Julia Golier - Academia.edu (original) (raw)

Papers by Julia Golier

This symposium examines the neurobiology of memory and dissociation in traumatized individuals. S... more This symposium examines the neurobiology of memory and dissociation in traumatized individuals. Several paradigms are presented that investigate the specific nature of differences in &amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;remembering&amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; in relation to neuroendocrine profiles among those with and without posttraumatic stress disorder (PTSD). These lines of research may help to clarify the paradox of distortion or absence of some memories and enhancement of others in PTSD.

Expert review of neurotherapeutics, 2009

Depression research and treatment, 2012

Background. We obtained pilot data to examine the clinical and neuroendocrine effects of short-te... more Background. We obtained pilot data to examine the clinical and neuroendocrine effects of short-term mifepristone treatment in male veterans with PTSD. Methods. Eight male veterans with military-related PTSD completed a randomized, double-blind trial of one week of treatment with mifepristone (600 mg/day) or placebo. The primary clinical outcome measures were improvement in PTSD symptoms and dichotomously defined clinical responder status as measured by the CAPS at one-month follow-up. Additional outcome measures included self-reported measures of PTSD symptom severity, CAPS-2 symptom subscale scores, and morning plasma cortisol and ACTH levels. Results. Mifepristone was associated with significant improvements in total CAPS-2 score. At one-month follow-up, all four veterans in the mifepristone group and one of four veterans in the placebo group achieved clinical response; three of four veterans in the mifepristone group and one of four veterans in the mifepristone group remitted. Mi...

Psychoneuroendocrinology, 2015

Background: Gulf War veterans were exposed to environmental toxins not present in other combat th... more Background: Gulf War veterans were exposed to environmental toxins not present in other combat theaters resulting in a unique biological signature that only partially resembles that seen in other combat veterans with PTSD. Thus it is important to determine if brain abnormalities seen in non-Gulf War veterans with PTSD are also present in Gulf War veterans. In this pilot study, diffusion tensor imaging (DTI) tractography was used to assess the ultra-structural integrity of fronto-limbic white matter connections in Gulf War veterans with and without PTSD. The effects of chronic multisymptom illness on DTI measures was also evaluated. Methods: Subjects were 20 previously studied Gulf War veterans on whom MRIs had been obtained. Mean diffusivity (MD) and fractional anisotropy (FA) were determined for left and right cingulum bundle by DTI tractography and compared in separate analyses for 12 veterans with, and 8 without PTSD. The effect of chronic multisymptom illness and it's interaction with PTSD, were similarly investigated using multivariate ACOVA. Partial correlations were used to test the associations of both DTI indices with PTSD severity and plasma cortisol, controlling for whole brain volume. Results: Significantly lower MD was demonstrated in the right cingulum bundle among Gulf War veterans with PTSD. There were no significant differences in MD or FA in the left cingulum bundle. The presence of chronic multisymptom illness significantly attenuated the PTSD associated decrement in right cingulum MD. Clinician and self-rated PTSD symptom severity scores were * Corresponding author at: James J. Peters VAMC -(116/A; OOMH), L.M. Bierer et al.

Psychoneuroendocrinology, 2009

Gulf War deployment has been associated with a distinct neuroendocrine profile characterized by l... more Gulf War deployment has been associated with a distinct neuroendocrine profile characterized by low 24h basal ACTH levels and enhanced cortisol and ACTH suppression to low-dose dexamethasone. The metyrapone stimulation test was performed to further characterize hypothalamic-pituitary activity in Gulf War veterans (GWV) and its relationship to unexplained medical symptoms and post-traumatic stress disorder (PTSD). Eleven GWV without PTSD, 18 GWV with PTSD and 15 healthy subjects not exposed to the Gulf War theater (non-exposed) underwent the metyrapone stimulation test, which inhibits cortisol synthesis, impairs cortisol-mediated negative feedback inhibition and in turn increases levels of ACTH and 11-deoxycortisol, a cortisol precursor. These hormones were measured at baseline (7:00 a.m.) and at intervals (from 8:00 a.m. to 4:00 p.m.) following the administration of metyrapone 750mg orally at 7:05 a.m. and at 10:05 a.m. There were group differences in the ACTH response despite similar cortisol and 11-deoxycortisol responses to metyrapone. GWV without PTSD had a significantly attenuated ACTH response compared to non-exposed subjects; GWV with PTSD had a significantly higher ACTH response than GWV without PTSD but did not differ from non-exposed subjects. Among GWV, unexplained medical health symptoms (e.g., neurological, musculoskeletal, cardiac, and pulmonary symptoms) and PTSD symptoms were significantly positively associated with the ACTH response to metyrapone. Gulf War deployment is associated with a substantially lower ACTH response to metyrapone. In contrast, unexplained health symptoms and PTSD in Gulf War veterans are associated with relatively greater hypothalamic-pituitary activity which may reflect increased CRF activity and is evident only in consideration of deployment effects. This pattern of differences suggests either that Gulf War deployment and its associated exposures results in enduring changes in pituitary function or that reduced hypothalamic-pituitary activity protects against the development of PTSD and other deployment-related health problems.

