Recent neuroimaging work suggests that increased amygdala responses to emotional stimuli and dysfunction within regions mediating top down attentional control (dorsomedial frontal, lateral frontal parietal cortices) may be associated with the emergence of anxiety disorders, including posttraumatic stress disorder (PTSD). This report examines responsiveness recruitment attention systems as a function task demands in population U.S. military service members who had recently returned from...

Burnout is prevalent in residency training and practice linked to medical error suboptimal patient care. However, little known about how burnout affects clinical reasoning, which essential safe effective The aim of this study was examine modulates brain activity during reasoning physicians. Using functional Magnetic Resonance Imaging (fMRI), assessed internal medicine residents (n=10) board-certified internists (faculty, n=17) from the Uniformed Services University (USU) while they answered...

Subthreshold posttraumatic stress disorder (PTSD) has garnered recent attention because of the significant distress and functional impairment associated with symptoms as well increased risk progression to full PTSD. However, clinical presentation subthreshold PTSD can vary widely therefore is not clearly defined, nor there an evidence-based treatment approach. Thus, we aim further understanding by reporting use a virtual combat environment in eliciting distinctive psychophysiological...

The shift toward a patient-centered and whole health care model offers promising approach for the management of symptoms among veterans with chronic multisymptom illness (CMI). A behavioral intervention aimed at reducing cognitive control dysregulation which is component impairments common CMI may be helpful. Therefore, pilot study was conducted to explore feasibility, safety, acceptability telehealth mental physical (MAP) training CMI. Utilizing two-arm randomized trial, participants were...

Functional magnetic resonance imaging (fMRI) is helping us better understand the neurologic pathways involved in posttraumatic stress disorder (PTSD). We previously reported that military service members with PTSD after deployment to Iraq or Afghanistan demonstrated significant improvement, normalization, fMRI-measured activation of amygdala, prefrontal cortex and anterior cingulate gyrus following exposure therapy for PTSD. However, our original study design did not include repeat scans...

Post traumatic stress disorder (PTSD) symptoms are common in military service members (SMs), but stigma can impede treatment initiation. Smartphone applications (apps) available anywhere, anytime, with the potential to both mitigate impact of and reduce PTSD symptom severity. We provided 144 SMs or family members, subthreshold (PTSD Checklist [PCL] scores 28-49), apps promoting psychoeducation, social engagement, relaxation randomized them 6 weeks resilience enhancement (brief...

Mild traumatic brain injury (mTBI) has been firmly associated with disrupted white matter integrity due to induced damage and degeneration. However, comparatively less is known about the changes of intrinsic functional connectivity mediated via neural synchronization in after mTBI. Moreover, despite presumed link between structural connectivity, no existing studies mTBI have demonstrated clear association abnormality axons disruption synchronization. To investigate these questions, we...

Objective: Military service members (SMs) with subthreshold combat-related post-traumatic stress disorder (PTSD) symptoms often have clinically significant functional impairment, even though they do not meet full PTSD criteria. We therefore assessed the psychophysical responses of SMs, upon their return from Afghanistan or Iraq, to a fear conditioning paradigm better understand biological underpinnings symptom severity. Methods: Heart rate (HR), skin conductance, electromyography startle,...

Posttraumatic stress disorder (PTSD) is a significant health concern for U.S. military service members (SMs) returning from Afghanistan and Iraq. Early intervention to prevent chronic disability requires greater understanding of subthreshold PTSD symptoms, which are associated with impaired physical health, mental risk delayed onset PTSD. We report comparison physiologic responses recently deployed SMs high low respectively, fear conditioning task novel virtual reality paradigm (Virtual...

Understanding clinical reasoning is essential for patient care and medical education. Dual-processing theory suggests that nonanalytic an aspect of expertise; however, assessing challenging because it believed to occur on the subconscious level. This assumption makes concurrent verbal protocols less reliable assessment tools.Functional magnetic resonance imaging was used explore neural basis in internal medicine interns (novices) board-certified staff internists (experts) while completing...

Skilled individuals demonstrate a spatially localized or relatively lower response in brain activity characterized as neural efficiency when performing within their domain of expertise. Elite athletes are experts chosen sport and thus must be not only adept the motor but resilient to under stress high-level competition. Such stability performance suggests this population processes emotion mental an adaptive efficient manner. This study sought determine if with history successful...

Diagnostic reasoning involves the thinking steps up to and including arrival at a diagnosis. Dual process theory posits that physician's is based on both non-analytic or fast, subconscious analytic slower, more conscious, effortful characterized by comparing contrasting alternatives. Expertise in clinical may relate two dimensions measured diagnostic inventory (DTI): memory structure flexibility thinking.Explored functional magnetic resonance imaging (fMRI) correlates of these aspects DTI:...

Posttraumatic stress disorder (PTSD) symptoms can result in functional impairment among service members (SMs), even those without a clinical diagnosis. The variability outcomes may be related to underlying catecholamine mechanisms. Individuals with PTSD tend have elevated basal levels, though less is known regarding responses trauma-related stimuli. We assessed whether virtual combat environment impact the relationship between symptom clusters and elements of functioning. Eighty-seven...

Background: Studies of resident fatigue and performance have shown mixed results. However, research has not examined daytime sleepiness among attending physicians. The purpose this study was to explore the relationship between sleep, prefrontal cortex (PFC) activity. We hypothesized that scores would negatively correlate with multiple-choice question (MCQ) also PFC

Posttraumatic stress disorder (PTSD) is linked with adverse health outcomes, and many military service members (SMs) are afflicted it after they return from combat. Since SMs have an initial honeymoon period characterized by limited symptoms before the onset of full-blown PTSD, identification independent predictors PTSD upon deployment could facilitate early intervention. We measured psychophysiologic responses to stimuli including explosions in a Virtual Iraq/Afghanistan environment, as...

The objective of this research project is the identification a physiological prodrome post-traumatic stress disorder (PTSD) that has reliability could justify preemptive treatment in sub-syndromal state. Because abnormalities event-related potentials (ERPs) have been observed fully expressed PTSD, possible utility abnormal ERPs predicting delayed-onset PTSD was investigated. were recorded from military service members recently returned Iraq or Afghanistan who did not meet diagnostic criteria...

The relationships between the anatomical representation of semantic knowledge in human brain and timing neurophysiological mechanisms involved manipulating such information remain unclear. This is case for superordinate categorization-the extraction general features shared by broad classes exemplars (e.g., living vs. non-living categories). We proposed that, because abstract nature this information, input from diverse modalities (visual or auditory, lexical non-lexical) should converge be...