Katharina Schultebraucks

Katharina Schultebraucks
Columbia University | CU · Emergency Medicine Center of Excellence

PhD

About

62
Publications
9,231
Reads
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601
Citations
Introduction
Katharina Schultebraucks applies machine learning to capture the high-dimensionality of candidate predictive models for clinical outcomes. In particular, she is investigating naturalistic, longitudinal and prospective studies to identify complex sets of early predictors. She developed predictive models for PTSD using data routinely collected in the Emergency Room. In addition, she worked on a project to identify risk factors in high risk populations such as veterans of the US military deployed to Afghanistan or United Nations workforce from around the world. And she is using advanced machine learning methods, such as deep learning to identify transdiagnostic multi-model markers of maladaptive stress response using digital phenotyping.
Additional affiliations
August 2019 - present
Columbia University
Position
  • Managing Director
November 2017 - August 2019
NYU Langone Medical Center
Position
  • PostDoc Position
Description
  • Two-year Deutsche Forschungsgemeinschaft (DFG) Research Fellowship (SCHU 3259/1-1); project number: 387444691
March 2014 - October 2017
Charité Universitätsmedizin Berlin
Position
  • PhD Student

Publications

Publications (62)
Article
Posttraumatic stress disorder (PTSD) is prevalent and associated with significant morbidity. Mild traumatic brain injury (mTBI) concurrent with psychiatric trauma may be associated with PTSD. Prior studies of PTSD‐related structural brain alterations have focused on military populations. The current study examined correlations between PTSD, acute m...
Article
Full-text available
Background: The COVID-19 pandemic has resulted in over 6 million deaths worldwide as of March 2022. Adverse psychological effects on patients and the general public linked to the pandemic have been well documented. Methods: We conducted a retrospective analysis of adult emergency department (ED) encounters with diagnoses of anxiety, depression,...
Article
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Post-traumatic stress disorder (PTSD) is a protracted and debilitating consequence of traumatic events. Identifying early predictors of PTSD can inform the disorder’s risk stratification and prevention. We used advanced computational models to evaluate the contribution of early neurocognitive performance measures to the accuracy of predicting chron...
Article
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A considerable number of depressed patients do not respond to treatment. Accurate prediction of non-response to routine clinical care may help in treatment planning and improve results. A longitudinal sample of N = 239 depressed patients was assessed at admission to multi-modal day clinic treatment, after six weeks, and at discharge. First, patient...
Chapter
The extensive use of smart technology (smart phones and wearables) and vast amount of information they contain has positioned remote devices and technology as providing a massive database for behavioral, personal, and social day-to-day activities. Harnessing smart devices into the clinical field has introduced new, real-time data sources that hold...
Article
Full-text available
Intrusive memories are a hallmark symptom of post-traumatic stress disorder (PTSD) and oxytocin has been implicated in the formation of intrusive memories. This study investigates how oxytocin influences the acquisition and consolidation of trauma-associated memories and whether these effects are influenced by individual neurobiological and genetic...
Article
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Active-duty Army personnel can be exposed to traumatic warzone events and are at increased risk for developing post-traumatic stress disorder (PTSD) compared with the general population. PTSD is associated with high individual and societal costs, but identification of predictive markers to determine deployment readiness and risk mitigation strategi...
Article
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Women are at higher risk for developing posttraumatic stress disorder (PTSD) compared to men, yet little is known about the biological contributors to this sex difference. One possible mechanism is differential immunological and neuroendocrine responses to traumatic stress exposure. In the current prospective study, we aimed to identify whether sex...
Article
Background Emergency department (ED) crowding is associated with numerous healthcare issues, but little is known about its effect on psychosocial aspects of patient-provider interactions or interpersonal care . We examined whether ED crowding was associated with perceptions of interpersonal care in patients evaluated for acute coronary syndrome (AC...
Article
Biomarkers that predict symptom trajectories after trauma can facilitate early detection or intervention for posttraumatic stress disorder (PTSD) and may also advance our understanding of its biology. Here, we aimed to identify trajectory-based biomarkers using blood transcriptomes collected in the immediate aftermath of trauma exposure. Participan...
Article
Importance Major life stressors, such as loss and trauma, increase the risk of depression. It is known that individuals show heterogeneous trajectories of depressive symptoms following major life stressors, including chronic depression, recovery, and resilience. Although common genetic variation has been associated with depression risk, genomic fac...
Article
Full-text available
The necessary requirement of a traumatic event preceding the development of Posttraumatic Stress Disorder, theoretically allows for administering preventive and early interventions in the early aftermath of such events. Machine learning models including biomedical data to forecast PTSD outcome after trauma are highly promising for detection of indi...
Article
Digital health technologies are advancing characterization of mental health and functioning using objective, sensitive, and scalable tools for measurement of disease. These efforts directly address well-documented issues with traditional clinical assessments of psychiatric functioning, which can be burdensome, subjective, and insensitive to change....
