Psychological Trauma

PTSD and Recovery 

Title: Reflections of an experiential feminist therapist.
Author(s): Hill, Marcia, Private practice, Montpelier, VT
Source: Women & Therapy, Vol 5(1), Spr 1986. Special issue: A woman's recovery from the trauma of war. pp. 27-32
Publisher: US: Haworth Press
Abstract: Describes reactions of a feminist therapist to the case
of an alcoholic woman suffering from posttraumatic stress disorder due to her experiences as a military nurse in Vietnam (see record 1987-34515-001). The importance of the S's current experiences is emphasized over personal history and symptom data in the S's records.
Other issues that must be faced by the therapist include identification of painfully withheld emotions, the S's style of interpersonal and intrapersonal relations, and the need to overcome attempts to negate or dismiss painful experiences. It is concluded that feminist therapy is not a technique or theory, but a stance of respect in relations with the patient. (0 ref)
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Title: A piece of the world: Some thoughts about Ruth.
Author(s): Klein, Binnie C.
Source: Women & Therapy, Vol 5(1), Spr 1986. Special issue: A woman's recovery from the trauma of war. pp. 33-40.
Publisher: US: Haworth Press
Abstract: Uses a feminist-oriented Jungian approach in discussing
a case study of an alcoholic woman suffering from posttraumatic stress disorder (PSD) due to her experiences as a military nurse in Vietnam (see record 1987-34515-001). The collective social implications of PSD associated with Vietnam veterans must be addressed in dealing with the guilt feelings of this S. The loss of the S's religious faith as a result of her Vietnam experiences and others' rejection of the validity of her Vietnam experiences are viewed as important in understanding her symptoms. The Jungian analysis is largely based on the idea of a symptom as a degraded symbol and the concept that the only suffering that cannot be endured is that which has no meaning.
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Title: Re-evaluation counseling: A self-help model for recovery from emotional distress.
Author(s): Bronstein, Phyllis, U Vermont & State Agricultural Coll, Clinical Faculty
Source: Women & Therapy, Vol 5(1), Spr 1986. Special issue: A woman's recovery from the trauma of war. pp. 41-54.
Publisher: US: Haworth Press
Abstract: Uses a family therapy perspective to analyze a case
study of an alcoholic woman suffering from posttraumatic stress disorder due to her experiences as a military nurse in Vietnam (see record 1987-34515-001). Early family dynamics, which were those of a typical lower middle-class Irish Catholic household, provide a framework with which to understand the S's perceptions of the war trauma and subsequent poor treatment by the psychiatric profession. The reevaluation counseling approach favored for the S's treatment is based on the principles that: (1) human beings have enormous potential for intelligence and creativity; (2) emotional and physical injuries diminish functioning; and (3) a process of discharging painful emotion enables the patient to recover. Counseling is done on a peer-to-peer reciprocal basis under the guidance of counseling teachers.
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Title: Post-Traumatic Stress Disorder in a Vietnam nurse: Behavioral analysis of a case study.
Author(s): Resick, Patricia A., U Missouri, St Louis
Source: Women & Therapy, Vol 5(1), Spr 1986. Special issue: A woman's recovery from the trauma of war. pp. 55-65.
Publisher: US: Haworth Press
Abstract: Uses a behavioral approach in discussing a case study of
an alcoholic woman suffering from posttraumatic stress disorder due to her experiences as a military nurse in Vietnam (see record 1987-34515-001). Classical conditioning of fear reactions due to the S's constant perception of danger and experiences with mutilation during the war resulted in escape and avoidance behavior and, eventually, phobias.
Family experiences and rejection of the S's war experiences by colleagues and therapist prevented the S from dealing with war via reexperiencing it in a safe environment. Assessment of the S is based on her general psychological functioning, specific fears and fear reactions, and social support. Therapeutic strategies recommended include reduction of symptoms, development of an understanding of her experiences, and maintenance of sobriety. (0 ref)
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Title: Perspective of a sex therapist.
Author(s): Sarrel, Lorna J., Yale U Human Sexuality Program
Source: Women & Therapy, Vol 5(1), Spr 1986. Special issue: A woman's recovery from the trauma of war. pp. 67-69.
Publisher: US: Haworth Press
Abstract: Uses a sex therapist's perspective to analyze a case
study of an alcoholic woman suffering from posttraumatic stress disorder due to her experiences as a military nurse in Vietnam (see record 1987-34515-001). Although sexual issues are perceived as secondary in the case, the S had a noncoital relation described as "loving" with her fiancee and a coital relation with a doctor described as "abusive" while in Vietnam. The S appeared to be confused about feelings that she should have about sexual relations and sexual responsibilities of partners toward each other. It is concluded that the S's experiences could result in the following reactions: irrational panic upon encountering a possible relationship with a man, fear of medical professionals who might remind S of the abusive doctor, and vaginismus during any attempt at vaginal penetration. (0 ref)
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Title: Alcoholism first.
Author(s): Clark, Michelle, Women's Mental Health Collective, Somerville, MA
Source: Women & Therapy, Vol 5(1), Spr 1986. Special issue: A woman's recovery from the trauma of war. pp. 71-76.
Publisher: US: Haworth Press
Abstract: Discusses the role of alcoholism in a case of a woman
suffering from posttraumatic stress disorder due to her experiences as a military nurse in Vietnam (see record 1987-34515-001). The S's situation was exacerbated by her psychiatrist's refusal to recognize alcoholism as central to the etiology of her disorder and the male orientation of Alcoholics Anonymous (AA) and the Veterans Administration. Recommended therapy includes day treatment to respond to the S's suicidal feelings, daily life relearning, unintense but continual interpersonal contact, daily attendance at AA or aftercare meetings, restructuring of the S's capacity to soothe herself without using alcohol and to show anger productively, and discussion of possible alcohol problems in the S's family history. The dangers involved in the patients' tendency to idealize the therapist and denigrate AA members and fellow veterans are discussed. (0 ref)
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Title: The interplay of individual psychodynamics and the female experience: A case study.
Author(s): Ryberg, Amy B.
Source: Women & Therapy, Vol 5(1), Spr 1986. Special issue: A woman's recovery from the trauma of war. pp. 77-89.
Publisher: US: Haworth Press
Abstract: Uses a feminist-psychodynamic orientation to
conceptualize a case study of an alcoholic woman suffering from posttraumatic stress disorder (PSD) due to her experiences as a military nurse in Vietnam (see PA, Vol 74:345151). The principles of psychodynamics and feminist therapy are discussed, and focus is on the effects on the S of a sexist family structure, work environment, interpersonal relationships, and psychiatric treatment. The traditional view of women as nurturing and the inability of the emergency response nurse to be rewarded for nurturing behavior are viewed as central to this case of PSD. Cultural views of women as neurotic and oversensitive resulted in abuse of the S by her first psychiatrist. Suggested therapy includes a dual focus of uncovering-interpretative and ego-building psychotherapy.
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Title: The diagnostic approach: The usefulness of the DSM-III and systematic interviews in treatment planning.
Author(s): John, Karen, Yale U School of Medicine, Depression Research & Clinical Methodology Units
Source: Women & Therapy, Vol 5(1), Spr 1986. Special issue: A woman's recovery from the trauma of war. pp. 91-99.
Publisher: US: Haworth Press
Abstract: Discusses the usefulness of the Diagnostic and
Statistical Manual of Mental Disorders (DSM-III) in assessing a case study of an alcoholic woman suffering from posttraumatic stress disorder
(PSD) due to her experiences as a military nurse in Vietnam (see record 1987-34515-001). The design and development of the DSM-III and the role of the structured diagnostic interview are outlined, and a DSM-III diagnostic model is applied to the S. The necessity of PSD patients, particularly those suffering from war-related PSD, to abreact their experiences among others with similar experiences is emphasized. The DSM-III serves as a useful tool in formulating treatment plans for individuals and in furthering general understanding of emotional problems.
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Title: Perspectives of a pastoral counselor.
Author(s): Adamson, Beth, Yale U Divinity School
Source: Women & Therapy, Vol 5(1), Spr 1986. Special issue: A woman's recovery from the trauma of war. pp. 101-106.
Publisher: US: Haworth Press
Abstract: Uses the perspective of a feminist pastoral counselor to
analyze the case of an alcoholic woman suffering from posttraumatic stress disorder (PSD) due to her experiences as a military nurse in Vietnam (see record 1987-34515-001). The aims of pastoral care include healing, sustaining, guiding, and reconciling. Application of pastoral techniques to the S's case could involve having her recount the possibly sexist inclinations of her Catholic upbringing, transformation of her memory of the confessional into a more open form of discussion, inclusion of significant others in joint sessions, use of Gestalt therapies and psychodrama to explore hidden feelings, maintenance of a dream diary, participation in a women's sexuality group, and discussion of religious feelings.
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Title: Propping up the patriarchy: The silenced soldiering of military nurses.
Author(s): Livingston, Joy A., Burlington Coll, Student Support Service; Rankin, Joanna M.
Source: Women & Therapy, Vol 5(1), Spr 1986. Special issue: A woman's recovery from the trauma of war. pp. 107-119.
Publisher: US: Haworth Press
Abstract: Presents excerpts from a conversation, by 2 researchers
who are developing an analysis of militarism from a feminist perspective, about the case of a woman suffering from posttraumatic stress disorder due to her experiences as a military nurse in Vietnam (see record 1987-34515-001). The effects on women of a patriarchal military life in general and participation in the Vietnam war in particular include feelings of exploitation combined with feelings of uselessness, lack of appropriate outlets for guilt and anger, lack of a sense of shared experience, and depersonalization of experience.
Treatment of women damaged by military life could include women's support groups, other means of validating women's experiences, and participation in feminist political groups.
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Title: Life after death: Vietnam veterans' struggle for meaning and recovery.
Author(s): Parson, Erwin R., VA Medical Ctr, Northport, NY
Source: Death Studies, Vol 10(1), 1986. pp. 11-26.
Publisher: United Kingdom: Taylor & Francis
Abstract: Proposes that a pervasive readjustment problem that cuts
across all diagnostic categories with Vietnam veterans can be referred to as "post-traumatic death syndrome" (PD). The syndrome and its components were analyzed in their relationship to major symptoms of posttraumatic stress disorder (PS). Persons likely to be diagnosed as having PS are those suffering the ill aftereffects of war, rape, vehicular accidents, plane crashes, Holocaust, muggings, or natural disasters, while PD is often observed in veterans with and without PS.
The PD syndrome is a complex configuration of chronic fears, chronic grief states, pronounced death anxiety, and a profound attraction to death themes, with a paradoxical fear of death and dying in reference to self and others. Death-enthralled veterans with PS manifest a continual emotional connection to death imagery of Vietnam through intrusive and numbing mechanisms of PS. PD is comprised of symptoms and conditions that contribute to the veteran's "functional disability" in affirming life. Psychotherapists can help these veterans by using the concepts of engagement, affinity, presence, self-generation, and community healing in analyzing the vital meaning system of the Vietnam war combatant. (31
ref)
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Title: Subsequent military adjustment of combat stress reaction casualties: A nine year follow-up study.
Author(s): Solomon, Zahava; Oppenheimer, Bruce; Noy, Shabtai
Source: Military Medicine, Vol 151(1), Jan 1986. pp. 8-11.
Publisher: US: Assn of Military Surgeons of the US
Abstract: Studied the military adjustment of soldiers who
experienced an episode of combat reaction (CBR) during the 1973 Yom Kippur War. These soldiers were compared to matched controls who participated in the Yom Kippur War but did not sustain any psychiatric injury. Nine years later, 94% of this CBR group continued to serve in the Israel Defense Force compared to 98% of the control group. 43.6% of the CBR group as compared to 90.36% in the control group retained their previous fitness rating as combatants. 80% of those eligible for combat among the CBR soldiers took part in the Lebanon War and only 1% of these soldiers suffered a recurrent episode of reaction. Results provide support for the notion that a complete recovery from combat reaction is possible and vindicate the clinical judgments made by the army medical personnel with regard to combat fitness. (12 ref)
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Title: The defense process in posttraumatic stress disorders.
Author(s): Emery, Paul E., VA Medical Ctr, Ctr for Stress Recovery, Brecksville, OH; Emery, Olga B.
Source: American Journal of Psychotherapy, Vol 39(4), Oct 1985. pp. 541-552.
Publisher: US: Assn for the Advancement of Psychotherapy
Abstract: Discusses the role of the subjective determinants in the
premorbid personality and in the symptom formation of patients who develop posttraumatic stress disorders. Such factors are assessed through a careful evaluation of the defense mechanisms. It is suggested that psychotherapists focus their attention on the dynamics of such mechanisms and shape their interventions accordingly. A clinical example, involving a narrative account of a Vietnam veteran 14 yrs after the event, is given. (30 ref)
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Title: Post-traumatic stress disorder after car accidents.
Author(s): Kuch, Klaus, U Toronto, Canada; Swinson, Richard P.; Kirby, Marlene
Source: Canadian Journal of Psychiatry, Vol 30(6), Oct 1985. pp. 426-427.
Publisher: Canada: Canadian Psychiatric Assn
Abstract: 30 Ss who had been involved in accidents severe enough
to warrant medical attention and who met Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria for posttraumatic stress disorder were exposed to imagery of driving and accidents. 77% were phobic of driving; 53% responded with increased anxiety to the imagery.
Six of 12 Ss who received exposure therapy improved markedly. An additional 4 Ss improved when a benzodiazepine was added temporarily.
Four of 8 Ss lost their unremitting pains along with their fears. When guided imagery evoked intense anxiety, this seemed to predict a favorable outcome. A resumption of pleasure trips was a reliable criterion of recovery. The frequency of phobic symptomatology and its importance to the understanding and management of posttraumatic anxiety states are discussed. (French abstract) (9 ref)
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Title: Psychological treatment of war veterans: A challenge for mental health professionals.
Author(s): Blank, Arthur S., VA Vietnam Veterans Counseling Centers, Washington, DC
Source: Medical Hypnoanalysis, Vol 6(3), Jul 1985. pp. 91-96.
Publisher: US: Colonial Press, Inc.
Abstract: Argues that the underlying stress disorder process in
war veterans with posttraumatic stress disorder (PTSD) is really a fixation or freezing of a normal stress reaction and that the chance for recovery is good. Difficulties that mental health professionals have had in arriving at a recognition of the nature of PTSD are described, and it is suggested that they should consider what is known about right brain functioning, about endorphins, and about the theory of dissipative structures when conducting research and refining the theoretical model of traumatic stress. Challenges that must be faced by therapists working with war veterans with PTSD include enduring the full brunt of suppressed rage, learning about and managing the therapist's own experiences that were affected by war, and accepting the fact that the therapist is a necessary, but not a sufficient, condition for the cure, which must involve contact with other veterans.
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Title: Vietnam veterans: The road to recovery.
Author(s): Brende, Joel Osler, US Veterans Administration Medical Ctr, Post-Traumatic Stress Disorder Treatment Unit, Clinical Director, Bay Pines, FL, US;
Parson, Erwin Randolph
Source: New York, NY, US: Plenum Press, 1985. xx, 270 pp.
Abstract: (from the jacket) Finally there is a book that explores
the rugged path that our Vietnam veterans are taking on their road to recovery.
Until 1980, there was not even a diagnostic category to define the serious condition of post-traumatic stress disorder plaguing 800,000 Vietnam veterans. Since returning home, so many of these men and women have been unable to find any sense of peace. So many have struggled to find and keep a job. And so many have felt isolated and alienated to the point that they are unable to show the faintest sign of affection to their spouses and children.
In painstaking detail they [the authors] describe the processes by which these men and women are learning to conquer their problems. They also go as far as providing a complete list of vital readjustment services available to these veterans and their families.
Of particular interest is the section devoted to the gripping war experiences and stories of recovery of those dedicated minority groups who fought in Vietnam and the women who so selflessly served as nurses throughout the war.
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Title: After Mount St. Helens: Disaster stress research.
Author(s): Murphy, Shirley A., Oregon Health Sciences U
Source: Journal of Psychosocial Nursing & Mental Health Services, Vol 22(7), Jul 1984. pp. 9-18.
Publisher: US: Charles B. Slack, Inc.
Abstract: Compared 4 conditions of disaster loss resulting from
