military Veterans resistant to antidepressant treatment.

Journal Article Int Clin Psychopharmacol · May 2015 Many individuals with post-traumatic stress disorder (PTSD) experience persistent symptoms despite pharmacological treatment with antidepressants. Several open-label monotherapy and adjunctive studies have suggested that aripiprazole (a second-generation a ... Full text Link to item Cite

Exploratory investigation of biomarker candidates for suicide in schizophrenia and bipolar disorder.

Journal Article Crisis · 2015 BACKGROUND: Clozapine and lithium increase neurosteroids in rodents, and both drugs demonstrate antisuicidal actions. We therefore hypothesized that neurosteroid levels may be reduced in patients with schizophrenia or bipolar disorder who completed suicide ... Full text Link to item Cite

The factor structure of psychiatric comorbidity among Iraq/Afghanistan-era veterans and its relationship to violence, incarceration, suicide attempts, and suicidality.

Journal Article Psychiatry Res · December 15, 2014 The present research examined how incarceration, suicide attempts, suicidality, and difficulty controlling violence relate to the underlying factor structure of psychiatric comorbidity among a large sample of Iraq/Afghanistan-era veterans (N=1897). Diagnos ... Full text Link to item Cite

DSM-5 posttraumatic stress disorder: factor structure and rates of diagnosis.

Journal Article J Psychiatr Res · December 2014 Posttraumatic stress disorder (PTSD) is a significant problem among Iraq/Afghanistan-era veterans. To date, however, there has been only limited research on how the recent changes in DSM-5 influence the prevalence and factor structure of PTSD. To address t ... Full text Link to item Cite

A randomized, double-blind, placebo-controlled trial of pregnenolone for bipolar depression.

Journal Article Neuropsychopharmacology · November 2014 Depression in bipolar disorder (BPD) is challenging to treat. Therefore, additional medication options are needed. In the current report, the effect of the neurosteroid pregnenolone on depressive symptoms in BPD was examined. Adults (n=80) with BPD, depres ... Full text Link to item Cite

Proof-of-concept randomized controlled trial of pregnenolone in schizophrenia.

Journal Article Psychopharmacology (Berl) · September 2014 RATIONALE: Preclinical and clinical data suggest that pregnenolone may be a promising therapeutic in schizophrenia. Pregnenolone is neuroprotective and enhances learning and memory, myelination, and microtubule polymerization. Treatment with pregnenolone e ... Full text Link to item Cite

Cathodal and anodal left prefrontal tDCS and the perception of control over pain.

Journal Article Clin J Pain · August 2014 OBJECTIVES: The prefrontal cortex may be a promising target for the use of transcranial direct current stimulation (tDCS) in the management of pain symptoms. The present study explored the effects of anodal and cathodal tDCS over the left dorsolateral pref ... Full text Link to item Cite

The neurosteroids allopregnanolone and dehydroepiandrosterone modulate resting-state amygdala connectivity.

Journal Article Hum Brain Mapp · July 2014 The neurosteroids allopregnanolone and dehydroepiandrosterone (DHEA) are integral components of the stress response and exert positive modulatory effects on emotion in both human and animal studies. Although these antidepressant and anxiolytic effects have ... Full text Link to item Cite

The impact of social support on psychological distress for U.S. Afghanistan/Iraq era veterans with PTSD and other psychiatric diagnoses.

Journal Article Psychiatry Res · June 30, 2014 This study aimed to examine the degree to which posttraumatic stress disorder (PTSD) affects the relationship between social support and psychological distress for U.S. Afghanistan/Iraq era veterans with and without co-occurring psychiatric disorders. Vete ... Full text Link to item Cite

Amino acids as biomarker candidates for suicidality in male OEF/OIF Veterans: relevance to NMDA receptor modulation and nitric oxide signaling.

Journal Article Mil Med · May 2014 Veteran populations are exposed to multiple stressful events, and suicidality among veterans is a serious problem. Identifying biomarkers of suicidality may enhance detection, prevention, and treatment. Multiple neurotransmitter systems are implicated in t ... Full text Link to item Cite

Pharmacotherapy of traumatic brain injury: state of the science and the road forward: report of the Department of Defense Neurotrauma Pharmacology Workgroup.