Schizophrenia Research, 1995

Psychiatric Clinics of North America, 2002

The unique constellation of symptoms that constitute post-traumatic stress disorder (PTSD) may re... more The unique constellation of symptoms that constitute post-traumatic stress disorder (PTSD) may reflect persistent alterations in attention and memory that are fundamental to this disorder. This article reviews the literature on the neuropsychology of PTSD and its relevance to phenomenological, clinical, and biological aspects of this disorder. It addresses the nature and magnitude of the neuropsychological alterations in PTSD and the extent to which they involve the processing of trauma-related or neutral stimuli. This article summarizes the types of deficits in attention and memory that have been found in a broad range of trauma survivors with PTSD and explores the extent to which the deficits may be risk factors for or consequences of trauma and PTSD. The implications of these findings for the course and pathophysiology of PTSD are also discussed.

Expert Review of Neurotherapeutics, 2009

Biological Psychiatry, 2002

Background: Because alterations in cortisol negative feedback inhibition associated with aging ar... more Background: Because alterations in cortisol negative feedback inhibition associated with aging are generally opposite of those observed in posttraumatic stress disorder (PTSD), we examined the cortisol and glucocorticoid receptor (GR) response to dexamethasone (DEX) in older trauma survivors. Methods: Twenty-three Holocaust survivors (9 men, 14 women), 27 combat veterans (all male), and 10 comparison subjects (7 men, 3 women) provided samples for plasma or salivary cortisol and glucocorticoid receptor determination in mononuclear leukocytes at 8:00 AM on the day of, and following, 0.5 mg of DEX at 11:00 PM. Results: Greater percent suppression of cortisol and lymphocyte GR was observed in older trauma survivors with PTSD compared to survivors without PTSD and comparison subjects. There was a significant main effect of depression in the direction of reduced suppression following DEX, consistent with the effects of DEX in major depressive disorder patients. Responses to DEX were uncorrelated with PTSD symptom severity, but cortisol suppression was associated with years elapsed since the most recent, but not focal, traumatic event. Conclusions: The response to DEX is generally similar in older and younger trauma survivors, but the findings suggest that age, symptom severity, and lifetime trauma exposure characteristics may influence this response.

Development and Psychopathology, 1998

This article reviews memory-related impairments in trauma survivors with posttraumatic stress dis... more This article reviews memory-related impairments in trauma survivors with posttraumatic stress disorder and their possible association to neuroendocrine alterations seen in this disorder. The neuroendocrine profile in PTSD first described in chronically ill combat veterans is characterized by lower basal cortisol levels, higher glucocorticoid receptor number, enhanced sensitivity to exogenous steroids, and increased variation in basal cortisol levels over the diurnal cycle. The generalizability and time course of these neuroendocrine alterations are explored in longitudinal studies and studies in other traumatized populations. These studies suggest that at least some aspects of this neuroendocrine profile can also be seen in other populations, including women, children, and victims of childhood trauma. Additionally, the alterations may be present early in the course of illness, perhaps even in the immediate aftermath of trauma, and may continue to be manifest in elderly trauma survivors. The mechanisms by which these neuroendocrine alterations may influence the formation and processing of traumatic memories are discussed.

The cognitive symptoms of posttraumatic stress disorder (PTSD) in general and the reexperiencing ... more The cognitive symptoms of posttraumatic stress disorder (PTSD) in general and the reexperiencing symptoms in particular may result from a failure to correctly identify the source of traumatic memories. For instance, the reexperiencing symptoms, such as flashbacks or intrusive thoughts, consist of retrieved memory information that is incorrectly interpreted as currently taking place. A consistent tendency towards confusion of information from different sources could also lead to anticipatory anxiety. Thus, poor ability to monitor the source of information in memory could correlate with the presence of PTSD. The goal of this study was to examine whether the symptoms of PTSD can be conceptualized as a special case of source monitoring failure. Source monitoring refers to the set of processes involved in making attributions about the origins of knowledge or memories.' The spatial and temporal context in which the memory was acquired and the modalities in which it was received are among the characteristics of the source. According to the source monitoring model, the source of a memory is attributed to it through a decision-making process performed during remembering.' The present study examines the hypothesis that PTSD symptoms should correlate with poor source monitoring and also examines the influence of general versus personally relevant traumatic information on performance.

Depression and Anxiety, 2001