the Mount St. Helens disaster to determine (1) the relationship between death and loss of residence, (2) whether self-efficacy and social supports buffer the negative effects of stress, and (3) the perceived effects of the media on coping with loss following disaster. 39 Ss (aged
18-67 yrs) who were bereaved because an intimate friend or relative was presumed dead after the disaster, 30 Ss (aged 19-72 yrs) who were bereaved because an intimate friend or relative was confirmed dead, 21 Ss (aged 30-40 yrs) who lost their homes, 15 Ss (aged 33-68 yrs) who lost their vacation homes, and 50 Ss (aged 19-69 yrs) who did not suffer losses as a result of the volcanic eruption completed instruments that assessed negative life stress, mental and physical health status, and coping patterns. These instruments included the Life Experiences Survey and the Hopkins Symptom Checklist. Findings support the hypothesis that high levels of disaster stress lead to lowered levels of health. Both self-efficacy and social support buffered the effects of stress on illness, but only with depression. Bereaved Ss reported that the media was a hindrance to their recoveries. (29 ref)
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Title: Regressive experiences in Vietnam veterans: Their relationship to war, post-traumatic symptoms and recovery.
Author(s): Brende, Joel O., Colmery-O'Neill VA Medical Ctr, Topeka, KA; McCann, I. L.
Source: Journal of Contemporary Psychotherapy, Vol 14(1), Spr-Sum 1984. pp. 57-75.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Regression has been commonly associated with war and
postwar symptomatology. Posttraumatic symptoms have been considered regressive when manifested by chronic dependent behavior or outbursts of primitive, aggressive behavior. Recovery from regressive symptoms may in itself induce regressive experiences since recovery necessarily leads to another change in ego boundaries; rigid or fused boundaries becoming realigned, intact, and flexible. Recovery therefore requires a stable and trusting therapeutic relationship to gradually permit such changes.
Psychological treatment of Vietnam veterans has often occurred in phases with immediate management of regressive symptoms occurring during early phases; induction of regressive states has often occurred during late phases to facilitate integration of "split-off" traumatic experiences and emotions. (58 ref)
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Title: An educational-therapeutic group for drug and alcohol abusing combat veterans.
Author(s): Brende, Joel O., Colmery-O'Neill VA Medical Ctr, Topeka, KS
Source: Journal of Contemporary Psychotherapy, Vol 14(1), Spr-Sum 1984. pp. 122-136.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Describes an open-ended group intervention for Vietnam
veterans with substance abuse problems resulting from attempts to control posttraumatic symptoms. Their recovery from drug and alcohol dependency has meant involvement in treatment for resolution of posttraumatic symptoms. The author found that the addition of a short-term educational-therapeutic group experience, focusing on the symptoms of posttraumatic stress disorder, was helpful for the participants. They worked-through important war-related experiences via the following phases: (1) breaking through detachment and establishing control over disruptive symptoms; (2) revealing experiences of death and dehumanization; (3) describing the internal "death of self" experience; and (4) beginning the grief response. Case materials are presented to illustrate the dynamics of these phases. (21 ref)
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Title: Posttraumatic stress disorder conceptualized as a problem in the person-environment system.
Author(s): Bradshaw, Cathryn; Thomlison, Barbara
Source: Adult psychopathology: A social work perspective (2nd ed.). Turner, Francis J. (Ed); pp. 638-661. New York, NY, US: Free Press, 1984. xxiv, 696 pp.
Abstract: Reviews the diagnostic criteria of posttraumatic stress
disorder (PTSD) and highlights the theoretical basis for assessment and treatment services to promote positive recovery. Topics covered in this chapter include: prevalence; definition of a stressor; historical overview of trauma; symptoms of PTSD; theoretical perspectives of PTSD; risk and protective factors; recovery and future directions.
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Title: Rape trauma syndrome.
Author(s): Burgess, Ann W., City of Boston, Dept of Health & Hosps, MA
Source: Behavioral Sciences & the Law, Vol 1(3), Sum 1983. pp. 97-113.
Publisher: US: John Wiley & Sons
Abstract: Discusses the relationship of rape trauma syndrome to
the official diagnostic nomenclature of Post-Traumatic Stress Disorder in the DSM-III. The rape trauma syndrome is divided into 2 phases that can disrupt the physical, psychological, social, or sexual aspects of a victim's life. The acute or disruptive phase can last from days to weeks and is characterized by general stress response symptoms. During the 2nd phase--the long-term process of reorganization--the victim has the recovery task of restoring order to his/her lifestyle and reestablishing a sense of control in the world. This phase is characterized by rape-related symptoms and can last from months to years. Theoretical and practical clinical issues involved in rape trauma are reviewed as well as the early court rulings on the admissibility of rape trauma syndrome in criminal and civil cases. (92 ref)
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Title: Posttraumatic stress disorder in children: A review of the past 10 years.
Author(s): Pfefferbaum, Betty, U Oklahoma, Health Sciences Ctr, Dept of Psychiatry & Behavioral Sciences, Oklahoma City, OK, US
Source: Journal of the American Academy of Child & Adolescent Psychiatry, Vol 36(11), Nov 1997. pp. 1503-1511.
Publisher: US: Lippincott Williams & Wilkins
Abstract: This article reviews the literature of the past 10 yrs
on the clinical presentation, assessment, and treatment of posttraumatic
stress disorder (PTSD) in children. The authors found PTSD described in
children exposed to a variety of traumatic experiences. Little has been
studied about the epidemiology of the disorder in children. Partial
symptomatology and comorbidity are discussed. A variety of factors were
revealed to influence response to trauma and affect recovery. They
include characteristics of the stressor and exposure to it; individual
factors such as gender, age and developmental level, and psychiatric
history; family characteristics; and cultural factors. Since the
condition is likely to occur after disaster situations, much of the
literature describes the child's response to disaster and interventions
tend to include efforts within schools and/or communities. A number of
clinical approaches used to treat the condition are presented. The
authors conclude that while assessment has been studied extensively, the
longitudinal course of PTSD and treatment effectiveness have not been.
They also suggest that biological correlates of the condition also warrant greater attention.
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Title: Perceived benefit and mental health after three types of disaster.
Author(s): McMillen, J. Curtis, Washington U, George Warren Brown School of Social Work, St Louis, MO, US; Smith, Elizabeth M.; Fisher, Rachel H.
Source: Journal of Consulting & Clinical Psychology, Vol 65(5), Oct 1997. pp. 733-739.
Publisher: US: American Psychological Assn
Abstract: The study of growth and perceived benefit after
traumatic events has been hailed as one of the most promising directions
for stress research. This research, however, has been limited by several
methodological limitations. These limitations are addressed in this
prospective study, which examines perceived benefit and mental health
adjustment after 3 different types of disaster. Survivors of a tornado
in Madison, Florida, had the highest rates of perceived benefit,
followed by survivors of a mass killing in Killeen, Texas, and survivors
of a plane crash in Indianapolis, Indiana. Perceived benefit 4-6 weeks
postdisaster predicted posttraumatic stress disorder 3 years later.
Perceived benefit moderated the effect of severity of disaster exposure
on mental health diagnosis change over time. Without perceived benefit,
as exposure severity increased, the amount of recovery decreased. If
benefit was perceived, as exposure severity increased, the amount of
recovery increased. Implications for clinical interventions and future
research are discussed.
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Title: The experience and caring needs of critically ill, mechanically ventilated patients.
Author(s): Adler, Diane Catherine, U Pennsylvania, US
Source: Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 58(3-B), Sep 1997. pp. 1204.
Publisher: US: Univ Microfilms International
Abstract: Twelve critically ill adults who had been mechanically
ventilated (seven days or more) retrospectively (six to nine months
after weaning) described their experiences and caring needs through a
formal, semi-structured interview format guided by the Cognitive
Interview (Fisher & Geiselman, 1987). Eight partners (relatives and
friends), who spent significant time at the patient's bedside also were
interviewed. This qualitative study used a combination of methods
including phenomenology, ethnography, and grounded theory
(Swanson-Kauffman, 1986). Three groups of themes emerged from data
analysis. The first, the MEANING of the experience included
fear/anxiety, relating to others (communication, connecting, and
communication difficulties), dependency, dehumanization and violation
(by professional caregivers), and pain. The second group of themes
involved the MANAGEMENT of the experience, e.g., methods of control,
creating a world of their own (labelled confusion or hallucinations),
and the role of hope. The final group, the CONSEQUENCES of the
experience contained reflections on why the illness had occurred
(smoking, alcoholism), and living with symptoms of Posttraumatic Stress
Disorder (PTSD). The critical illness experience was central to the
context of being mechanically ventilated. Although the subjects
initially were fearful and anxious about being mechanically ventilated,
most later referred to the ventilator as supportive and essential to
their recovery. Ten of the patients created an insular world of their
own that required little energy expenditure when compared to that of the
Intensive Care Unit (ICU). They sometimes found comfort through scenes
and visitors not seen by others in the ICU. Difficulties in
communication were a universal and unresolved problem. Reports of
dehumanizing behavior by nurse and physician caregivers demonstrated a
violation of the ethical principles of "truth telling" and "do no harm".
Four of the patients and one partner still had symptoms.
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Title: Objective assessment of peritraumatic dissociation:
Psychophysiological indicators.
Author(s): Griffin, Michael G., U Missouri, Dept of Psychology, Ctr for Trauma Recovery, St Louis, MO, U;
Resick, Patricia A.; Mechanic, Mindy B.
Source: American Journal of Psychiatry, Vol 154(8), Aug 1997. pp. 1081-1088.
Publisher: US: American Psychiatric Assn
Abstract: Examined psychophysiological changes associated with
peritraumatic dissociation in 85 female victims of recent rape (aged
18-54 yrs) and assessed the relation between these changes and symptoms
of posttraumatic stress disorder (PTSD). Two weeks after the rape, Ss'
heart rate, skin conductance, and nonspecific movement were assessed and
self-report indexes of reactions to the trauma and interviews assessing
PTSD symptoms and peritraumatic dissociation were also completed. On the
basis of Peritraumatic Dissociation Index scores, the Ss were classified
as having low or high levels of dissociation. Ss in the high
dissociation group showed a significantly different pattern of
physiological responses from those of the low dissociation group. In
general, these high dissociation Ss showed a suppression of autonomic
physiological responses, contained a larger proportion of Ss (94%)
identified as meeting PTSD symptom criteria, and showed a discrepancy
between self-reported distress and objective physiological indicators of
distress. These results provide support for the idea that there is a
dissociative subtype of persons with PTSD symptoms who exhibit
diminished physiological reactivity, and underscore the importance of
assessing dissociative symptoms in trauma survivors.
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Title: Repressed memories and World War II: Lest we forget!
Author(s): Karon, Bertram P., Michigan State U, Dept of Psychology, East Lansing, MI, US;
Widener, Anmarie J.
Source: Professional Psychology: Research & Practice, Vol 28(4), Aug 1997. pp. 338-340.
Publisher: US: American Psychological Assn
Abstract: The war neuroses of World War II (WWII) provide ample
evidence that repression does indeed occur, and that the recovery of
these traumatic memories and their related affects led to remission of
symptoms. Moreover, these recovered memories were of events that had
occurred. An illustrative case history from WWII is described. This
well-documented body of data, well-known at the time, seems to have been
forgotten in current discussions concerning repressed memories.
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Title: Predicting PTSD in trauma survivors: Prospective evaluation of self-report and clinician-administered instruments.
Author(s): Shalev, Arieh Y., Hadassah University Hosp, Ctr for Traumatic Stress, Dept of Psychiatry, Jerusalem, Israel; Freedman, Sara; Peri, Tuvia; Brandes, Dalia; Sahar, Tali
Source: British Journal of Psychiatry, Vol 170, Jun 1997. pp. 558-564.
Publisher: United Kingdom: Royal College of Psychiatrists
Abstract: Examined the ability of commonly used questionnaires and
a structured clinical interview to predict posttraumatic stress disorder
(PTSD) in recent trauma survivors. The Impact of Event Scale (IES), the
State Trait Anxiety Inventory (SANX), and the Peritraumatic Dissociation
Questionnaire (PDEQ) were administered 1 wk posttrauma to 207
traumatized individuals (aged 16-65 yrs) recruited from a general
hospital emergency room. The IES, the SANX, the civilian version of the
Mississippi Rating Scale for Combat Related PTSD (MISS), and the
Clinician Administered PTSD Scale (CAPS) were administered 1 mo and 4 mo
posttrauma. Receiver operator characteristic analysis was used with
these data. Results show that all questionnaires were better than chance
at predicting PTSD. The PTSD-focused questionnaires (IES and MISS) were
not better than the more general ones at predicting PTSD. No difference
in predictive value was found when questionnaires were carried out 1 wk
or 1 mo after a trauma. Recovery was better predicted than PTSD, and the
CAPS was a better predictor than were the questionnaires. It is
suggested that the use of psychometrics and clinical interviews to
predict PTSD should be guided by clinical relevance and by the availability of resources.
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Title: A study of clinicians' attitudes and sex bias in the diagnosis of borderline personality disorder and posttraumatic stress disorder.
Author(s): Giacalone, Rita Carla, The Wright Inst, US
Source: Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 57(12-B), Jun 1997. pp. 7725.
Publisher: US: Univ Microfilms International
Abstract: This study examines the extent to which the diagnoses
borderline personality disorder (BPD) and posttraumatic stress disorder
(PTSD) evoke negative attitudes and sex bias in clinicians.
Approximately 800 psychologists were asked in a mail survey to assess
the applicability of a variety of diagnoses to one of four case
histories differing only in gender and diagnostic label (BPD and PTSD),
and containing mixed criteria for the BPD and PTSD diagnoses. Subjects
then responded to an "attitudes questionnaire" regarding the condition,
treatment, and prognosis of the hypothetical client. The 135 returned
questionnaires revealed that clinicians who preferred the BPD diagnosis
over the PTSD diagnosis expressed significantly more negative attitudes
towards the client than clinicians who preferred PTSD to BPD. In
addition, clinicians who preferred the BPD diagnosis also tended to
disagree with a statement that the client's current difficulties are
directly related to the history of sexual abuse present in the case
histories. In contrast, clinicians who preferred the PTSD diagnosis
tended to agree that the client's symptoms are directly related to
her/his sexual abuse history. Results also revealed the existence of sex
bias in the diagnosis of BPD, with women receiving more BPD diagnoses
than their male counterparts. In addition, clinicians expressed
significantly more negative attitudes towards female than male case
histories. Finally, female clinicians diagnosed the case with PTSD
significantly more than male clinicians, suggesting sex bias with regard
to sex of practitioner. In discussing these findings, this study
suggests that the use of BPD as a diagnostic classification should be
seriously reconsidered. The pejorative and sex biased meaning attached
to BPD sets up a therapeutic situation wrought with the potential for
further victimization and retraumatization of those who already suffer
from the complex effects of childhood abuse. The findings of tbe current
study support the view that BPD should be abandoned and replaced with
the PTSD diagnosis or Judith Herman's proposed Complex PTSD diagnosis
because these diagnoses provide recognition that a person's difficulties
came from an abusive past and encourage a treatment approach that
actually focuses on recovery from trauma.
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Title: Management of post traumatic stress disorder using the technique of debriefing.
Author(s): Eapen, V., United Arab Emirates U, Faculty of Medicine & Health Sciences, Al Ain, United Arab Emirate;
John, G.
Source: Arab Journal of Psychiatry, Vol 8(1), May 1997. pp. 22-30.
Publisher: Jordan: Arab Federation of Psychiatrists
Abstract: Presents a comprehensive treatment programme for
posttraumatic stress disorder (PTSD) using the technique of debriefing.
Debriefing attempts to prevent the development of the initial response
pattern of the individual to symptoms and then into a disorder. The
individual usually perceives their experience following the traumatic
event as abnormal reactions, and in debriefing, this is reframed as
normal reactions to an abnormal event. The emphasis on the reactions as
normal prevents cognitive reappraisal of oneself as abnormal when they
experience the symptoms. The primary aim of debriefing is to reduce the
negative impact of the event and to speed up the recovery process. The
case of a 7-yr-old female who was referred for an evaluation of her
change in behavior and school refusal following a fire that engulfed
part of her family home is presented to illustrate the use of the debriefing technique.
_____