Journal Article J Neurotrauma · January 15, 2014 Despite substantial investments by government, philanthropic, and commercial sources over the past several decades, traumatic brain injury (TBI) remains an unmet medical need and a major source of disability and mortality in both developed and developing s ... Full text Link to item Cite

Altered resting-state functional connectivity of basolateral and centromedial amygdala complexes in posttraumatic stress disorder.

Journal Article Neuropsychopharmacology · January 2014 The amygdala is a major structure that orchestrates defensive reactions to environmental threats and is implicated in hypervigilance and symptoms of heightened arousal in posttraumatic stress disorder (PTSD). The basolateral and centromedial amygdala (CMA) ... Full text Open Access Link to item Cite

Effects of chronic mild traumatic brain injury on white matter integrity in Iraq and Afghanistan war veterans.

Journal Article Hum Brain Mapp · November 2013 Mild traumatic brain injury (TBI) is a common source of morbidity from the wars in Iraq and Afghanistan. With no overt lesions on structural MRI, diagnosis of chronic mild TBI in military veterans relies on obtaining an accurate history and assessment of b ... Full text Open Access Link to item Cite

Adverse impact of coercive treatments on psychiatric inpatients' satisfaction with care.

Journal Article Community Ment Health J · August 2013 Consumers' satisfaction with inpatient mental health care is recognized as a key quality indicator that prospectively predicts functional and clinical outcomes. Coercive treatment experience is a frequently cited source of dissatisfaction with inpatient ca ... Full text Link to item Cite

DHEA enhances emotion regulation neurocircuits and modulates memory for emotional stimuli.

Journal Article Neuropsychopharmacology · August 2013 Dehydroepiandrosterone (DHEA) is a neurosteroid with anxiolytic, antidepressant, and antiglucocorticoid properties. It is endogenously released in response to stress, and may reduce negative affect when administered exogenously. Although there have been mu ... Full text Link to item Cite

The Association of Sleep Duration, Mental Health, and Health Risk Behaviors among U.S. Afghanistan/Iraq Era Veterans.

Journal Article Sleep · July 1, 2013 STUDY OBJECTIVES: Short and long sleep duration have been linked with higher rates of comorbid medical and mental health issues, as well as increased mortality. The current study examined the association between sleep duration, mental health problems, and ... Full text Link to item Cite

Allopregnanolone elevations following pregnenolone administration are associated with enhanced activation of emotion regulation neurocircuits.

Journal Article Biol Psychiatry · June 1, 2013 BACKGROUND: The neurosteroid allopregnanolone is a potent allosteric modulator of the gamma-aminobutyric acid type A receptor with anxiolytic properties. Exogenous administration of allopregnanolone reduces anxiety, and allopregnanolone blockade impairs so ... Full text Link to item Cite

A pilot randomized controlled trial with paroxetine for subthreshold PTSD in Operation Enduring Freedom/Operation Iraqi Freedom era veterans.

Journal Article Psychiatry Res · April 30, 2013 Subthreshold posttraumatic stress disorder (PTSD) is associated with increased risk for suicidality, depression, and functional impairment. We thus conducted a small (N=12) pilot randomized controlled trial (RCT) with paroxetine for subthreshold PTSD in Op ... Full text Open Access Link to item Cite

An open-label pilot study of aripiprazole for male and female veterans with chronic post-traumatic stress disorder who respond suboptimally to antidepressants.

Journal Article Int Clin Psychopharmacol · July 2012 Emerging data suggest that second-generation antipsychotics such as aripiprazole may be effective in the treatment of post-traumatic stress disorder (PTSD). However, few clinical trials have used aripiprazole in PTSD, and data are limited on its use in Vet ... Full text Link to item Cite

Pregnenolone rescues schizophrenia-like behavior in dopamine transporter knockout mice.

Journal Article PLoS One · 2012 Pregnenolone belongs to a class of endogenous neurosteroids in the central nervous system (CNS), which has been suggested to enhance cognitive functions through GABA(A) receptor signaling by its metabolites. It has been shown that the level of pregnenolone ... Full text Link to item Cite

The Singapore flagship programme in translational and clinical research in psychosis.

Journal Article Early Interv Psychiatry · November 2011 AIM: This paper describes the rationale, aims and development of the Singapore Translational and Clinical Research in Psychosis, which is a 5-year programme. METHODS: The authors provide a selective review of the pertinent findings from the clinical, neuro ... Full text Link to item Cite

Pregnenolone as a novel therapeutic candidate in schizophrenia: emerging preclinical and clinical evidence.