Article
Posttraumatic stress disorder (PTSD) is a condition characterized by symptom heterogeneity and persistent avoidance patterns. These characteristics hinder the identification of candidates for early intervention and identification of treatment recommendations appropriate for an individual person’s needs. Moreover, treatment barriers (particularly in...
Article
Personalized medicine has led to important discoveries and medical innovations. For the successful trans-lation of that progress into precision psychiatry, the complexity of mental illness and its underpinning mecha-nisms must be considered, and da-ta-driven approaches are needed. Computational approaches such as machine learning are important driv...
Article
Full-text available
Background: Adverse childhood experiences (ACE) are associated with an increased risk of major depressive disorder (MDD) and hypothalamic-pituitary-adrenal (HPA) axis dysregulation. Within the HPA axis, corticotropin-releasing hormone and vasopressin (AVP) synergistically stimulate the release of adrenocorticotropic hormone, which promotes cortisol...
Article
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Background: Alterations in multiple domains of cognition have been observed in individuals who have experienced a traumatic stressor. These domains may provide important insights in identifying underlying neurobiological dysfunction driving an individual's clinical response to trauma. However, such assessments are burdensome, costly, and time-cons...
Article
Personalized medicine is among the most exciting innovations in recent clinical research, offering the opportunity for tailored screening and management at the individual level. Biomarker-enriched clinical trials have shown increased efficiency and informativeness in cancer research due to the selective exclusion of patients unlikely to benefit. In...
Article
Posttraumatic stress disorder (PTSD) is a debilitating disease that can occur after experiencing a traumatic event. Despite recent progress in computational research, it has not yet been possible to identify precise and reliable risk factors that enable predictive models of individual risk for posttraumatic stress after trauma. In this overview, we...
Article
Background Visual and auditory signs of patient functioning have long been used for clinical diagnosis, treatment selection, and prognosis. Direct measurement and quantification of these signals can aim to improve the consistency, sensitivity, and scalability of clinical assessment. Currently, we investigate if machine learning-based computer visio...
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Full-text available
Annually, approximately 30 million patients are discharged from the emergency department (ED) after a traumatic event1. These patients are at substantial psychiatric risk, with approximately 10–20% developing one or more disorders, including anxiety, depression or post-traumatic stress disorder (PTSD)2–4. At present, no accurate method exists to pr...
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Diagnosing autism spectrum disorders (ASD) is a complicated, time-consuming process which is particularly challenging in older individuals. One of the most widely used behavioral diagnostic tools is the Autism Diagnostic Observation Schedule (ADOS). Previous work using machine learning techniques suggested that ASD detection in children can be achi...
Article
Full-text available
Purpose of Review Stroke is a devastating event that annually affects over 800,000 million individuals in the USA and is associated with significant individual and social costs. In this narrative review, we summarize current evidence regarding post-traumatic stress disorder (PTSD) following acute stroke. Recent Findings In addition to the long-ter...
Article
Full-text available
Background United Nations (UN) personnel address a diverse range of political, social, and cultural crises throughout the world. Compared with other occupations routinely exposed to traumatic stress, there remains a paucity of research on mental health disorders and access to mental healthcare in this population. To fill this gap, personnel from UN...
Article
Objective: The Fort Campbell Cohort study was designed to assess predeployment biological and behavioral markers and build predictive models to identify risk and resilience for posttraumatic stress disorder (PTSD) following deployment. This article addresses neurocognitive functioning variables as potential prospective predictors. Method: In a s...
Article
Objectives: Survivors of acute cardiovascular disease events, such as acute coronary syndrome and stroke may experience significant psychological distress during and following the acute event. Long term adverse effects may follow, including the development of posttraumatic stress disorder (PTSD) and increased overall all-cause mortality and recurr...
Article
Objective: Although several reports have documented heightened systemic inflammation in posttraumatic stress disorder (PTSD), few studies have assessed whether inflammatory markers serve as prospective biomarkers for PTSD risk. The present study aimed to characterize whether peripheral immune factors measured in blood samples collected in an emerge...
Article
Full-text available
Impaired cognitive functioning constitutes an important symptom of major depressive disorder (MDD), potentially associated with elevated cortisol levels. Adverse childhood experiences (ACE) enhance the risk for MDD and can contribute to disturbances in the stress systems, including cortisol and cognitive functions. In healthy participants, cortisol...
Article
Objective: Although several reports have documented heightened systemic inflammation in posttraumatic stress disorder (PTSD), few studies have assessed whether inflammatory markers serve as prospective biomarkers for PTSD risk. The present study aimed to characterize whether peripheral immune factors measured in blood samples collected in an emerg...
Article
Some people develop symptoms of posttraumatic stress disorder (PTSD) after having experienced a traumatic event, whereas others do not. Intrusive memories are a cardinal symptom of PTSD and a better understanding of encoding and consolidation of intrusive memory may yield important insights on differences in the response to trauma. The primary aim...