Title: Psychosocial community education and war trauma: Conceptual issues and case of Central American mental health workers.
Author(s): Lesser, Mishy, U Massachusetts, US
Source: Dissertation Abstracts International Section A: Humanities & Social Sciences, Vol 57(10-A), Apr 1997. pp. 4229.
Publisher: US: Univ Microfilms International
Abstract: Increasingly, war and armed conflict are having
devastating effects on the psychological and social well-being of
civilian survivors throughout the world. There is a serious shortage of
practitioners and culturally-appropriate models for assisting victims of
psychological trauma with their healing and recovery. Educational
settings, be they formal or nonformal, are appropriate places for
psychotherapeutic interventions. This dissertation focuses on the
intentional use of a nonformal educational setting for psychosocial
healing of those exposed to war-induced trauma. A participatory
education program designed to teach Central American community mental
health workers the basic concepts and techniques of trauma treatment
also served as a healing environment for the trainees. Individual
psychological trauma as well as war-related intra-group conflict were
addressed. Using an integrative model of healing and recovery, the
intervention combined cognitive, emotional, spiritual, social, and
physical approaches. The educational setting provided a larger
interactional framework for the social contextualization of intrapsychic
wounds, thus supporting healing. The case illustrates the importance of
self-care for professionals and para-professionals working with the
psychologically traumatized, which is rarely mentioned in the
literature. This is a qaulitative study that combines a literature
review on the nature of trauma and recovery, a case study with Central
American community mental health workers, interviews with practitioners,
and personal experience. The literature review takes into consideration
cultural and Latin American perspectives, the importance of
community-based approaches, and the linkage of individual and social
dimensions. It includes a critique of posttraumatic stress disorder as a
conceptual framework. The inquiry examines the viability of intentional
incorporation of psychosocial healing into an educational setting, and
indicates which components of participatory nonformal education best
lend themselves to interfacing with psychological healing. Findings from
both the literature and case study point to a need to question long-held
assumptions of psychotherapy when working with trauma survivors.
Self-care, safe container-building, peer support, mentoring, and a
heightened role for para-professionals are recommended. The training and
preparation of community mental health workers is seen as an effective
response to the proliferation of war-related trauma.
_____

Title: Self-disclosure, social anxiety, and symptomatology in rape victim-survivors: The effects of cognitive and emotional processing.
Author(s): Brown, Elissa Jill, State U New York at Albany, US
Source: Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 57(10-B), Apr 1997. pp. 6559.
Publisher: US: Univ Microfilms International
Abstract: The goal of the present study was to examine the role of
self-disclosure in the recovery of victim-survivors from a serious
psychological trauma, attempted or completed rape. As found in previous
investigations, 25% of college-aged women had experienced attempted
and/or completed rape. Rape victims experienced higher levels of
depression, social anxiety, and self-concealment than did those women
who had not been raped. Eighty-five of the victims participated in the
experimental self-disclosure task, involving writing about their rape
experience and then reading their narratives. In a 2 x 2 design, the
value of writing only factual information versus factual and emotional
information was compared, as well as the value of reading to oneself
versus aloud to another young woman. Before and after completing the
self-disclosure task, victims were assessed for symptoms of depression,
social anxiety, and PTSD. Characteristics of the rape and quality of
previous attempts at self-disclosure were significant predictors of the
degree of detail, emotional content, and personalization during the
experimental self-disclosure task. In turn, greater detail, more
emotionally-laden content, and more personalized description of the rape
were associated with a decrease in symptoms of depression, social
anxiety, and PTSD. Nevertheless, the instructions given for the writing
of the narrative and the environment in which the narrative was read
were not predictive of degree of symptom reduction. Implications and
limitations of the present study are discussed and suggestions for future research are described.
_____

Title: Prediction of remission of acute posttraumatic stress disorder in motor vehicle accident victims.
Author(s): Blanchard, Edward B., State University of New York, Ctr for Stress & Anxiety Disorders, Albany, NY, U;
Hickling, Edward J.; Forneris, Catherine A.; Taylor, Ann E.; Buckley, Todd C.; Loos, Warren R.; Jaccard, James
Source: Journal of Traumatic Stress, Vol 10(2), Apr 1997. pp. 215-234.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: 145 individuals (aged 17-73 yrs) who sought medical
attention as a result of a motor vehicle accident (MVA), and who were
initially assessed 1-4 mo post-MVA, were followed up prospectively for 6
mo to determine how many of the 55 with posttraumatic stress disorder
(PTSD) and the 43 with sub-syndromal PTSD would remit and what variables
would predict remission. 30 (55%) of those with initial PTSD had
remitted at least in part by 6 mo while 67% of those with sub-syndromal
PTSD had remitted (and 5% had worsened). Four variables, including
severity of initial symptoms, degree of initial physical injury,
relative degree of physical recovery by 4 mo and whether a close family
member suffered a trauma during the follow-up interval, combined to
classify 6-mo clinical status of 84% of those with initial PTSD secondary to MVAs.
_____

Title: Effects of group treatment on rape victims.
Author(s): Carey, Lois A., New York U, US
Source: Dissertation Abstracts International Section A: Humanities &
Social Sciences, Vol 57(9-A), Mar 1997. pp. 4129.
Publisher: US: Univ Microfilms International
Abstract: The biopsychosocial aspects of the reaction of females
to rape trauma are complex and interactive. Symptoms of post traumatic
stress disorder are frequently noted. This dissertation is a qualitative
naturalistic study based on in-depth interviews with nine female rape
victims who participated in rape survivors' support groups. Group
members provide a rich description of the experience of group treatment.
Some of the themes discussed are: self-blame, terror, confrontation with
death, HIV/AIDS, avoidance of exploring trauma, personality conflicts,
sexual issues, rage, safety, empowerment, suicidal ideation,
alcohol/drugs. The study demonstrated the effects of long-term group
treatment, which facilitated members to enter into a group process on a
profoundly intimate level to reexperience and integrate the memory and
affect of the trauma, and begin the process of recovery in order to
reduce the frequency and intensity of post traumatic stress symptoms.
_____