Journal Article Neuroscience · September 15, 2011 Emerging preclinical and clinical evidence suggests that pregnenolone may be a promising novel therapeutic candidate in schizophrenia. Pregnenolone is a neurosteroid with pleiotropic actions in rodents that include the enhancement of learning and memory, n ... Full text Link to item Cite

Is obstructive sleep apnea associated with ADHD?

Journal Article Ann Clin Psychiatry · August 2011 BACKGROUND: It has been suggested that obstructive sleep apnea (OSA) may result in symptoms similar to those experienced in attention-deficit/hyperactivity disorder (ADHD). Because this may have important public health implications, we reviewed the literat ... Link to item Cite

Is military sexual trauma associated with trading sex among women veterans seeking outpatient mental health care?

Journal Article J Trauma Dissociation · 2011 A robust association between sexual trauma and trading sex has been documented in civilian samples but has not been examined in veterans. Women veterans experience high rates of sexual victimization across the lifespan, including during military service (m ... Full text Link to item Cite

Adherence and psychotherapy

Journal Article · December 1, 2010 Psychotherapists target a wide range of clinical disorders, adopt diverse theoretical approaches, and operate within multiple treatment settings. As such, a unifying definition of adherence in the field of psychotherapy is not yet tenable. We therefore lim ... Full text Cite

Neurosteroids and self-reported pain in veterans who served in the U.S. Military after September 11, 2001.

Journal Article Pain Med · October 2010 OBJECTIVE: Nearly half of Operation Enduring Freedom/Operation Iraqi Freedom veterans experience continued pain post-deployment. Several investigations report analgesic effects of allopregnanolone and other neurosteroids in animal models, but few data are ... Full text Link to item Cite

Correlates of anger and hostility in Iraq and Afghanistan war veterans.

Journal Article Am J Psychiatry · September 2010 OBJECTIVE: As troops return from Iraq and Afghanistan to civilian life, clinicians are starting to grapple with how best to detect those at risk of postdeployment adjustment problems. Data reveal the presence of mental health problems in these soldiers, in ... Full text Link to item Cite

Allopregnanolone levels are reduced in temporal cortex in patients with Alzheimer's disease compared to cognitively intact control subjects.

Journal Article Biochim Biophys Acta · August 2010 The neurosteroid allopregnanolone has pronounced neuroprotective actions, increases myelination, and enhances neurogenesis. Evidence suggests that allopregnanolone dysregulation may play a role in the pathophysiology of Alzheimer's disease (AD) and other n ... Full text Link to item Cite

Guided imagery as a therapeutic tool in post-traumatic stress disorder

Journal Article · December 1, 2009 Guided imagery is a behavioral technique used to direct individuals to effectively create and manipulate mental representations to produce therapeutic changes. A growing empirical literature supports the use of these techniques in a variety of physical and ... Full text Cite

An assessment of the understanding and motivations of patients with schizophrenia about participating in a clinical trial.

Journal Article Contemp Clin Trials · September 2009 Enrollment of an adequate number of subjects for a clinical trial is a perennial challenge and this might arguably be even more difficult and complex in trials involving patients with schizophrenia. In this paper, we used a modification of the Prospective ... Full text Link to item Cite

Proof-of-concept trial with the neurosteroid pregnenolone targeting cognitive and negative symptoms in schizophrenia.

Journal Article Neuropsychopharmacology · July 2009 The neurosteroid pregnenolone and its sulfated derivative enhance learning and memory in rodents. Pregnenolone sulfate also positively modulates NMDA receptors and could thus ameliorate hypothesized NMDA receptor hypofunction in schizophrenia. Furthermore, ... Full text Link to item Cite

Association of trauma exposure with psychiatric morbidity in military veterans who have served since September 11, 2001.

Journal Article J Psychiatr Res · June 2009 OBJECTIVE: This study examined the association of lifetime traumatic stress with psychiatric diagnostic status and symptom severity in veterans serving in the US military after 9/11/01. METHOD: Data from 356 US military veterans were analyzed. Measures inc ... Full text Link to item Cite

NEUROSTEROIDS AS NOVEL THERAPEUTIC AGENTS IN SCHIZOPHRENIA AND PTSD

Journal Article SCHIZOPHRENIA BULLETIN · March 1, 2009 Link to item Cite

Applications of proteomics to nerve regeneration research

Chapter · January 1, 2009 Peripheral nerve injury is a major clinical and public health challenge. Although a common and increasingly prevalent wartime condition (1), injury to peripheral nerves, plexuses, and roots is present in 5% of patients seen in civilian trauma centers (2). ... Cite

Simultaneous quantification of GABAergic 3alpha,5alpha/3alpha,5beta neuroactive steroids in human and rat serum.

