Purpose of Review Since 1980, posttraumatic stress (PTS) disorder has been controversial because of its origin as a social construct, its discriminating trauma definition, and the Procrustean array of symptoms/clusters chosen for inclusion/ exclusion. This review summarizes the history of traumarelated nosology and proposed changes, within current categorical models (trauma definitions, symptoms/clusters, subtypes/ specifiers, disorders) and new models. Recent Findings Considering that trauma is a risk factor for virtually all mental disorders (particularly depressive, anxiety, dissociative, personality), the multi-finality of trauma (some survivors are resilient, and some develop PTS and/or non-PTS symptoms), and the various symptoms that trauma survivors express (mood, cognitive, perceptual, somatic), it is difficult to classify PTS. Summary Because the human mind best comprehends categories, reliable classification generally necessitates using a categorical nosology but PTS defies categories (internalizing and/or externalizing, fear-based and/or numbing symptoms), the authors conclude that PTS-like DSM-5' s panic attacks specifier-is currently best conceptualized as a specifier for other mental disorders.

Many US military families have faced separations of at least 1 family member for extended periods of time. This article shows how changes in military culture have increased the repercussions for military families, and especially for military-connected children. This article provides an introduction to aspects of military culture that are most applicable to children, an overview of important aspects of childhood development, a discussion of the impact of deployment on the emotional development and behavior of children left at home and their caregivers, and a review of some interventions and resources available to help these families navigate these challenges.

Military child and adolescent psychiatry (CAP) fellowship programs offer educational experiences universal to all civilian training programs in the USA. They also offer unique training opportunities not found in civilian CAP fellowships in order to prepare graduates to serve the needs of military families. Military-specific curricula and exposures prepare trainees to address various issues faced by military families, in contending with frequent military moves, parental deployments, and disrupted social ties. Curricula are also designed to provide the psychiatrist with a greater understanding of the rigors of military service. CAP training and subsequent assignments prepare military psychiatrists for diverse career paths in the military environment. CAP military careers often include duties in addition to treating patients. Administrative roles, academic teaching positions, as well as school consultation positions are all career options available to military CAP.

Previous studies have demonstrated that catecholaminergic, tyrosine hydroxylase (TH)-immunoreactive (IR) perikarya and fibers are widely distributed in the human hypothalamus. Since TH is the key and rate-limiting enzyme for catecholaminergic synthesis, these IR neurons may represent dopaminergic, noradrenergic or adrenergic neural elements. However, the distribution and morphology of these neurotransmitter systems in the human hypothalamus is not entirely known. Since the different catecholaminergic systems can be detected by identifying the neurons containing the specific key enzymes of catecholaminergic synthesis, in the present study we mapped the catecholaminergic elements in the human hypothalamus using immunohistochemistry against the catecholaminergic enzymes, TH, dopamine beta-hydroxylase (DBH) and phenylethanolamine-N-methyltransferase (PNMT). Only a few, PNMT-IR, adrenergic neuronal elements were found mainly in the infundibulum and the periventricular zone. DBH-IR structures were more widely distributed in the human hypothalamus occupying chiefly the infundibulum/infundibular nucleus, periventricular area, supraoptic and paraventricular nuclei. Dopaminergic elements were detected by utilizing double label immunohistochemistry. First, the DBH-IR elements were visualized; then the TH-IR structures, that lack DBH, were detected with a different chromogen. In our study, we conclude that all of the catecholaminergic perikarya and the majority of the catecholaminergic fibers represent dopaminergic neurons in the human hypothalamus. Due to the extremely small number of PNMT-IR, adrenergic structures in the human hypothalamus, the DBH-IR fibers represent almost exclusively noradrenergic neuronal processes. These findings suggest that the juxtapositions between the TH-IR and numerous peptidergic systems revealed by previous reports indicate mostly dopaminergic synapses.

Previous studies revealed that growth hormone-releasing hormone (GHRH)-immunoreactive (IR) neurons form a circumscribed cell group in the basal infundibulum/median eminence of the human hypothalamus. GHRH from these neurons is released into the hypothalamo-hypophyseal portal circulatory system in a pulsatile manner. It is a common consensus that the pulsatile release of GHRH is the main driving force behind the pulsatile release of growth hormone (GH) and may contribute to the regulation of other hypothalamic functions. The pulsatile release of GHRH requires synchronized activity of GHRH-IR neurons. However, the morphological basis of this synchronization between the GHRH-IR neural elements has not been elucidated yet.Since the utilization of electron microscopy combined with immunohistochemistry is virtually impossible in the human brain due to the long post mortem period, immunohistochemistry, evaluated with oil immersion light microscopy, was used in order to reveal the associations between the GHRH elements. Numerous GHRH-GHRH juxtapositions have been detected in the infundibular area/median eminence, where GHRH-IR axonal varicosities often formed multiple contacts with GHRH-IR perikarya. Examination of these associations with high magnification oil immersion light microscopy revealed (1) axonal swellings at the site of the contacts and (2) no gaps between the contacting elements suggesting that these juxtapositions may be functional synapses. The large number of GHRH-GHRH juxtapositions in the infundibular area/median eminence suggests that these synapse-like structures may represent the morphological substrate of the synchronized activity of GHRH neurons that in turn may result in the pulsatile release of GHRH in human. (C) 2010 Growth Hormone Research Society Published by Elsevier Ltd. All rights reserved.