Title: Trauma and healing: The construction of meaning among survivors of the Cambodian Holocaust.
Author(s): Morelli, Paula Toki Tanemura, U Washington, US
Source: Dissertation Abstracts International Section A: Humanities & Social Sciences, Vol 57(9-A), Mar 1997. pp. 4133.
Publisher: US: Univ Microfilms International
Abstract: The purpose of this study was to examine Cambodian
Holocaust survivors' experiences of trauma, suffering and adaptation,
and to explore what part these personal constructions based on
experience played in their healing. Utilizing constructivist and
critical theoretical lenses survivor accounts of trauma and suffering
were analyzed within a larger structural context of: historic
geo-political events, culture, class, ethnic and gender factors,
economic and political structures, ideology and praxis. Cambodian
survivors, ranging in age from 30 to 60 were interviewed in three to
six, one and a half to two hour sessions, using open-ended and
semi-structured questions. The interviews were conducted over a six
month period between 1995 and 1996. From a larger sample of an on-going
study, a purposeful sample of four survivor-cases was selected for
analysis using critical social research and qualitative research
methods. The analysis yielded concepts useful for sensitizing social and
health services practice as well as health and mental health policy. (1)
The survivors in this study suffered from: cultural bereavement,
physical illness, pain of unknown etiology, posttraumatic stress
disorder, major depression, or combinations of physical and
psychological illness. (2) Their suffering was obdurate and continuous,
despite years of Western bio-medical and/or traditional Cambodian
treatment. They sought help from sources that were respectful of this
need for long-term care. (3) Within the biomedical system, some
physicians regard the symptoms of Posttraumatic Stress Disorder as
without medical basis, discredit the sufferer and make unrealistic
demands for short-term recovery. (4) A survivor who was able to
associate his suffering with the collective pain of his countrymen was
able to use this externalizing construction as a source of strength and
meaning. (5) The systemic lack of understanding of how the geo-political
history of Southeast Asia is related to social structures, such as
immigration-refugee policy and the Western biomedical system, operates
to isolate the phenomenon of trauma and suffering, and thereby,
perpetuates the oppression of refugees.
_____

Title: Trauma counseling and rehabilitation.
Author(s): Watts, Rod, Auckland Health Care, Rehabilitation Services, Auckland, New Zealand
Source: Journal of Applied Rehabilitation Counseling, Vol 28(1), Spr 1997. pp. 8-10.
Publisher: US: NRCA
Abstract: Discusses the psychological factors that may persist
beyond the acute phase of recovery following traumatic physical injury,
and the utility of interventions to (1) reduce the level of distress,
(2) minimize the ongoing development of pathology, and (3) mitigate the
occurrence of secondary psychosocial problems. Two cases are presented
within the context of the trauma literature that show the necessity of
proactively providing intervention as a component of the process of
rehabilitation following injury. The author contends that earlier
referral and treatment would have led to better outcomes. Therefore,
professionals involved in acute medical care and rehabilitation need to
be familiar with post traumatic stress reactions, risk factors
associated with poor outcome and early signs of the development of a pathology.
_____

Title: The role of physical injury in the development and maintenance  of PTSD among MVA survivors.
Author(s): Blanchard, Edward B., State U New York, Ctr for Stress & Anxiety Disorders, Albany, NY, US; Hickling, Edward J.
Source: After the crash: Assessment and treatment of motor vehicle
accident survivors. Blanchard, Edward B.; Hickling, Edward J.; pp. 163-169. Washington, DC, US: American Psychological Association, 1997. ix, 353 pp.
Abstract: (from the chapter) In this chapter we examine our data
to address two points that have received little attention in the
literature: (a) What is the relation between extent of initial motor
vehicle accident (MVA) injury and the development of psychological
symptoms, particularly PTSD and (b) What role does physical healing play
in the maintenance of, or recovery from, psychological symptoms? Often,
investigators implicitly assume that there is likely to be a connection
between physical injury and psychological difficulty or at least that
one is more likely to find psychological problems in MVA survivors with
some physical injury. To the best of our knowledge, this very reasonable
assumption has never been examined empirically. An analysis of the
Albany MVA Study data revealed that both extent of injury and extent of
fear of death at the time of the MVA were independent predictors of
posttraumatic stress symptoms. Long-lasting, nagging injuries,
especially the soft tissue injuries of whiplash, seem to impede
psychological recovery. This is a topic area in need of more extensive
research and of collaboration among orthopedists, physical therapists,
and mental health professionals.
_____

Title: The Albany MVA Treatment Project.
Author(s): Blanchard, Edward B., State U New York, Ctr for Stress & Anxiety Disorders, Albany, NY, US; Hickling, Edward J.
Source: After the crash: Assessment and treatment of motor vehicle
accident survivors. Blanchard, Edward B.; Hickling, Edward J.; pp. 241-273. Washington, DC, US: American Psychological Association, 1997. ix, 353 pp.
Abstract: (from the chapter) This chapter begins with a
description of the thinking under lying our approach to treatment for
posttraumatic stress disorder (PTSD) as a result of motor vehicle
accidents (MVAs). The treatment is guided and driven by these
theoretical understandings. We provide the description of our pilot
studies in detail to illustrate the results that led to our current
approach in treatment. Where it is useful, we provide clinical examples
and anecdotes. Particular symptoms of PTSD are discussed in the context
of specialized forms of treatment. The changes in overall Clinician
Administered Post-Traumatic Stress Disorder Scale (CAPS) scores strongly
suggest that this pilot investigation of an intensive, manual-based
treatment protocol was effective in the reduction of symptoms of PTSD in
survivors of MVAs. It is also suggestive that the symptom improvement
can be delivered in a relatively short period of time and that results
last for as long as 3 months. The results hold true for at least two
psychologists who delivered the treatment and do not show differences in
treatment outcome between therapists. Furthermore, the scores for
psychological tests and LIFE-Base evaluations support the outcome of the pilot investigation.
_____


Title: Debriefing, social support and PTSD in the New Zealand police: Testing a multidimensional model of organisational traumatic stress.
Author(s): Stephens, Christine V., Massey U, Dept of Psychology,
Palmerston North, New Zealand, C.V.Stephens@massey.ac.nz
Address: Stephens, Christine V., Massey U, Dept of Psychology, Palmerston North, New Zealand, C.V.Stephens@massey.ac.nz
Source: Australasian Journal of Disaster & Trauma Studies, Vol 1(1), 1997. pp. NP.
Publisher: New Zealand: Massey Univ
Abstract: (Posted date: February 3, 1997). Organisations whose
workers risk traumatic exposure, are increasingly interested in
preventing sequelae such as posttraumatic stress disorder (PTSD). A
common intervention is the provision of psychological debriefing
following trauma. In accordance with recent criticisms of this approach,
M. R. Harvey (1996) has proposed a multidimensional model of trauma
recovery. The present study tested some of the person, event and
environmental variables in the model with 527 New Zealand police
officers who responded to a questionnaire survey of trauma and social
support at work. The results show no differences in PTSD symptoms
between officers who had and those who had not been debriefed. However,
greater social support and opportunities to talk about traumatic
experiences and their emotional impact, with others in the work place,
were shown to be related to fewer PTSD symptoms. The findings support
current suggestions that organisational post-trauma interventions should
be developed take into account social environmental factors and recovery
needs over time.
Conference: International Society for Stress & Trauma Studies Annual
Conference, Nov, 1996, San Francisco, CA, US
Conference Notes: Preliminary versions of this paper were
presented at the aforementioned conference and at the British Psychological Society, Scottish Branch, Annual Conference, Crieff, Nov, 1996.
_____

Title: Cognitive factors in persistent versus recovered post-traumatic stress disorder after physical or sexual assault: A pilot study.
Author(s): Dunmore, Emma, U Oxford, Dept of Psychiatry, Oxford, England; Clark, David M.; Ehlers, Anke
Source: Behavioural & Cognitive Psychotherapy, Vol 25(2), 1997. pp. 147-159.
Publisher: US: Cambridge Univ Press
Abstract: Cognitive models have linked individual differences in
the appraisal of traumatic events and their sequelae to the persistence
of posttraumatic stress disorder (PTSD). This pilot study investigated
the proposal with victims of assault. 11 assault victims suffering from
persistent PTSD and 9 victims who had recovered from PTSD were
interviewed retrospectively and compared on potentially relevant
cognitive factors. Groups were comparable in terms of characteristics of
the assault, gender, age, and initial PTSD severity. Ss with persistent
PTSD were less likely than those who had recovered to have engaged in
mental planning during the assault and more likely to have experienced
mental defeat, and to indicate negative appraisals of their actions
during the assault, of others' reactions after the assault, and of their
initial PTSD symptoms. They were also more likely to indicate global
negative beliefs concerning their perception of themselves, their world
or their future. These cognitive factors may maintain PTSD symptoms
either directly or by motivating the individual to engage in behavior that prevents change.
_____

Title: Integrating objective indicators of treatment outcome in posttraumatic stress disorder.
Series Title: Annals of the New York Academy of Sciences; Vol. 821.
Author(s): Griffin, Michael G., U Missouri, Ctr for Trauma
Recovery, Dept of Psychology, St Louis, MO, US; Nishith, Pallavi; Resick, Patricia A.; Yehuda, Rachel
Source: Psychobiology of posttraumatic stress disorder. Yehuda, Rachel (Ed); McFarlane, Alexander C. (Ed); pp. 388-409. New York, NY, US: New York Academy of Sciences, 1997. xv, 550 pp.
Abstract: (from the chapter) Two of the primary biological
approaches that hold promise for developing objective indicators of
treatment outcome in posttraumatic stress disorder (PTSD) are
psychophysiological and psychoendocrine assessment. In particular,
psychophysiological measures including heart rate, electrodermal
activity (e.g., skin conductance) and facial EMG, and the
psychoendocrine challenge test, the low-dose dexamethasone suppression
test (DST). These approaches are reviewed briefly, and pilot data from
our laboratory using these approaches at pre- and posttreatment of
sexual assault survivors are presented.
Data are presented from 2 preliminary investigations designed to
incorporate biological measures into treatment outcome assessments. In
study 1, 3 female Ss ages 21-29 seeking treatment for rape-related PTSD
were assessed with standard self-report and interview measures and were
also assessed in a laboratory setting during which physiological
measures of heart rate and skin conductance were collected during
periods when the traumatic event was recalled.
In study 2, a group of 5 female Ss ages 22-32 seeking treatment for
rape-related PTSD were assessed with standard clinical instruments and
were also administered low-dose DST.
_____

Title: Psychological processes related to recovery from a trauma and an effective treatment for PTSD.
Series Title: Annals of the New York Academy of Sciences; Vol. 821.                                                                     Author(s): Foa, Edna B., Allegheny U of the Health Sciences, Philadelphia, PA, US
Source: Psychobiology of posttraumatic stress disorder. Yehuda, Rachel (Ed); McFarlane, Alexander C. (Ed); pp. 410-424. New York, NY, US: New York Academy of Sciences, 1997. xv, 550 pp.
Abstract: (from the chapter) This chapter focuses on psychological
factors that seem related to the etiology or maintenance of chronic
posttraumatic stress disorder (PTSD). To this end, I first present data
to indicate that individuals differ in their ability to process a trauma
successfully, discussing psychological factors that impede natural
processing and thereby contribute to the development of chronic PTSD. I
then discuss data demonstrating that psychosocial treatments,
particularly cognitive behavioral treatments, are effective in reducing
PTSD in female victims of assault. Finally, I discuss psychological
factors that seem to mediate both the naturally occurring reduction in
posttrauma disturbances and symptom reduction via treatment.
_____

Title: Memory quest: Trauma and the search for personal history.
Author(s): Waites, Elizabeth A., Private Practice, Ann Arbor, MI, US
Source: New York, NY, US: W. W. Norton & Co, Inc, 1997. xi, 308 pp.
Abstract: (from the jacket) How is memory formed, reformed,
modified in the telling, lost and found? How does it contribute to our
sense of self? How are both memory and self affected by trauma and
subsequent distortions and evasion? And how can the past be brought into
the present safely and productively?
Merging memory research and clinical experience, this book explores
these questions and many more that are encountered in a quest for
personal memory. . . . The search for autobiographical memory becomes a
search for the authentic voice of the self, a voice often drowned out by
competing narratives, contradicted by cover stories, and silenced by
intimidation.
Waites focuses on the impact of trauma on several levels of
information-processing and memory organization, showing how memory "goes
haywire" in posttraumatic stress disorder (PTSD). Controversies around
memory, such as the issue of so-called "recovered memories" of abuse,
are considered within a broad context that recognizes that accuracy of
such memories is not an absolute.
The final chapters deal specifically with the access and use of memories
in psychotherapy.
_____

Title: Posttraumatic stress disorder: Acute and long-term responses to trauma and disaster.
Series Title: Progress in psychiatry series; No. 51
Author(s): Fullerton, Carol S., (Ed), Uniformed Services U of the Health Sciences, F. Edward Hébert School of Medicine, Dept of Psychiatry, Bethesda, MD, US; Ursano, Robert J., (Ed)
Source: Washington, DC, US: American Psychiatric Association, 1997. xii, 296 pp.
Abstract: (from the jacket) [This book] provides clinicians,
researchers, and policy makers with an examination of current advances
in research and treatment of posttraumatic stress disorder (PTSD). [The]
book incorporates Diagnostic and Statistical Manual of Mental
Disorders-IV (DSM-IV) criteria and the new diagnostic category acute
stress disorder, which emphasizes the breadth of posttraumatic stress
symptoms and disorders and the importance of distinguishing between
acute and long-term responses to traumatic events. Individual chapters
go beyond PTSD to examine other posttraumatic disorders and responses,
the mechanisms of transmission of posttraumatic stress, and its effects
on behavior and health in natural and societal disasters and traumas, including war.
_____