Journal Article Steroids · 2009 The 3alpha,5alpha- and 3alpha,5beta-reduced derivatives of progesterone, deoxycorticosterone, dehydroepiandrosterone and testosterone enhance GABAergic neurotransmission and produce inhibitory neurobehavioral and anti-inflammatory effects. Despite substant ... Full text Link to item Cite

Allopregnanolone and pregnenolone alterations following pharmacological agents in rodents and clinic populations

Journal Article · December 1, 2008 Recent research has revealed potential roles for neuroactive steroids in the pathophysiology and treatment of a number of psychiatric and neurological disorders. A wide array of preclinical investigations also reports neuroactive steroid actions in areas r ... Full text Cite

Antipsychotic drugs: comparison in animal models of efficacy, neurotransmitter regulation, and neuroprotection.

Journal Article Pharmacol Rev · September 2008 Various lines of evidence indicate the presence of progressive pathophysiological processes occurring within the brains of patients with schizophrenia. By modulating chemical neurotransmission, antipsychotic drugs may influence a variety of functions regul ... Full text Link to item Cite

Cerebrospinal fluid dehydroepiandrosterone levels are correlated with brain dehydroepiandrosterone levels, elevated in Alzheimer's disease, and related to neuropathological disease stage.

Journal Article J Clin Endocrinol Metab · August 2008 OBJECTIVE: It is currently unknown whether cerebrospinal fluid (CSF) neurosteroid levels are related to brain neurosteroid levels in humans. CSF and brain dehydroepiandrosterone (DHEA) levels are elevated in patients with Alzheimer's disease (AD), but it i ... Full text Link to item Cite

Access to medical care among persons with psychotic and major affective disorders.

Journal Article Psychiatr Serv · August 2008 OBJECTIVE: People with serious mental illness have higher mortality rates than the general population, and this difference is not explained by such causes as suicide or accidents. This study therefore examined access and barriers to medical care among pers ... Full text Link to item Cite

Factorial invariance of posttraumatic stress disorder symptoms across three veteran samples.

Journal Article J Trauma Stress · June 2008 Research generally supports a 4-factor structure of posttraumatic stress disorder (PTSD) symptoms. However, few studies have established factor invariance by comparing multiple groups. This study examined PTSD symptom structure using the Davidson Trauma Sc ... Full text Link to item Cite

Neuroactive steroids, mood stabilizers, and neuroplasticity: alterations following lithium and changes in Bcl-2 knockout mice.

Journal Article Int J Neuropsychopharmacol · June 2008 Many neuroactive steroids (NS) demonstrate neurotrophic and neuroprotective actions, including protection against apoptosis via Bcl-2 protein. NS are altered in post-mortem brain tissue from subjects with bipolar disorder, and several agents with efficacy ... Full text Link to item Cite

Alcohol use among OEF-OIF veterans with and without posttraumatic stress disorder

Conference ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH · June 1, 2008 Link to item Cite

Neurosteroid modulation of GABAergic neurotransmission in the central amygdala: a role for NMDA receptors.

Journal Article Neurosci Lett · March 26, 2007 The neurosteroid 3alpha-hydroxy-5alpha-pregnan-20-one (allopregnanolone or ALLO) positively modulates GABA(A) receptors, an action that may contribute to the anxiolytic effects of ALLO. Recent evidence suggests that ALLO's anxiolytic effects appear to be m ... Full text Link to item Cite

Interpersonal trauma, war zone exposure, and posttraumatic stress disorder among veterans with schizophrenia.

Journal Article Schizophr Res · March 2007 The present study examined the prevalence of war zone exposure, interpersonal trauma and post-traumatic stress disorder (PTSD) in veterans with primary schizophrenia hospitalized on a VA inpatient psychiatric unit. Data were collected on a sample of male v ... Full text Link to item Cite

New developments in proteomics.

Journal Article N C Med J · 2007 Link to item Cite

Sexuality and commitment

Journal Article Sexologies · January 1, 2007 The aim of this article is to investigate the relationship between sexuality and the concept of commitment. Sexuality implies commitment in its erotic, genital and relational aspects. This word can be used differently depending on the context: 1) To bind o ... Full text Cite

The neurosteroid allopregnanolone is reduced in prefrontal cortex in Alzheimer's disease.

