LAUSR

The Amygdala, Stress, and Posttraumatic Stress Disorder (PTSD) Conference, often referred to simply as the Amygdala Conference, is a continuing education conference held each April at the Uniformed Services University of the Health Sciences (USUHS) and sponsored by the Center for the Study of Traumatic Stress in collaboration with the USUHS Department of Psychiatry, USUHS Neuroscience Program, USUHS Department of Family Medicine, and the Walter Reed National Military Medical Center Department of Psychiatry. This annual conference is free and open to the public, providing educational credits to a variety of clinical specialties with the goal of bringing together nationally and internationally recognized scientists and clinicians to help support the transition of high-quality science into excellent clinical care. The 11 Annual Amygdala Conference was once again an outstanding event with excellent talks by world-class scientific minds and leaders in the field. As with our previous year’s conference, we felt it vital to reach as broad an audience as possible in order to facilitate the transition of this high-quality science into excellent clinical care. In order to further our reach, we again teamed up with the Journal of Neuroscience Research. This year we have worked to create an In Focus issue related to the conference. In compiling this issue we reached out to the conference speakers, requesting they submit articles for consideration. The resulting articles speak to the outstanding nature of the conference and the high quality science done by these leaders in the field. The theme of the 11 Annual Amygdala Conference was the effect of stress and loss and our three articles in this issue delve in to important aspects of this vital health issue. The first article addresses the difficult question of grief. In particular, Simon et al. (2018) look at the loss of a fellow service member in relation to complicated grief. Complicated grief can have symtoms grouped within six-symptom clusters, including preoccupation with the deceased, anger, disbelief, estrangement, hallucinations of the deceased, and behavioral changes (Simon et al., 2011). Understandably complicated grief can be comorbid with PTSD as well as other disorders. Additionally, there is overlap in the symptoms experienced by those suffering from PTSD and complicated grief. In order to investigate this further, Simon et al. (2018) examined the effect of the loss of an important person in 204 active duty and veterans with combat-related posttraumatic stress disorder. Nearly 80% of those evaluated reported the loss of an important individual during their lives. Of these individuals, nearly half reported the loss of a fellow service member. The rate of complicated grief was highest among those reporting the loss of a fellow service member, compared to those reporting the loss of another important individual in their lives. Additionally, those with complicated grief had more severe symptoms of PTSD and higher rates of depression. This work sheds light on an under-studied area, specifically, the effect of losing a fellow combatant for those who experience the stresses of war. The remaining articles in this mini-issue come from the work of PTSD-related brain banks. The first article, by Mighdoll et al. (2018) looks at the implementation and clinical characteristics of a posttraumatic stress disorder brain-bank collection as part of a larger brain bank previously established by the Lieber Institute for Brain Development. This article walks through some of the basic methodology and mechanisms involved in setting up the new collection to include collection criteria, retrospective diagnosis assessment for PTSD, and tissue examination. Mighdoll et al. (2018) then discuss the basic characteristics of the sample and focus on the notable differences between individuals with a history of combat-related and domestic-related PTSD. The overall sample was notable for the high rate of comorbidity, with more than half the sample having depression, substance abuse, or drug related death, and nearly 1 in 5 with completed suicide. When comparing those with combat-related PTSD and domestic PTSD, Mighdoll et al. (2018) found very similar rates of co-morbid mood disorder and substance use disorder, but significantly different rates of bipolar disorder and drug related death. Individuals with combat-related PTSD had nearly zero bipolar disorder and substantially less drug related death, compared to domestic PTSD. This early work in establishing a well-characterized brain bank, inclusive of individuals with PTSD, will facilitate a great deal of work towards understanding the underlying biological mechanisms of this pervasive and complicated disorder.