Title: Psychobiology of posttraumatic stress disorder.
Series Title: Annals of the New York Academy of Sciences; Vol. 821
Author(s): Yehuda, Rachel, (Ed), Mt Sinai School of Medicine, Psychiatry Dept, Traumatic Stress Studies Program, New York, NY, US; McFarlane, Alexander C., (Ed)
Source: New York, NY, US: New York Academy of Sciences, 1997. xv, 550 pp.
Abstract: (from the introduction) This volume summarizes the major
findings and themes in the psychobiology of posttraumatic stress
disorder (PTSD). One of the major points highlighted in this volume
concerns the biological or pathophysiological differences between PTSD,
stress, and other psychiatric disorders.
The 1st section of this volume deals with the epidemiological and
phenomenological studies that objectified the important clinical
observations on the prevalence of trauma and its manifestations. The 2nd
section represents the core of the psychobiological studies of chronic
PTSD in adults. The 3rd section introduces an important framework that
is becoming increasingly recognized in trauma studies--the developmental
perspective. The 4th section deals with the biology of normal and
traumatic memories in both animals and humans. The 5th section provides
theoretical models to explain the way that traumatic experiences might
be potentiated to pathological states. The 6th section provides an
analysis of the influences of biological studies on the treatment of PTSD.
(from the book) This volume is a result of a conference entitled
Psychobiology of Posttraumatic Stress Disorder sponsored by the New York
Academy of Sciences and held on September 7-10, 1996 in New York, New York.
_____

Title: Trauma and memory: Clinical and legal controversies.
Author(s): Appelbaum, Paul S., (Ed), U Massachusetts, Medical Ctr, Dept of Psychiatry, Worcester, MA,;
Uyehara, Lisa A., (Ed); Elin, Mark R., (Ed)
Source: London,: Oxford University Press, 1997. xv, 552 pp.
Abstract: (from the jacket) The authenticity of memories of
childhood sexual abuse has become one of the major social controversies
of the 1990s.
This volume provides a comprehensive picture of the psychological,
physiological, and legal aspects of trauma. Beginning by defining the
opposing positions in the debate, the contributors offer a variety of
perspectives on the nature of memory, including reviews of recent
developments in this fast-growing area of research. Next, consideration
is given to the impact of trauma on memory, both in adults and in
children. The authors then examine a variety of treatment approaches
available to victims of trauma, who are trying to cope with the painful
consequences of those events.
The book is intended for clinicians treating patients with traumatic
memories. It is also intended for psychologists, physicians, social
workers, and lawyers who need a reference on trauma and sexual abuse during childhood.
_____

Title: Crisis support following the Herald of Free-Enterprise disaster:
A longitudinal perspective.
Author(s): Dalgleish, Tim, Medical Research Council, Applied Psychology Unit, Cambridge, England; Joseph, Stephen; Thrasher, Sian; Tranah, Troy; et al.
Source: Journal of Traumatic Stress, Vol 9(4), Oct 1996. pp. 833-845.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Assessed crisis support in 27 male and 10 female (mean
ages 40.32 and 39.3 yrs) survivors of the Herald of Free Enterprise
ferry sinking. Ss completed the Crisis Support Scale, the Impact of
Event Scale and the General Health Questionnaire between 2.5-3 yrs
postdisaster and completed the Beck Depression Inventory and the
Spielberger State-Trait Inventory between 5.5-6 yrs postdisaster.
Analyses showed that the severity of reported posttraumatic symptoms
declined over time, showing a process of recovery. This reduction
consisted of a decrease in the amount of intrusive symptoms associated
with the event, replicating earlier findings from the survivors of the
Jupiter Cruise ship disaster (S. Joseph et al., 1993). The relative
maintenance of levels of avoidance symptomatology in both studies was
probably because they reflect controlled coping procedures used by the
traumatized person which are likely to be maintained even when the
levels of intrusive symptomatology have been reduced.
_____

Title: Rhythms of recovery: Trauma, nature and the body.
Author(s): Korn, Leslie Ellen, The Union Inst, US
Source: Dissertation Abstracts International: Section B: The Sciences &n Engineering, Vol 57(2-B), Aug 1996. pp. 1444.
Publisher: US: Univ Microfilms International
Abstract: Rhythms of Recovery: Trauma, Nature and the Body, is a
creative, scholarly dissertation about Post Traumatic Stress. Written
from a holistic, cross-cultural, ecological, feminist paradigm, the core
of the dissertation is a clinical handbook which reviews and integrates
conventional and innovative approaches to assessment, diagnosis and
treatment. Concepts of rhythm are explored in philosophical,
psychophysiological and geobiological context. Approaches to clinical
praxis are informed by psychology, medical anthropology, history of
medicine and conventional and traditional healing systems. The author's
perspectives arise out of heuristic inquiry, including state-specific
research on healing. A synthesis of theory and practice are presented
including theory and methods of touch, (with an analysis of the taboo of
touch) and the author's concept of Somatic Empathy; the
psychobiological, subtle energy field substrate of interpersonal empathy
and healing. The text includes a thematic analysis of cultural and
socio-political categories of illness and healing and integrates ancient
myths to illuminate present categories of interpretation. Matching
textual form to theoretical content, which stresses the multi-vocality
of illness and healing in the context of culture, the author integrates
her creative prose to complement her scholarship.
_____

Title: Traumatic stress reactions in police.
Author(s): Higgins, Jeannie Nancy, U Wollongong, Australia
Source: Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 57(2-B), Aug 1996. pp. 1484.
Publisher: US: Univ Microfilms International
Abstract: A personal construct model of traumatic stress reactions
was developed to predict the relationships between personal, trauma, and
recovery factors. This model was evaluated in two studies with police.
The cross-sectional study included 750 police recruits and inexperienced
constables. The repeated measures study re-assessed 193 recruits after
one year of policing. Data were obtained on history, personal theories,
potentially traumatizing events, perceived availability of social
support, and trauma symptoms. The existence of Posttraumatic Stress
Disorder (PTSD) was assessed by structured interview with 20% of
participants. Personal factors influenced the presence or severity of
trauma symptoms. A negative personal theory, a family history of
psychological assistance, a reported emotional abuse or neglect history,
and Catholicism were significant explanatory variables. Some
characteristics of traumatic events were significant predictors of
trauma symptoms including the type of trauma, a perception of life
threat, total exposure weighted by subjective impact, and personal
identification with a traumatic event. Policing environments were
conducive to traumatization and unfavourable to recovery from stressful
life events. Constables in the cross-sectional study had PTSD prevalence
rates of (6.05%) compared to recruits (3.36%). Current prevalence rates
for PTSD in the repeated measures study for constables were (8.29%)
compared to themselves as recruits (3.36%). Trauma symptoms were
associated with being a constable with one year of operational
experience. Exposure to, or the perceived relevance of, the current
sources of information and advice predicted the presence of trauma
symptoms in both studies. Participants who perceived emotional support
as relevant had more severe trauma symptoms, irrespective of perceived
availability, in the cross-sectional study. A perceived lack of availability of practical assistance following a traumatic event predicted the presence of trauma.
_____


Title: Violence in the workplace, 1970-1995: A review of the literature.
Author(s): Flannery, Raymond B. Jr., Cambridge Hosp, Dept of Psychiatry, Cambridge, MA, US
Source: Aggression & Violent Behavior, Vol 1(1), Spr 1996. pp. 57-68.
Publisher: Netherlands: Elsevier Science
Abstract: Violence is increasing both in society and in the
workplace. Such episodes of violence may result in psychological trauma
and in posttraumatic stress disorder (PTSD) in employee victims. This
article reviews the published peer-reviewed literature in 4 areas of
worksite violence: corporations and industry, police and corrections,
schools and colleges, and healthcare settings. The review examines the
nature and extent of worksite violence as well as the current
interventions that are in place to facilitate employees' response to and
recovery from these events. Five preliminary findings emerge from the
data and their implications are discussed.
_____

Title: Emotional disturbances in trauma patients during the rehabilitation phase: Studies of posttraumatic stress disorder and alexithymia.
Author(s): Fukunishi, Isao, Tokyo Inst of Psychiatry, Tokyo, Japan; Sasaki, Keiichi; Chishima, Yasunori; Anze, Masanori; et al.
Source: General Hospital Psychiatry, Vol 18(2), Mar 1996. pp. 121-127.
Publisher: Netherlands: Elsevier Science
Abstract: Examined the relationship between posttraumatic stress
disorder (PTSD) and alexithymia (ALX) in 26 patients with burn injury
and 27 patients with digit amputation during rehabilitation. The
prevalence rates of Diagnostic and Statistical Manual of Mental
Disorders-III-Revised (DSM-III-R) PTSD and ALX were significantly higher
for injury patients than for healthy volunteers. The rate of PTSD
symptoms of avoidance and emotional numbing was significantly and
positively correlated with scores in injury patients. The PTSD symptoms
of avoidance and emotional numbing had a significant relationship with
function after digit replantation. ALX also had a similar relationship
with physical conditions. Results suggest that: (1) in some cases, ALX
may be evident when PTSD emotional symptoms appear in injury patients,
and (2) emotional disturbances (i.e., PTSD symptoms of avoidance and
emotional numbing and ALX) may be influenced by the level of functional
recovery after digit replantation.
_____

Title: War-induced psychic trauma: An 18-year follow-up of Israeli veterans.
Author(s): Solomon, Zahava, Tel Aviv U, School of Social Work, Tel Aviv, Israel; Kleinhauz, Moris
Source: American Journal of Orthopsychiatry, Vol 66(1), Jan 1996. pp. 152-160.
Publisher: US: American Orthopsychiatric Association, Inc.
Abstract: Conducted an 18-yr follow-up assessment of 112 Israeli
combat stress reaction (CSR) casualties in the Yom Kippur War and 189
comparable Israeli veteran controls to examine the long-term sequelae of
combat in the war and to determine posttraumatic residues in the form of
psychiatric symptomatology. Ss completed the PTSD Inventory, the SCL-90,
and the Impact of Event Scale. CSR casualties had higher rates of
posttraumatic stress disorder (PTSD) than did controls, both initially
and at 18-yr follow-up. Intrusion and avoidance tendencies and
psychiatric symptomatology were evidenced more often by CSR casualties
than by controls. The level of distress reported by Ss in both groups
declined over time, reflecting a trend of recovery. However, CSR
casualties demonstrated lower rates of recovery than did controls.
_____

Title: A multicultural developmental approach for treating trauma.
Author(s): Gusman, Fred D., US Dept of Veterans Affairs, Palo Alto Health Care System, Palo Alto, CA, US; Stewart, Judith; Young, Bruce Hiley; Riney, Sherry J.; Abueg, Francis R.; Blake, Dudley David
Source: Ethnocultural aspects of posttraumatic stress disorder: Issues, research, and clinical applications. Marsella, Anthony J. (Ed); Friedman, Matthew J. (Ed); et al; pp. 439-457. Washington, DC, US: American Psychological Association, 1996. xxii, 576 pp.
Abstract: (from the chapter) the ability to treat trauma victims
is enhanced when the clinician fully integrates an appreciation of
cultural differences / this chapter draws upon decades of direct
clinical experience with victims of a wide range of catastrophic stress
including natural disaster, child abuse, sexual assault, and combat /
begin with case examples drawn from (a) the Japanese American internment
experience and (b) the Vietnam war / these extreme traumas of isolation,
terror, and fear of death highlight the convergence of social, moral,
and political issues in the minority experience of victimization
a developmental model for viewing traumatization / culturally sensitive
treatment of PTSD / related multicultural perspectives on trauma and recovery
_____

Title: Post-traumatic stress disorder.
Author(s): Resick, Patricia A., U Missouri, Ctr for Trauma
Recovery, St Louis, MO, US; Calhoun, Karen S.
Source: Handbook of the treatment of the anxiety disorders (2nd ed.). Lindemann, Carol G. (Ed); pp. 191-216. Northvale, NJ, US: Jason Aronson, Inc, 1996. xx, 426 pp.
Abstract: (from the chapter) provides an expanded discussion of
diagnostic and assessment issues and theoretical models for treatment of
the stress disorders / [discusses] theoretical models for posttraumatic
stress disorder (PTSD) [highlighting] the similarities to as well as the
differences from the other anxiety disorders / [focuses on] victims of
rape / [gives an] example of a treatment model that is primarily based
on cognitive techniques
_____

Title: Structured treatment and prevention activities for sexually abused children.
Series Title: The Hatherleigh guides series; Vol. 5.
Author(s): Hazzard, Ann, Emory U, School of Medicine, Atlanta, GA, US
Source: Hatherleigh guide to child and adolescent therapy.; pp. 23-39.
New York, NY, US: Hatherleigh Press, 1996. xv, 318 pp.
Abstract: (from the chapter) Two theoretical models widely used to
conceptualize the emotional and behavioral consequences of childhood
sexual abuse are the posttraumatic stress disorder (PTSD) model (McLeer
et al, 1988) and D. Finkelhor's model (1986). This chapter discusses the
underpinnings of both models and explores their nuances by using a
case-study approach. Implications for treatment are highlighted.
Prevention activities from the Recovery from Abuse Project (RAP) are
offered as guidelines for clinicians.
_____