Journal Article Biol Psychiatry · December 15, 2006 BACKGROUND: Few data are currently available investigating neurosteroids (NS) in Alzheimer's disease (AD). The NS allopregnanolone may be decreased in serum and plasma in patients with AD, but it is unclear if allopregnanolone is also reduced in brain. Bec ... Full text Link to item Cite

Clozapine markedly elevates pregnenolone in rat hippocampus, cerebral cortex, and serum: candidate mechanism for superior efficacy?

Journal Article Pharmacol Biochem Behav · August 2006 Clozapine demonstrates superior efficacy in patients with schizophrenia, but the precise mechanisms contributing to this clinical advantage are not clear. Clozapine and olanzapine increase the GABAergic neuroactive steroid (NS) allopregnanolone, and it has ... Full text Link to item Cite

Olanzapine and fluoxetine administration and coadministration increase rat hippocampal pregnenolone, allopregnanolone and peripheral deoxycorticosterone: implications for therapeutic actions.

Journal Article Pharmacol Biochem Behav · August 2006 Olanzapine and fluoxetine elevate the GABAergic neuroactive steroid allopregnanolone to physiologically relevant concentrations in rodent cerebral cortex. It is unknown if these agents also alter pregnenolone or deoxycorticosterone. Since olanzapine and fl ... Full text Link to item Cite

Neuroactive steroids, negative affect, and nicotine dependence severity in male smokers.

Journal Article Psychopharmacology (Berl) · June 2006 RATIONALE: Nicotine administration alters neuroactive steroids in rodent models, and serum levels of the neuroactive steroid DHEAS (dehydroepiandrosterone sulfate) appear to be higher in smokers. These molecules may be relevant to tobacco addiction and aff ... Full text Link to item Cite

Neuroactive steroids are altered in schizophrenia and bipolar disorder: relevance to pathophysiology and therapeutics.

Journal Article Neuropsychopharmacology · June 2006 Evidence suggests that neuroactive steroids may be candidate modulators of schizophrenia pathophysiology and therapeutics. We therefore investigated neuroactive steroid levels in post-mortem brain tissue from subjects with schizophrenia, bipolar disorder, ... Full text Link to item Cite

Subjective effects and changes in steroid hormone concentrations in humans following acute consumption of alcohol.

Journal Article Psychopharmacology (Berl) · June 2006 BACKGROUND: GABAA receptors are an important site of action of endogenous neurosteroids and an important mediator of several behavioral effects of alcohol. This study examined the effects of alcohol on plasma steroid hormone concentrations on the hypothesi ... Full text Link to item Cite

Comorbid posttraumatic stress disorder is associated with suicidality in male veterans with schizophrenia or schizoaffective disorder.

Journal Article Schizophr Res · May 2006 The purpose of this study was to determine if patients with schizophrenia or schizoaffective disorders and comorbid posttraumatic stress disorder (PTSD) are at higher risk for suicidality than patients without comorbid PTSD. Participants were 165 male vete ... Full text Link to item Cite

Neuroactive steroids and suicidality in posttraumatic stress disorder.

Journal Article Am J Psychiatry · February 2005 OBJECTIVE: Recent studies suggest that neuroactive steroids may be altered in posttraumatic stress disorder (PTSD). Since high rates of suicidality accompany PTSD, the authors investigated neuroactive steroid levels and correlations to suicide attempts in ... Full text Link to item Cite

Treatments for schizophrenia: a critical review of pharmacology and mechanisms of action of antipsychotic drugs.

Journal Article Mol Psychiatry · January 2005 The treatment of schizophrenia has evolved over the past half century primarily in the context of antipsychotic drug development. Although there has been significant progress resulting in the availability and use of numerous medications, these reflect thre ... Full text Link to item Cite

Chapter 3.5 Atypical antipsychotic drugs and stress

Journal Article · January 1, 2005 Both preclinical and clinical evidence suggest that atypical antipsychotics may modulate the stress response in a manner that is distinct from conventional agents. For example, atypical antipsychotics have anxiolytic-like actions in a number of animal mode ... Full text Cite

Olanzapine and clozapine increase the GABAergic neuroactive steroid allopregnanolone in rodents.

