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Human studies have often found that brain regions rich in glucocorticoid receptors exhibit smaller volume in samples with past trauma and ongoing stress; however, relatively little research has addressed the hypothesis that such smaller volumes can be traced to elevated circulating glucocorticoid hormones (GCs). This issue takes on renewed interest in light of recent proposals to treat symptoms of stress disorders such as posttraumatic stress disorder (PTSD) with exogenous synthetic GCs. We sought to examine the relation of circulating GCs to brain macrostructure among veterans with and without PTSD.

•Neurobiological research indicates cannabis as possible pharmacological intervention for PTSD.•CBD and THC+CBD modulate fear memory in rodents.•Experimental data suggest CBD has acute anti-depressive and anxiolytic effects.•Data suggest THC reduces nightmares and OSA, while THC+CBD could reduce insomnia.•Randomized placebo-controlled human trials of cannabinoids for PTSD are underway.

A cardinal feature of posttraumatic stress disorder (PTSD) is decreased sleep quality. Anxiety sensitivity (AS) is one factor that has shown early theoretical and empirical promise in better understanding the relation between sleep quality and PTSD outcomes. The current study is the first to test the independent and interactive effects of sleep quality and AS on PTSD symptoms. Consistent with hypotheses, AS and sleep quality were found to be independent and interactive predictors of PTSD symptom severity in our sample of male military veterans seeking treatment for PTSD. Slope analyses revealed that AS was differentially related to PTSD symptom severity as a function of quality of sleep. The veterans with good sleep quality and relatively lower levels of AS had the lowest level of PTSD symptoms, whereas the veterans with poor sleep quality and low AS evidenced severity of PTSD symptoms similar to those with high AS.

More than 70 million people in the United States experience primary insomnia (PI) at some point in their life, resulting in an estimated $65 billion in health care costs and lost productivity. PI is therefore one of the most common health care problems in the United States. To mollify the negative effects of PI, scholars have sought to evaluate and improve treatments of this costly health care problem. A breadth of research has demonstrated that cognitive behavioral therapy (CBT) is an effective intervention for PI. The goal of this article is to provide an overview of CBT for PI, including evidence regarding treatment efficacy, effectiveness, and practitioner considerations.

Traumatic event exposure and subsequent posttraumatic stress have been linked to increased use of various substances among adults. Relatively less is known about this linkage among youth, despite high rates of traumatic event exposure and substance use within this population. To address this gap, the current review presents a detailed summary and critical analysis of the empirical literature focused on the co-occurrence of traumatic event exposure, posttraumatic stress, and substance use among youth. The evidence suggests that multiple types of substance use are highly related to exposure to a traumatic event and posttraumatic stress reactions among youth. Relatively little is known about the directionality or specificity of this relation, and additional research on factors that affect or account for this association is needed. Critical challenges of this literature, as well as specific recommendations for future research, are discussed.