Title: IQ loss and emotional dysfunctions after mild head injury in a motor vehicle accident.
Author(s): Parker, Roland S., New York U, Medical Ctr, New York, NY, US; Rosenblum, Andrew
Source: Journal of Clinical Psychology, Vol 52(1), Jan 1996. pp. 32-43.
Publisher: US: John Wiley & Sons
Abstract: Studied intelligence and personality dysfunctions after
minor traumatic brain injury (TBI) incurred in a motor vehicle accident
in adults after an average of 20 mo. There was a mean loss of 14 points
on Full Scale IQ from estimated preinjury baseline IQ from the
standardization group (Wechsler Adult Intelligence Scale-Revised
[WAIS--R ]) without evidence for recovery. Personality dysfunctions
included cerebral personality disorder, psychiatric diagnosis (31 of 33
Ss), posttraumatic stress disorders, (PTSDs), persistent altered
consciousness, and psychodynamic reactions to impairment. Cognitive loss
is caused by interaction of brain injury with distractions such as pain
and emotional distress. Unreported head impact and altered consciousness
at the time of accident contribute to the underestimation of brain
trauma after minor TBI.
_____

Title: An ecological view of psychological trauma and trauma recovery.
Author(s): Harvey, Mary R., Cambridge Hosp, Harvard Medical School, Dept of Psychiatry, Cambridge, MA, US
Source: Journal of Traumatic Stress, Vol 9(1), Jan 1996. pp. 3-23.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: This paper presents an ecological view of psychological
trauma and trauma recovery. Individual differences in posttraumatic
response and recovery are the result of complex interactions among
person, event, and environmental factors. These interactions define the
interrelationship of individual and community and together may foster or
impede individual recovery. The ecological model proposes a
multidimensional definition of trauma recovery and suggests that the
efficacy of trauma-focused interventions depends on the degree to which
they enhance the person-community relationship and achieve "ecological
fit" within individually varied recovery contexts. In attending to the
social, cultural and political context of victimization and
acknowledging that survivors of traumatic experiences may recover
without benefit of clinical intervention, the model highlights the
phenomenon of resiliency, and the relevance of community intervention efforts.
_____

Title: Stress debriefing and patterns of recovery following a natural disaster.
Author(s): Kenardy, Justin A., U Queensland, Dept of Psychology, Brisbane, Australia; Webster, Rosemary A.; Lewin, Terry J.; Carr, Vaughan J.; Hazell, Phillip L.; Carter, Gregory L.
Source: Journal of Traumatic Stress, Vol 9(1), Jan 1996. pp. 37-49.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Examined the effects of stress debriefing on the rate of
recovery of 195 helpers (e.g., emergency service personnel and disaster
workers) following an earthquake in Newcastle, Australia (62 debriefed
helpers vs 133 who were not debriefed). Post-trauma stress reactions and
general psychological morbidity were assessed on 4 occasions over the
1st 2-yrs postearthquake. There was no evidence of an improved rate of
recovery among those helpers who were debriefed, even when level of exposure and helping-related stress were taken into account.
_____

Title: Case study: Treatment of posttraumatic stress disorder from a Christian perspective.
Author(s): O'Reilly, Brenda Kennedy
Source: Psyche and faith: Beyond professionalism. Verhagen, Peter J.
(Ed); Glas, Gerrit (Ed); pp. 53-57. Oxford, England: Uitgeverij Boekencentrum, 1996. xx, 189 pp.
Abstract: (from the chapter) [presents] an actual psychotherapy
case in which posttraumatic stress disorder (PTSD) was treated with
medical, psychological, and spiritual interventions / although the
medical and psychological treatments enabled much recovery, an
unconscious spiritual issue in this client resulted in a therapeutic
impasse that blocked further recovery / when this issue was treated, the patient's disability markedly improved
(from the preface) [the author] gives a short description of the use of
Christian imagery in cognitive psychotherapy [with an adult female presenting with symptoms of PTSD]
_____

Title: The psychosocial experience of mental health professionals as patients themselves in the mental health system.
Author(s): Spadola, Madeline Ladd, Massachusetts School of Professional Psychology, US
Source: Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 56(6-B), Dec 1995. pp. 3464.
Publisher: US: Univ Microfilms International
Abstract: This qualitative research study investigated the
psychosocial experiences of eight MHPs (psychologists, social workers
and psychiatric nurses) who themselves had become patients in the mental
health system. To qualify as patients, they had experienced either one
or more psychiatric hospitalizations or had received psychotropic
medications as part of their treatment plan. The conditions were limited
to affective disorder, thought disorder, posttraumatic stress disorder
and suicidality. The literature review addressed four main areas: the
scope of the problem, the personal accounts of MHP/patients about their
experience of patienthood, observations by the treaters of distressed
professionals, and the impact to the public as a result of impaired
MHPs. Estimates are that 5-15% of MHPs in the United States are impaired
due to mental illness and/or chemical dependency; this may result in
approximately 2500 to 7500 impaired MHPs at any given time. Whereas MHPs
are essential to mental health treatment services, only 25% receive
treatment. Making services more accessible to MHPs is a crucial issue
for the field. Eight participants were recruited through letter and word
of mouth channels. The participants were interviewed individually, for
one to two hours, with the main probe question focussing on their
experiences as both MHPs and patients in the mental health system. The
most important finding from the data was that these subjects felt as
though society did not expect MHPs to be emotionally ill. When they did
become ill, they felt that society could not tolerate it, and in fact,
neither could they. Shame, stigma and powerlessness were important
aspects of their cognitive and behavioral experiences of illness and
recovery. A secondary finding was that subjects went through a process
of transformation, even transfiguration, coming to a recognition of the
mixed benefits and dilemmas of being both a MHP and a patient in the mental health system.
_____

Title: Los Angeles County after the 1992 civil disturbances: Degree of exposure and impact on mental health.
Author(s): Hanson, Rochelle F., U Florida, Ctr for Sexual
Assault/Abuse Recovery & Education, Student Health Care Ctr, Gainesville, FL, US; Kilpatrick, Dean G.; Freedy, John R.; Saunders, Benjamin E.
Source: Journal of Consulting & Clinical Psychology, Vol 63(6), Dec 1995. pp. 987-996.
Publisher: US: American Psychological Assn
Abstract: The impact of the 1992 Los Angeles (LA) civil
disturbances on psychosocial functioning was assessed as part of a
larger project investigating the views and attitudes of residents in LA
County. Random digit dialing methodology identified a household
probability sample of 1,200 adults (age 18 or older) from LA County.
Respondents completed a telephone interview 6 to 8 months after the
disturbances. Respondents' degree of exposure to the disturbances,
mental health impact of the disturbances, and mental health effects of
chronic versus acute exposure to violence were assessed. Consistent with
hypotheses, the impact of the disturbances was the worst in the South
Central communities. Higher rates of posttraumatic stress disorder
(PTSD) (both diagnostic level and subclinical symptomatology) were found
among respondents who reported disturbance-related experiences. Exposure
to an acute event (i.e., the disturbances) was predictive of current
PTSD symptomatology after controlling for demographics, lifetime trauma, and other types of stressful events.
_____

Title: Psychiatric dimensions of disaster: Patient care, community consultation, and preventive medicine.
Author(s): Ursano, Robert J., Uniformed Services U of the Health Sciences, School of Medicine, Dept of Psychiatry, Bethesda, MD, US; Fullerton, Carol S.; Norwood, Ann E.
Source: Harvard Review of Psychiatry, Vol 3(4), Nov-Dec 1995. pp. 196-209.
Publisher: United Kingdom: Taylor & Francis
Abstract: Examines the posttraumatic responses of direct concern
to psychiatrists working in a community exposed to a disaster. Drawing
on English-language literature from 1980-1995, epidemiology of
posttraumatic responses is reviewed, as well as disaster response,
including mediating factors, the interface of psychiatry and traumatic
stress, the psychiatric disorders associated with trauma, and the
psychiatric consultation to the disaster community. Overall, psychiatric
intervention after a disaster is based on the principles of preventive
medicine and includes community consultation and outreach programs with
the goals of identifying high-risk groups, promoting community recovery,
and minimizing social disruption.
_____

Title: A general model for the treatment of post-traumatic stress disorder in war veterans.
Author(s): Marshall, Richard P., Australian National U, NHMRC Social Psychiatry Research Unit, Canberra, ACT, Australia; Dobson, Matthew
Source: Psychotherapy: Theory, Research, Practice, Training, Vol 32(3), Fal 1995. pp. 389-396.
Publisher: US: Division of Psychotherapy (29), American
Psychological Association
Abstract: Presents a general conceptual model of the recovery
processes required for a successful therapeutic resolution of
war-related PTSD. These processes involve relationship building, the
development of emotional and cognitive connections with the trauma,
recognition of the divergence between pre- and post-trauma values,
modifying one's sense of self, establishing meaning for the trauma, and
reestablishing appropriate self management and social skills. The
authors emphasize the importance of the therapist-veteran relationship
to client engagement in the recovery process. Case vignettes are
included to illustrate model dynamics.
_____

Title: Adverse events in PTSD patients taking fluoxetine.
Author(s): Marshall, Randall D.; Printz, David; Cardenas, Dora; Abbate, Linda; et al.
Source: American Journal of Psychiatry, Vol 152(8), Aug 1995. pp. 1238-1239.
Publisher: US: American Psychiatric Assn
Abstract: Reports on an open prospective trial of fluoxetine for
posttraumatic stress disorder (PTSD) in nonveteran patients. After an
initial wk of single-blind placebo, fluoxetine therapy was given at 10
mg/day for 2 wks and increased to 20 mg/day for 2 wks, with subsequent
increases if necessary. Three of 6 Ss withdrew because of adverse
effects; 2 experienced agitation and worse hyperarousal symptoms and 1
experienced exacerbated panic symptoms. A 4th S experienced severe
agitation and anxiety at 30 mg/day but tolerated 20 mg/day with complete
recovery. Results are similar to those observed in panic disorder Ss treated with fluoxetine.
_____

Title: Sibling death in adolescence: The relationship of coping responses to adjustment, stressor type, and age.
Author(s): Aupperle, Douglas Ronald, Depaul U, US
Source: Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 56(2-B), Aug 1995. pp. 1098.
Publisher: US: Univ Microfilms International
Abstract: This study attempted to identify how adolescents cope
with traumatic sibling death. Participants were 10 male and 10 female
young people from the Chicago metropolitan area. Their average age was
16.20 years, and all had lost a sibling to either suicide (n = 9) or an
automobile accident (n = 11). They were 60% white, 30% African-American,
5% Latino, and 5% Native American. Interviews occurred 8 to 34 months
after the deaths of the siblings (M = 14.3 months). Participants
completed the Ways of Coping Questionnaire (WCQ) for both the sibling
death and a minor stressor. They also completed the Family Environment
Scale (FES), Children's Depression Inventory (CDI), Posttraumatic
Reaction Index (PRI), and the grief recovery section of the Grief
Inventory (GI). Adolescents reported less use of planful problem-solving
and greater use of escape-avoidance and positive reappraisal when coping
with traumatic sibling death than when coping with minor stressors.
Appraised control of the stressor was less for sibling death than for
minor stressors. In addition, the number of coping behaviors used with
sibling death was greater than with minor stressors. With regard to
traumatic sibling death, the use of escape-avoidance to cope decreased
as adolescents' age increased. With regard to minor stressors, the use
of distancing to cope decreased and the use of planful problem-solving
to cope increased as adolescents' age increased. Higher use of
escape-avoidance to cope with sibling death correlated with higher
severity of depression, severity of posttraumatic stress disorder
(PTSD), intrusiveness/numbing/avoidance symptoms of PTSD, and
fear/anxiety symptoms of PTSD. Higher use of confrontive coping
correlated with higher PTSD severity, intrusiveness/numbing/avoidance
symptoms, and fear anxiety symptoms but not depression. Higher seeking
of social support correlated with higher PTSD severity and fear/anxiety
symptoms only. Higher accepting responsibility correlated with higher PTSD severity.
_____

Title: Symptoms of PTSD following recovery of war dead: 13-15-month follow-up.
Author(s): McCarroll, James E., Walter Reed US Army Inst of Research, Dept of Military Psychiatry, Washington, DC, US; Ursano, Robert J.; Fullerton, Carol S.
Source: American Journal of Psychiatry, Vol 152(6), Jun 1995. pp. 939-941.
Publisher: US: American Psychiatric Assn
Abstract: Explored whether individuals who participated in the
recovery of war dead were more likely to experience later symptoms of
posttraumatic stress disorder (PTSD) than were individuals who were not
involved in the recovery of war dead. PTSD symptoms were assessed by
questionnaire in men and women who had or had not handled human remains
during the Persian Gulf War: 116 men and women who had and 118 who had
not handled human remains participated in the study 3-5 mo after
returning from the war; 55 Ss who had and 56 Ss who had not handled
human remains participated in a follow-up assessment 13-15 mo after
their return. Ss who had been involved in the recovery of war dead had
significantly higher symptom levels than comparison Ss at both time points.
_____

