Shawn D Youngstedt1,2, Christopher E Kline3, Alexandria M Reynolds4, Shannon K Crowley5, James B Burch6, Nidha Khan7, SeungYong Han1. 1. Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004, USA. 2. Phoenix VA Health Care System, Phoenix, AZ 85012, USA. 3. Department of Health and Human Development, Research Service, University of Pittsburgh, Pittsburgh, PA 15261, USA. 4. Department of Psychology, University of Virginia's College at Wise, Wise, VA 24293, USA. 5. Department of Exercise Science, Department of Health Promotion, North Carolina Wesleyan College, Rocky Mount, NC 27804, USA. 6. Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA. 7. Department of Environmental Health Sciences, University of South Carolina, Columbia, SC 29208, USA.
Abstract
INTRODUCTION: Post-traumatic stress disorder (PTSD) is a prevalent consequence of combat with significant associated morbidity. Available treatments for PTSD have had limitations, suggesting a need to explore alternative or adjuvant treatments. Numerous rationales for bright light treatment of PTSD include its benefits for common PTSD comorbidities of depression, anxiety, and circadian misalignment and its relative ease of use with few side effects. The primary aims of this research were to examine the effects of bright light treatment for combat-related PTSD and associated morbidity. MATERIALS AND METHODS: A randomized controlled trial was performed in N = 69 veterans with PTSD attributable to combat in Afghanistan and/or Iraq. Following a 1-week baseline, participants were randomized to 4 weeks of daily morning bright light treatment (10,000 lux for 30 min/day) or a control treatment (inactivated negative ion generator). At baseline and at the end of treatment, participants were rated blindly on the Clinician Assessed PTSD Scale (CAPS), the Clinical Global Impressions Scale (CGI), and the Hamilton Depression Scale and rated themselves on the PTSD Checklist-Military (PCL-M). Following baseline and each treatment week, participants completed self-reported scales of state anxiety, depression, and sleep, and sleep and the circadian rhythm of wrist activity were also assessed with wrist actigraphy. RESULTS: Compared with the control treatment, bright light elicited significantly greater improvements in the CAPS and CGI-Improvement. The bright light also elicited a significantly greater rate of treatment response (reduction ≥33%) for the CAPS (44.1% vs. 8.6%) and PCL-M (33% vs. 6%), but no participant had remission from PTSD. Changes in depression, anxiety, and sleep did not differ between treatments. Improvement in CAPS was significantly correlated with a phase advance of the circadian rhythm of wrist activity. CONCLUSIONS: The most comprehensive study on the topic to date indicated significant short-term efficacy of bright light treatment on the primary variables (CAPS and CGI) with clinical relevance (i.e., treatment response) in veterans with chronic PTSD who did not report extremely high habitual light exposure. No significant effects were found for anxiety, depression, or sleep disturbance. Further research is warranted, particularly exploration of circadian phase-shifting mechanisms of bright light for PTSD. Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2021. This work is written by (a) US Government employee(s) and is in the public domain in the US.
INTRODUCTION: Post-traumatic stress disorder (PTSD) is a prevalent consequence of combat with significant associated morbidity. Available treatments for PTSD have had limitations, suggesting a need to explore alternative or adjuvant treatments. Numerous rationales for bright light treatment of PTSD include its benefits for common PTSD comorbidities of depression, anxiety, and circadian misalignment and its relative ease of use with few side effects. The primary aims of this research were to examine the effects of bright light treatment for combat-related PTSD and associated morbidity. MATERIALS AND METHODS: A randomized controlled trial was performed in N = 69 veterans with PTSD attributable to combat in Afghanistan and/or Iraq. Following a 1-week baseline, participants were randomized to 4 weeks of daily morning bright light treatment (10,000 lux for 30 min/day) or a control treatment (inactivated negative ion generator). At baseline and at the end of treatment, participants were rated blindly on the Clinician Assessed PTSD Scale (CAPS), the Clinical Global Impressions Scale (CGI), and the Hamilton Depression Scale and rated themselves on the PTSD Checklist-Military (PCL-M). Following baseline and each treatment week, participants completed self-reported scales of state anxiety, depression, and sleep, and sleep and the circadian rhythm of wrist activity were also assessed with wrist actigraphy. RESULTS: Compared with the control treatment, bright light elicited significantly greater improvements in the CAPS and CGI-Improvement. The bright light also elicited a significantly greater rate of treatment response (reduction ≥33%) for the CAPS (44.1% vs. 8.6%) and PCL-M (33% vs. 6%), but no participant had remission from PTSD. Changes in depression, anxiety, and sleep did not differ between treatments. Improvement in CAPS was significantly correlated with a phase advance of the circadian rhythm of wrist activity. CONCLUSIONS: The most comprehensive study on the topic to date indicated significant short-term efficacy of bright light treatment on the primary variables (CAPS and CGI) with clinical relevance (i.e., treatment response) in veterans with chronic PTSD who did not report extremely high habitual light exposure. No significant effects were found for anxiety, depression, or sleep disturbance. Further research is warranted, particularly exploration of circadian phase-shifting mechanisms of bright light for PTSD. Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2021. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Authors: David P Cenkner; Helen J Burgess; Brooke Huizenga; Elizabeth R Duval; Hyungjin Myra Kim; K Luan Phan; Israel Liberzon; Heide Klumpp; James Abelson; Adam Horwitz; Ann Mooney; Greta B Raglan; Alyson K Zalta Journal: PLoS One Date: 2022-06-08 Impact factor: 3.752
Authors: Michelle Rissling; Lianqi Liu; Shawn D Youngstedt; Vera Trofimenko; Loki Natarajan; Ariel B Neikrug; Neelum Jeste; Barbara A Parker; Sonia Ancoli-Israel Journal: Front Neurosci Date: 2022-03-09 Impact factor: 4.677
Authors: Jonathan E Elliott; Alisha A McBride; Nadir M Balba; Stanley V Thomas; Cassandra L Pattinson; Benjamin J Morasco; Andrea Wilkerson; Jessica M Gill; Miranda M Lim Journal: PLoS One Date: 2022-04-14 Impact factor: 3.752
Authors: John R Vanuk; Edward F Pace-Schott; Ayla Bullock; Simon Esbit; Natalie S Dailey; William D S Killgore Journal: Front Behav Neurosci Date: 2022-09-12 Impact factor: 3.617
Authors: Shelby L Langer; Felipe González Castro; Angela Chia-Chen Chen; Kelly Cue Davis; Rodney P Joseph; Wonsun Sunny Kim; Linda Larkey; Rebecca E Lee; Megan E Petrov; Elizabeth Reifsnider; Shawn D Youngstedt; Gabriel Q Shaibi Journal: Public Health Nurs Date: 2021-07-08 Impact factor: 1.462