Journal Article Neuropsychopharmacology · January 2003 The neuroactive steroid allopregnanolone is a potent gamma-aminobutyric acid type A (GABA(A)) receptor modulator with anxiolytic and anticonvulsant effects. Olanzapine and clozapine also have anxiolytic-like effects in behavioral models. We therefore postu ... Full text Link to item Cite

Post-traumatic stress disorder in women: current concepts and treatments.

Journal Article Curr Psychiatry Rep · December 2002 In the US, 13% of women develop post-traumatic stress disorder (PTSD) during their lifetime. An accurate diagnosis of PTSD requires screening for trauma and symptoms of PTSD. Current research in the neurobiologic and psychologic responses to traumatic stre ... Full text Link to item Cite

New onset of neuropsychiatric symptoms in the elderly: possible primary hyperparathyroidism.

Journal Article Psychosomatics · 2002 Primary hyperparathyroidism is a disorder of calcium homeostasis that occurs most commonly in older adults. Resultant hypercalcemia may be accompanied by neuropsychiatric symptoms, ranging from mild depression and cognitive changes to extreme agitation and ... Full text Link to item Cite

Cytokine effects on cortical neuron MAP-2 immunoreactivity: implications for schizophrenia.

Journal Article Biol Psychiatry · November 15, 2001 BACKGROUND: Cytokines demonstrate diverse actions in the brain and modulate systemic and central nervous system (CNS) responses to injury, infection, and inflammation. Cytokines in the CNS are elevated during infection and ischemia, two neurodevelopmental ... Full text Link to item Cite

Neurosteroid modulation of embryonic neuronal survival in vitro following anoxia.

Journal Article Brain Res · July 14, 2000 Neurosteroids are synthesized de novo in the brain from cholesterol or peripheral steroid precursors and modulate inhibitory gamma-aminobutyric acid (GABA(A)) and excitatory N-methyl-D-aspartate (NMDA) receptors. Evidence indicates that neurosteroids are n ... Full text Link to item Cite

Olanzapine increases allopregnanolone in the rat cerebral cortex.

Journal Article Biol Psychiatry · June 1, 2000 BACKGROUND: The neurosteroid allopregnanolone (3alpha-hydroxy-5alpha-pregnan-20-one) has anxiolytic and anticonvulsant properties, potentiating GABA(A) receptor chloride channel function with 20-fold higher potency than benzodiazepines. Behavioral studies ... Full text Link to item Cite

Nerve growth factor, brain-derived neurotrophic factor, and neurotrophin-3 levels in human amniotic fluid.

Journal Article Am J Obstet Gynecol · November 1999 OBJECTIVE: Neurotrophins are proteins that promote neuronal growth and differentiation. In this pilot study we determined whether the neurotrophins nerve growth factor, brain-derived neurotrophic factor, and neurotrophin-3 were present in amniotic fluid sp ... Full text Link to item Cite

Psychoneuroendocrinology of schizophrenia.

Journal Article Psychiatr Clin North Am · June 1998 The study of psychoneuroendocrinology of schizophrenia has yielded an extensive but inconclusive body of data. Investigations to date have been limited by several factors, including the confounding effects of neuroleptic drugs, methodological limitations, ... Full text Link to item Cite

Laboratory and clinical evaluation of Mycobacterium xenopi isolates.

Journal Article Diagn Microbiol Infect Dis · April 1995 Mycobacterium xenopi and Mycobacterium avium complex (MAC) are biochemically similar. To define the laboratory characteristics of M. xenopi that distinguish it from MAC, 53 M. xenopi isolates from different areas in the United States and 47 isolates recove ... Full text Link to item Cite

Clinical impact of bacteria and fungi recovered only from broth cultures.

Journal Article J Clin Microbiol · January 1995 We prospectively evaluated 356 bacteria and fungi recovered from broth enrichment tubes from cultures with sterile direct plates to determine the clinical impact of isolates recovered only from broth cultures. These "broth only" isolates (BOI) were classif ... Full text Link to item Cite

Fecal leukocytes in stool specimens submitted for Clostridium difficile toxin assay.

Journal Article Diagn Microbiol Infect Dis · 1993 To determine their diagnostic utility, fecal leukocytes were sought by methylene blue stain in 502 consecutive stool specimens submitted for Clostridium difficile toxin assay. In addition, the stability of fecal leukocytes was assessed by daily examination ... Full text Link to item Cite