Title: A prospective examination of symptoms of posttraumatic stress disorder in vicitms of nonsexual assault.
Author(s): Riggs, David S., Veterans Affairs Medical Ctr, National Ctr for Post Traumatic Stress Disorder, Boston, MA, US; Rothbaum, Barbara O.; Foa, Edna B.
Source: Journal of Interpersonal Violence, Vol 10(2), Jun 1995. pp. 201-214.
Publisher: US: Sage Publications
Abstract: Investigated the prevalence and severity of
posttraumatic stress disorder (PTSD) in 53 female and 31 male victims of
nonsexual assault. Victims were interviewed at baseline and 3 mo later
with (1) the Assault Reaction Interview, which assessed PTSD symbols,
changes in lifestyle, and psychiatric and physical problems, and (2) the
PTSD Diagnosis and Severity Interview, which assessed symptoms of
re-experiencing, numbing, arousal, and avoidance. At the initial
assessment, more than 70% of women and 50% of men showed PTSD symptoms;
however, the prevalence of PTSD decreased in the next 3 mo. In the final
assessment 21% of the women and none of the men showed PTSD symptoms.
However, anxiety symptoms were likely to persist in both men and women.
PTSD was more persistent in Ss with more severe initial symptoms.
_____

Title: Eye movement desensitization: Three unusual cases.
Author(s): Spates, C. Richard, Western Michigan U, Dept of Psychology, Kalamazoo, US; Burnette, M. Michele
Source: Journal of Behavior Therapy & Experimental Psychiatry, Vol 26(1), Mar 1995. pp. 51-55.
Publisher: Netherlands: Elsevier Science
Abstract: Presented 3 complex cases to document further the broad
applicability of eye movement desensitization for posttraumatic stress
disorder (PTSD). In the 1st S (an adult male) this disorder was combined
with panic attacks; in the 2nd (a 39-yr-old woman), sexual dysfunction
was an additional consequence of childhood sexual abuse; and in the 3rd
(a 38-yr-old male), the causative situation directly resulted in
profound impairment of occupational and social function. In all 3 cases,
treatment produced rapid resolution of symptoms and functional recovery in relatively few or a single session and seemed to be stable over time.
_____

Title: Tratamiento psicológico del trastorno de estrés postraumático crónico en víctimas de agresiones sexuales: un estudio experimental.
Translated Title: Psychological treatment of chronic posttraumatic stress disorder in victims of sexual aggression: An experimental study.
Author(s): Corral Gargallo, Paz del, U del País Vasco, Facultad de Psicología, Bilbao, Facultad de Psicología, Bilbao, Spain; Echeburúa Odriozola, Enrique;
Zubizarreta Anguera, Irene; Sarasua Sanz, Belén
Source: Analisis y Modificacion de Conducta, Vol 21(78), 1995. pp. 455-482.
Publisher: Spain: Promolibro
Abstract: Studied the efficacy of exposure therapy and cognitive
reevaluation compared to progressive relaxation training for the
treatment of posttraumatic stress disorder in sexual assault victims.
Human Ss: 20 female Spanish adolescents and adults (aged 15-41 yrs)
(sexual assault victims). Information on the characteristics associated
with sexual assault, psychological symptoms, and treatment response was
obtained by semistructured interview. Exposure therapy consisted of
gradual recovery of social activities, exposure to erotic or violent
stimuli, imagination of traumatic dreams or thoughts, and training in
sexual abilities. Cognitive reevaluation included explanation of normal
reactions to sexual assault, modification of negative thought processes
associated with violation, and development of coping mechanisms.
Progressive relaxation training following the method proposed by D. A.
Berustein and T. D. Borkovec, 1973 was practiced twice daily. A
multigroup experimental design with repeated measures (pretreatment,
posttreatment and at 1, 3, and 6 mo follow up) was used to evaluate
changes in depressive, anxiety, adaptation, and other psychological
symptoms. Tests used: The Beck Depression Inventory, the State-Trait
Anxiety Inventory, the Adaptation Scale (Echeburúa and Corral, 1987),
the Modified Fears Questionnaire (L. J. Veronen and D. G. Kilpatrick,
1980), and the Severity of Posttraumatic Stress Syndrome Symptoms Scale (Echeburúa et al, 1994). Statistical tests were used. (English abstract)
_____

Title: LA 94 earthquake in the eyes of children: Art therapy with elementary school children who were victims of disaster.
Author(s): Roje, Jasenka
Source: Art Therapy, Vol 12(4), 1995. pp. 237-243.
Publisher: US: American Art Therapy
Abstract: Examined the efficacy of art therapy (ATY) in dealing
with manifestations of posttraumatic stress disorder (PTSD) in 25
earthquake victims (aged 4-11 yrs). Ss were seen either individually, in
small groups, or with their families. They were encouraged to express
their experiences related to the earthquake through words and pictures.
Ss experienced loss of control, fear of falling asleep and abandonment,
and felt unsafe in their homes. Thoughts of permanent loss or death,
concerns for the future, and behavioral and emotional problems
associated with the trauma were also observed in Ss. Through ATY, they
were able to regain their inner sense of security and trust in the
world, and give vent to their stress feelings. Working through defenses
like denial, regression, and humor enabled identification of those
underlying conflicts that hindered recovery. Results suggest that ATY is
a successful treatment modality in the recovery of earthquake trauma.
_____


Title: A cognitive processing formulation of posttrauma reactions.
Series Title: Plenum series on stress and coping
Author(s): Creamer, Mark, U Melbourne, Dept of Psychology, Parkville, VIC, Australia
Source: Beyond trauma: Cultural and societal dynamics. Kleber, Rolf J. (Ed); Figley, Charles R. (Ed); et al; pp. 55-74. New York, NY, US: Plenum Press, 1995. xviii, 313 pp.
Abstract: (from the chapter) purpose . . . is to develop a
cognitive processing model based on a synthesis and reformulation of
some existing theories [of posttrauma reactions] and to evaluate that
model empirically / provides additional data in support of the model
originally proposed by M. Creamer, P. Burgess, and P. Pattison (1992) /
cognitive processing theories propose that individuals enter novel
situations with preexisting mental schemata, or memory networks / the
experience of a trauma confronts the survivor with information that is
likely to be inconsistent with these preexisting views of the world /
for recovery to occur, this new information from the traumatic
experience must be processed until it can be made congruent with these
inner models / the proposed longitudinal model [includes 5 stages of
posttrauma reactions: objective exposure, traumatic memory network
formation, intrusion, avoidance, and outcome]
the [empirical validation] study investigated reactions to a multiple
shooting that occurred in [Melbourne, Australia, killing 8 people in an]
office building / [Ss were 108 employees] who were present in the
building at the time of the shootings / the research utilized a
repeated-measures survey design, with data collection at 4, 14, and 27
mo posttrauma.
Conference Notes: Based on the 1st World Conference of the
International Society for Traumatic Stress Studies on Trauma and
Tragedy: The Origins, Management, and Prevention of Traumatic Stress in
Today's World, Amsterdam, Netherlands, Jun 22-26, 1992.
_____

Title: Working with people with PTSD: Research implications.
Series Title: Brunner/Mazel psychological stress series, No; 23
Author(s): Dutton, Mary Ann, George Washington U, Medical Ctr, Dept of Emergency Medicine, Washington, DC, US; Rubinstein, Francine L.
Source: Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. Figley, Charles R. (Ed); pp. 82-100. Philadelphia, PA, US: Brunner/Mazel, Inc, 1995. xxii, 268
pp.
Abstract: (from the chapter) review the literature so as to
develop an understanding of the trauma worker's secondary traumatic
stress (STS) reactions, that is, the psychological effects of exposure
to traumatic events through contact with survivors of trauma, as well as
with perpetrators of traumatic events on others (e.g., rapist, batterer,
war criminal) / trauma workers are persons who work directly with or
have direct exposure to trauma victims, and include mental health
professionals, lawyers, victim advocates, caseworkers, judges,
physicians and applied researchers, among others

presents a theoretical framework for understanding STS reactions and
discusses implications for assessment, intervention, and prevention /
the model includes the following: (1) the traumatic event(s) to which
the trauma worker has been exposed, (2) the trauma worker's PTS
[posttraumatic stress] reactions, (3) the trauma worker's coping
strategies for responding to the traumatic situation and to its
psychological sequelae, and (4) the personal (e.g., characteristics of
the trauma worker) and environmental (e.g., characteristics of the
environment in which secondary exposure to the traumatic event occurred and of the recovery environment) mediators of STS reactions
_____

Title: The pathogenic effects of war stress: The Israeli experience.
Series Title: NATO ASI series
Author(s): Solomon, Zahava, Israel Defense Forces, Medical Corps, Mental Health Dept, Tel Aviv, Israel
Source: Extreme stress and communities: Impact and
intervention. Hobfoll, Stevan E. (Ed); deVries, Marten W. (Ed); pp. 229-246. New York, NY, US: Kluwer Academic/Plenum Publishers, 1995. xxii, 535 pp.
Abstract: (from the chapter) over the past 12 yrs, with Israeli
Army colleagues at the Army Medical Corps and Tel Aviv University, we
have conducted a series of studies of 3 wars, the 1973 Yom Kippur War,
1982 Lebanon War, and the 1991 Gulf War / assessed the social,
psychological, and physiological outcomes of war-related stress in
periods of hours, days, and many years after exposure, and examined the
implication of a host of psychological, social, and cultural factors in
the genesis of and recovery from war-induced psychopathology / present
some of the results of our studies, attesting to the heavy toll of war on civilians and soldiers
the following 5 issues will be presented and discussed: (1) the clinical
manifestations and prevalence of acute psychological reactions during or
shortly after exposure to war; (2) the long term psychological sequelae
of war stress; (3) delayed onset post traumatic stress disorders; (4)
reactivation of previous war stress reactions [and] (5) secondary
traumatization of people close to traumatized individuals
Conference Notes: This volume is a reflection on the themes from
the NATO Advanced Research Workshop on Stress and Communities at Chateau
de Bonas, France, Jun 1994.
_____

Title: Prevention of work-related posttraumatic stress: The critical incident stress debriefing process.
Author(s): Everly, George S. Jr., International Critical Incident Stress Foundation, Inc., Ellicott City, MD, US;
Mitchell, Jeffrey T.
Source: Job stress interventions. Murphy, Lawrence R. (Ed); Hurrell, Joseph J. Jr. (Ed); Sauter, Steven L. (Ed); Keita, Gwendolyn Puryear
(Ed); pp. 173-183. Washington, DC, US: American Psychological Association, 1995. xiii, 439 pp. Publisher
Abstract: (from the chapter) the CISD [critical incident stress
debriefing] and defusing processes may be defined as group meetings or
discussions about a traumatic event or series of traumatic events / the
CISD and defusing processes are designed to mitigate the psychological
impact of a traumatic event, prevent the subsequent development of
posttraumatic stress disorder (PTSD), and serve as an early
identification mechanism for individuals who will require professional
mental health followup after a traumatic event / describe the
development of CISD, its basic components, and its 12-yr history as a
preventive intervention for PTSD among high-risk occupational groups

the CISD and defusings were developed with 2 main goals: (a) to mitigate
the harmful effects of traumatic stress on emergency personnel and (b)
to accelerate normal recovery processes in normal people who were
experiencing normal reactions to abnormal events / it was believed that
the CISD, as a structured small-group process, would be a positive
factor in the prevention of posttraumatic stress and PTSD among
high-risk occupational groups, specifically firefighters, law
enforcement officers, emergency medical workers, disaster response
personnel, emergency dispatchers, and public safety personnel
_____

Title: Acute emotional response to common whiplash predicts subsequent
pain complaints: A prospective of 107 subjects sustaining whiplash injury.
Author(s): Drottning, Monica, Ullevål Sykehus, Oslo, Norway; Staff, Peer H.; Levin, Leif; Malt, Ulrik F.
Source: Nordic Journal of Psychiatry, Vol 49(4), 1995. pp. 293-299.
Publisher: United Kingdom: Taylor & Francis
Abstract: Studied 107 Ss consecutively admitted to a Norwegian
emergency service hours after sustaining a whiplash injury. Acute
assessment included clinical examination, a questionnaire about
preaccident health problems, M. Horowitz et al's (1979) Impact of Event
Scale (IES), and visual analog scale (VAS) assessment of the acute pain.
93% of the Ss completed a questionnaire about their symptoms 4 wks
later. A significant correlation between acute VAS neck pain and IES
scores were found. At 4 wks, 42% of the Ss still reported significant
pain problems. 70% of these Ss had high IES scores acutely, compared
with only 26% in the low-pain group. Findings indicate that the acute
psychologic response to a whiplash incident is the strongest predictor
of maintenance of pain symptoms 4 wks later.
_____

Title: Delayed reaction to sibling-loss: The unmourned sibling as a block to procreation and creativity; a post-traumatic state.
Author(s): Rosen, Maria
Source: Psychoanalytic Psychotherapy, Vol 9(1), 1995. pp. 75-83.
Publisher: United Kingdom: Taylor & Francis
Abstract: Describes a delayed reaction to sibling loss in a
38-yr-old female patient who had decided to start a family. She began to
have unexplained panic attacks after making the decision to have a baby.
In analysis it gradually became apparent that these panic attacks were a
delayed reaction to the trauma of the loss of her baby brother when she
was 16 yrs old. Recovery of her feelings about the death of her brother
led to a gradual resolution of her symptoms and to her successfully
being able to have her own baby. It also led to a marked increase in her
creativity and to greater satisfactions in personal relationships. The
unmourned nature of the death of her brother had had a deadening effect on her feelings including her own maternal feelings and procreative capacity.
_____

