Apolipoprotein E Isoform-specific changes related to stress and trauma exposure.

Post-Traumatic Stress Disorder (PTSD) is a highly prevalent mental health disorder. Due to the high level of variability in susceptibility and severity, PTSD therapies are still insufficient. In addition to environmental exposures, genetic risks play a prominent role and one such factor is apolipoprotein E.

Experiencing Mental Illness: Suffering, Hope, and Healing.

The experience of mental illness can be painful and isolating for those suffering in silence. Early symptoms frequently are confusing and disorienting for individuals and families, and stigma towards mental illness in societies across the globe contributes to further isolation from sources of support during the healing process. The evocative personal stories from a variety of cultures in this symposium provide a window into universal elements of the experience of mental illness, with the accompanying fear, shame, and stigma.

Aging, Depression, and Wisdom: A Pilot Study of Life-Review Intervention and PTSD Treatment With Two Groups of Vietnam Veterans.

Vietnam War veterans are a sometimes overlooked subgroup of the aging baby boomer generation. Forty years after the war ended, war veterans still seek out VA or Vet Center counselors to assist with traumatic stress symptoms. However, there currently are no specific age-related protocols for treating older war veterans suffering from posttraumatic stress disorder (PTSD), nor have established PTSD interventions incorporated gerontology content for these older trauma survivors.

The influence of developmental, education, and mentorship experiences on career paths in cultural psychiatry.

Career paths in cultural psychiatry and other areas of medicine often are influenced by a combination of developmental, academic and training experiences. One of the satisfactions for the cultural psychiatrist is the opportunity to integrate lifelong interests that are not central to medical training, such as anthropology, philosophy, history or geography into one's daily work and career path, and this is not necessarily just applicable to clinical work or research. A background in social sciences can be very helpful in navigating the political and interpersonal challenges of working in an academic medical center or designing effective education programs across the career spectrum in medicine.

Central American victims of gang violence as asylum seekers: the role of the forensic expert.

Individuals fleeing persecution have the right to asylum. This most fundamental right was guaranteed by the 1951 United Nations (UN) Convention Relating to the Status of Refugees and was implemented in the 1967 UN protocol regarding refugee status. The United States codified refugee protection and the procedures for asylum in the Refugee Act of 1980, which was made part of the Immigration and Nationality Act (INA).

Imagery rehearsal therapy for posttraumatic nightmares in U.S. veterans.

Imagery rehearsal therapy (IRT) may help reduce residual nightmares and posttraumatic stress disorder (PTSD) symptoms in veterans after trauma-focused PTSD treatment. Fifteen male U.S.

Cross-cultural psychiatric residency training: the Oregon experience.

Objective: The purpose of this article is to describe the goals and structure of cross-cultural psychiatric training at Oregon Health and Science University (OHSU). This training in core knowledge, skills, and attitudes of cultural psychiatry over the past three decades has included medical students, residents, and fellows, along with allied mental health personnel. The curriculum includes both didactic sessions devoted to core topics in the field and varied clinical experiences in community settings and the Intercultural Psychiatric Program under the supervision of experienced academic faculty.

High prevalence rates of diabetes and hypertension among refugee psychiatric patients.

There is increasing evidence that immigrants and traumatized individuals have elevated prevalence of medical disease. This study focuses on 459 Vietnamese, Cambodian, Somali, and Bosnian refugee psychiatric patients to determine the prevalence of hypertension and diabetes. The prevalence of hypertension was 42% and of diabetes was 15.

Our favorite tips for interviewing veterans.

Like many mental health patients, veterans often come to psychiatrists with their defenses raised by past experience with caregivers whom they perceive as lacking in understanding. Although health care professionals' own veteran and combat status sometimes can afford instant credibility, not all providers have wartime experience to use in developing rapport with their patients. To connect rapidly and effectively with their sometimes suspicious patients, they must find other ways to speed rapport.

Pharmacologic reduction of CNS noradrenergic activity in PTSD: the case for clonidine and prazosin.

This article reviews the neurobiologic rationale for and presents clinical guidance concerning the use of medications that reduce central nervous system noradrenergic activity in the treatment of intrusive symptoms of posttraumatic stress disorder. The authors reviewed neurobiological studies, nonclinical studies using animal models, clinical case reports, open-label drug studies, and blinded, placebo-controlled drug studies. This review of the basic science and clinical literature, and the authors' clinical experience with culturally and demographically diverse populations, indicate that clonidine and prazosin can play a useful role in treating sleep disturbance and hyperarousal in posttraumatic stress disorder, with minimal adverse effects and low financial cost.

Religion and spirituality in psychiatric care: looking back, looking ahead.

Cultural psychiatry has been an important contributor to the enhanced dialogue between psychiatry and religion in the past couple of decades. During this time, religion and spirituality have become more prominent in mainstream psychiatry in a number of areas of study and clinical care, including refugee and immigrant health, trauma and loss, psychotherapy, collaboration with clergy, bioethics, and psychiatric research. In looking towards the future, there is a great deal of promise for future enhancement of the study of religion and spirituality in psychiatric education, research, and clinical care.

Cultural considerations in the criminal law: the sentencing process.

In forensic psychiatry, there is increasing recognition of the importance of culture and ethnicity in the criminal justice process as the population becomes more culturally diverse. However, there has been little consideration of the role of cultural factors in the trial process for criminal defendants, particularly in the sentencing phase of trial. Using a capital murder case study, this article explores the role of cultural forensic psychiatric consultation, focusing on the sentencing phase of trial as the place where the full scope and power of a cultural evaluation can be brought most effectively to the attention of the court.

A ten-year treatment outcome study of traumatized Cambodian refugees.

The purpose of this study was to assess treatment outcome among 23 severely traumatized Cambodian refugee patients with posttraumatic stress disorder who had been in continuous treatment for 10 or more years. Primary outcome parameters were symptom severity, social and vocational disability, and subjective quality of life. All patients were interviewed using standard assessment tools by a research psychiatrist not connected with the treatment, and charts were reviewed for past and current traumas and for treatment history.