Article
Full-text available
Background: Exposure to a traumatic event leads to posttraumatic stress disorder (PTSD) in 10-20% of exposed individuals. Predictors of risk are needed to target early interventions to those who are most vulnerable. The objective of the study was to test whether a noninvasive mobile device that measures a physiological biomarker of autonomic nervo...
Article
Posttraumatic stress responses are characterized by a heterogeneity in clinical appearance and etiology. This heterogeneity impacts the field's ability to characterize, predict, and remediate maladaptive responses to trauma. Machine learning (ML) approaches are increasingly utilized to overcome this foundational problem in characterization, predict...
Article
The influence of stress on executive functions has been demonstrated in numerous studies and is potentially mediated by the stress-induced cortisol release. Yet, the impact of cortisol on cognitive flexibility and task switching in particular remains equivocal. In this study, we investigated the influence of pharmacological glucocorticoid receptor...
Article
A better understanding of suicidal behavior is important to detect suicidality in at-risk populations such as patients with borderline personality disorder (BPD), posttraumatic stress disorder (PTSD), and major depressive disorder (MDD). Suicidal tendencies are clinically assessed by verbal thoughts rather than by specifically asking about mental i...
Article
Atrial natriuretic peptide (ANP) exerts anxiolytic effects in animals and humans. Patients with anxiety, trauma-associated and depressive disorders exhibit lower ANP plasma levels compared to healthy individuals. However, the role of ANP in patients with major depressive disorder (MDD) with and without concomitant adverse childhood experiences (ACE...
Article
Alterations of the hypothalamic-pituitary-adrenal (HPA) axis such as altered glucocorticoid receptor sensitivity and increased immune reactivity might contribute to the pathogenesis of major depressive disorder (MDD). Exposure to adverse childhood experiences (ACE) precipitates vulnerability to MDD and might be associated with endocrine and immune...
Article
Background: Alterations of the hypothalamic-pituitary-adrenal (HPA) axis are a prominent finding in patients with major depressive disorder (MDD). Inconsistencies regarding a hyper- or hypoactive HPA axis may be explained by the moderating effect of childhood adverse experiences (ACE) which are associated with both HPA axis dysfunction and MDD in...
Article
Adverse childhood experiences (ACE) enhance the risk for mental disorders, e.g. major depressive disorder (MDD). Increasing evidence suggests an association between ACE and impaired physical health, e.g. metabolic syndrome. The aim of this study was to assess several metabolic risk markers in healthy individuals with and without ACE and depressed p...
Article
Background: Adverse childhood experiences (ACE) increase the risk to develop major depressive disorder (MDD) and obesity or metabolic syndrome in adulthood. In addition, ACE may be associated with an exaggerated endocrine response to stress, which, in turn, may lead to enhanced food intake resulting in obesity and metabolic problems. Methods: We...
Article
Objectives: Stress hormones such as cortisol are known to influence a wide range of cognitive functions, including hippocampal based spatial memory. In the brain, cortisol acts via two different receptors: the glucocorticoid (GR) and the mineralocorticoid receptor (MR). As the MR has a high density in the hippocampus, we examined the effects of ph...
Article
Risk taking is influenced by stress, with riskier decisions after exposure to an acute stressor and consecutively elevated cortisol levels. In the brain, cortisol acts on two receptors with different functional profiles: the glucocorticoid receptor (GR) and the mineralocorticoid receptor (MR). In the current study we investigated the effect of MR s...
Article
Full-text available
Rationale Selective attention toward emotional cues and emotion recognition of facial expressions are important aspects of social cognition. Stress modulates social cognition through cortisol, which acts on glucocorticoid (GR) and mineralocorticoid receptors (MR) in the brain. Objectives We examined the role of MR activation on attentional bias tow...
Article
Primary adrenal insufficiency (AI) requires hormone replacement therapy with fludrocortisone and hydrocortisone stimulating glucocorticoid (GR) and mineralocorticoid receptors (MR). Evidence from animal and human studies shows that MR function is crucial for cognitive function and mood. Regarding patients with AI very little is known about the role...
Article
Patients with primary adrenal insufficiency (AI) need to replace glucocorticoids and mineralocorticoids that act on glucocorticoid (GR) and mineralocorticoid receptors (MR). Both receptors are highly expressed in the hippocampus and are closely associated with cognitive function, which might be impaired by insufficient or increased GR and MR stimul...

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Projects

Projects (2)
Project
Refugees have to cope with stressful situations and potential traumatic events at their home country and during the journey. These stressful situations are extreme both in frequency or duration as well as magnitude or intensity. Even after migration, refugees are exposed to a high risk of developing trauma-related disorders. The proposal aims to develop a machine learning framework to identify peri-migration risk factors that enable individual prognosis of mental health status and enables forecasting change points from prodromal to clinical symptoms. In consequence, time-to-treatment will be reduced and interventions more precisely targeted to individual needs. The proposal is of high clinical importance. It aims to facilitate individualized clinical decision-making based on available and easily collectable data. The predictive model will enable to tailor preventive measures for refugees’ specific needs, to reduce the risk of trauma disorder and to promote resilience in refugee camps.