Title: Twelve themes and spiritual steps: A recovery program for survivors of traumatic experiences.
Series Title: Plenum series on stress and coping
Author(s): Brende, Joel Osler, Central State Hosp, Regional Psychiatric Div, Milledgeville, GA, US
Source: Psychotraumatology: Key papers and core concepts in post-traumatic stress. Everly, George S. Jr. (Ed); Lating, Jeffrey M. (Ed); pp. 211-229. New York, NY, US: Plenum Press, 1995. xxii, 418 pp.
Abstract: (from the book) presents a therapeutic process anchored
in the legacy of the 12-step models but applied to post-traumatic stress
/ introduces the spiritual aspects of healin
(from the chapter) [describes a] 12 step program, called TRAUMA SURVIVORS ANONYMOUS [psychoeducational program developed by the author].
power vs victimization / seeking meaning / trust vs shame and doubt /
self-inventory / anger / fear / guilt / grief / life vs death / justice
vs revenge / finding a purpose / love and relationships
_____

Title: Systemic PTSD: Family treatment experiences and implications.
Series Title: Plenum series on stress and coping
Author(s): Figley, Charles R., Florida State U, Psychosocial Stress Research Program, Tallahassee, FL, US
Source: Psychotraumatology: Key papers and core concepts in post-traumatic stress. Everly, George S. Jr. (Ed); Lating, Jeffrey M. (Ed); pp. 341-358. New York, NY, US: Plenum Press, 1995. xxii, 418 pp.
Abstract: (from the book) addresses the family as a victim of
post-traumatic stress and reviews the treatment process
(from the chapter) review the extant scholarly and practice literatures
that focus on some aspect of "systemic" PTSD in order to demonstrate how
families are exposed to traumatic material, attempt to cope and recover
from it, and how various treatment programs help to facilitate the recovery process
_____

Title: Self-care and the vulnerable therapist.
Author(s): Williams, Mary Beth, Trauma Recovery Education Counseling Ctr, Warrenton, VA, U;
Sommer, John F. Jr.
Source: Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators. Stamm, B. Hudnall (Ed); pp. 230-246. Baltimore, MD, US: The Sidran Press, 1995. xxiii, 279 pp.
Abstract: (from the chapter) [frame] standards of practice
guidelines for [trauma] therapy from a distinctly self-care and ethical
perspective / address pertinent clinical issues, raise questions, and
offer possible alternatives [in self care for the therapist vulnerable to secondary traumatic stress]
the need for a strong ethical sense and ethical principles of practice /
the need for knowledge of theory and ongoing training / the need for
resolution of the therapist's own issues and trauma history / the need
for competence in practice strategies and techniques / the need for
awareness of the impact of "the work" on the self of the therapist and the willingness to take steps to lessen that secondary impact
_____

Title: Traumatic event debriefing: Service delivery designs and the role of social work.
Author(s): Bell, Janet L., Arizona State U, School of Social Work, Tempe, US
Source: Social Work, Vol 40(1), Jan 1995. pp. 36-43.
Publisher: US: NASW Press
Abstract: Describes the process of traumatic event debriefing
(TED), which is conducted 24-72 hrs after exposure to the traumatic
event using a form of intensive group crisis intervention. The method is
designed to help reduce acute stress symptoms and accelerate the
recovery process, thereby diminishing the subsequent development of
posttraumatic stress disorder (PTSD). Social workers have the precise
constellation of skills, social-environmental perspectives, and practice
methodologies indispensable both to developing TED teams and to leading
the debriefings. The 7 phases of TED include the introduction, fact
phase, thought phase, reaction phase, symptom phase, teaching phase, and
reentry phase. Three types of environment-specific teams for the
delivery of debriefings include the in-house TED, contract TED, and humanitarian-civil TED.
_____

Title: Military trauma.
Series Title: Plenum series on stress and coping
Author(s): Weathers, Frank W., US Dept of Veterans Affairs Medical Ctr, Boston, MA, US; Litz, Brett T.; Keane, Terence M.
Source: Traumatic stress: From theory to practice. Freedy, John R. (Ed); Hobfoll, Stevan E. (Ed); pp. 103-128. New York, NY, US: Plenum Press, 1995. xvii, 402 pp.
Abstract: (from the chapter) [begins with a] historical
perspective [on war-related trauma] / [argue that] an individual's
unique adaptation to war-zone stress is best understood in terms of
complex interactions among the aspects of the trauma, aspects of the
individual, and aspects of the recovery environment / review the
existing literature [on combat stress reactions (CSR) and posttraumatic
stress disorder (PTSD)] in an effort to address several key questions:
what is the nature of war, and what makes it traumatic; what are the
psychological consequences of exposure to war-zone stress; how prevalent
are war-zone stress reactions; what are the risk factors for developing
a war-zone stress reaction [and] what are the resilience factors / this
chapter is limited to a discussion of combatants
women in the war zone
_____

Title: Violent crime and mental health.
Series Title: Plenum series on stress and coping
Author(s): Hanson, Rochelle F., U Florida, Student Health Care Ctr, Ctr for Sexual Assault/Abuse Recovery & Education, Gainesville, FL, US; Kilpatrick, Dean G.; Falsetti, Sherry A.; Resnick, Heidi S.
Source: Traumatic stress: From theory to practice. Freedy, John R. (Ed); Hobfoll, Stevan E. (Ed); pp. 129-161. New York, NY, US: Plenum Press, 1995. xvii, 402 pp.
Abstract: (from the chapter) discuss key conceptual and
methodological issues involved in measuring violence and its mental
health impact [in the US] / present prevalence data for violent crime
and for crime-related mental health problems [posttraumatic stress
disorder (PTSD), substance abuse, depression and sexual dysfunction] /
describe and present supporting evidence for a hypothetical model
addressing risk factors for exposure to violent crime / describe
violence-related mental health problems following exposure to violent
crime / discuss factors that increase or decrease the risk of developing
violence-related mental health problems / highlight some implications
for prevention and mental health treatment.
_____

Title: Coping with trauma: A guide to self-understanding.
Author(s): Allen, Jon G., Menninger Clinic, Trauma Recovery Program, Topeka, KS, US
Source: Washington, DC, US: American Psychiatric Association, 1995. xx, 385 pp.
Abstract: (from the jacket) Traumatic experience is alarmingly
prevalent; few people escape its direct or indirect effects. J. Allen .
. . has written this book to help laypersons understand the complex and
often bewildering impact of traumatic experience. [This book] provides a
comprehensive [and] readable summary of current professional knowledge
for people of diverse backgrounds and education.
Based on an extensive review of contemporary professional literature,
"Coping With Trauma" incorporates the author's experience conducting
educational groups for patients with a history of severe trauma. In
teaching these groups, J. Allen learns from his patients, who have
generously and openly shared their personal experiences. Their lessons
form a vital part of this book.
Those who are struggling to cope with the direct effects of trauma will
find [this book] to be an informative and sensitive guide to better
understanding themselves and their experience. Partners and family
members of traumatized individuals can gain increased understanding of
and empathy for their loved ones, in addition to learning how to be more
supportive. Mental health professionals who work with people with a
history of trauma will find the book to be a useful digest of current
knowledge that they can share with their patients.
_____

Title: Managing traumatic stress through art: Drawing from the center.
Author(s): Cohen, Barry M.; Barnes, Mary-Michola; Rankin, Anita B.
Source: Baltimore, MD, US: The Sidran Press, 1995. xviii, 137 pp.
Abstract: (from the foreword) This workbook addresses the stages
of post-traumatic stress recovery. The 1st section is devoted to
establishing a safe framework for trauma resolution. The 2nd section
deals with acknowledging and regulating emotion; it helps the trauma
survivor make sense of confusing and overwhelming emotional experiences.
Reflective writing segments allow for ongoing integration of thinking
and feeling. The final section focuses on self and relational
development and improved functioning and growth. The art experiences
presented are broad enough to be relevant to those recovering from a
wide variety of traumatic experiences ranging from childhood abuse to
disabling medical illness.
_____

Title: Psychotraumatology: Key papers and core concepts in post-traumatic stress.
Series Title: Plenum series on stress and coping
Author(s): Everly, George S. Jr., (Ed), International Critical Incident Stress Foundation, Ellicott City, MD, US; Lating, Jeffrey M., (Ed)
Source: New York, NY, US: Plenum Press, 1995. xxii, 418 pp.
Abstract: (from the cover) [This book] provides concise coverage
of key topics, employing a novel 2-factor model of post-traumatic stress
to evaluate and unify critical aspects of the field.
A unique compilation of original articles, scholarly reviews, and
previously published papers important to the psychotraumatology
literature, this volume discusses the nature, assessment, treatment, and
prevention of post-traumatic stress, as well as special issues attendant to this condition.
The contributions to "Psychotraumatology" challenge readers to reflect
on the phenomenology of post-traumatic stress. With the aim of improving
the therapeutic process, these explorations of major phenomenological
issues will prove valuable to practicing clinicians, researchers, and
graduate-level students in psychology, psychiatry, nursing, and counseling.
_____

Title: Soldier's heart: Survivors' views of combat trauma.
Author(s): Hansel, Sarah B., (Ed), US Dept of Veterans Affairs Medical Ctr, Trauma Recovery Service Team, Perry Point, MD, US; Steidle, Ann, (Ed); Zaczek, Grace, (Ed); Zaczek, Ron, (Ed)
Source: Baltimore, MD, US: The Sidran Press, 1995. xii, 242 pp.
Abstract: (from the publicity materials) This [book is a]
compilation of original poetry, prose, and art . . . by
veterans--primarily Vietnam vets, yet with contributions by veterans of
World War II, Korea, and Desert Storm--with combat-induced trauma
disorders. "Soldier's Heart" seeks to illuminate the range of emotions
and reactions to diagnosis that often characterize individuals healing
from posttraumatic stress disorder (PTSD). In the process, this book
offers survivors and their families a sense of community, helping to
dispel the isolation frequently felt by people with trauma disorders.
Veterans' contributions have been organized in 7 chapters to reflect the
general recovery path of survivors living with PTSD. Veterans write of a
growing awareness that "something" is wrong; complex feelings of
isolation and alienation; the frequently difficult--if not actually
traumatic--process of seeking therapy; the toll that PTSD takes on
families; the lost years and dreams; grief for friends killed and the toll of survivor guilt; escape; and finally, hope and recovery.
_____

Title: Traumatic experiences and substance abuse: Mapping the territory.
Author(s): Zweben, Joan Ellen, 14th Street Clinic & Medical Group, Oakland, CA, US; Clark, H. Westley; Smith, David E.
Source: Journal of Psychoactive Drugs, Vol 26(4), Oct-Dec 1994. pp. 327-344.
Publisher: US: Haight-Ashbury Publications
Abstract: Examines the relationships between various types of
traumatic experiences and addictive behavior, with an eye to formulating
effective treatment strategies. Interventions in the posttraumatic
stress disorder (PTSD) and related fields are reviewed to discover how
best to integrate them into substance abuse treatment. The
recovery-oriented therapy model is used as a framework to define
treatment tasks at each stage of the recovery process. These tasks
include making a commitment to abstinence, stopping alcohol and other
drug use, consolidating abstinence and changing lifestyles, and
addressing short- and long-term psychosocial issues. The clinical
features of PTSD are discussed to enhance the practitioner's ability to
address this disorder in the context of substance abuse treatment.
_____

Title: Psychotherapy of bereavement after homicide.
Author(s): Rynearson, Ted, Virginia Mason Medical Ctr, Section of
Psychiatry, Seattle, WA, US
Source: Journal of Psychotherapy Practice & Research, Vol 3(4), Fal
1994. pp. 341-347.
Publisher: US: American Psychiatric Press
Abstract: Presents guidelines for the assessment and initial
treatment of bereavement after a homicide. A preliminary model of
unnatural dying is proposed, which suggests that violence, violation,
and volition (all associated with homicide) are related to syndromal
effects. These responses include posttraumatic stress disorder (PTSD),
victimization, and compulsive inquiry. Early interventions include
nonverbal techniques applied in individual and group therapy. Because
patients are overwhelmed and reactive, initial treatment strategy is
supportive and focuses on reestablishing resiliency rather than on
preexisting vulnerabilities (ambivalence, guilt, repression, denial).
Case histories of a 35-yr-old man with short-term recovery and a
35-yr-old woman with limited recovery illustrate how their resiliency
and vulnerability were reflected in the depth and course of their therapy.
_____

Title: Comparability of two administration formats of the Keane
Posttraumatic Stress Disorder Scale.
Author(s): Lyons, Judith A., Dept of Veterans Affairs Medical Ctr,
Trauma Recovery Program, Jackson, MS, US
Scotti, Joseph R.
Source: Psychological Assessment, Vol 6(3), Sep 1994. pp. 209-211.
Publisher: US: American Psychological Assn
Abstract: Evaluated the utility of administering the 49 items of
the Keane MMPI posttraumatic stress disorder (PTSD) scale (T. M. Keane
et al; see record 1985-02913-001) as an instrument separate from the
full MMPI. Scores obtained through a separate administration of the PTSD
scale were significantly positively correlated with scores obtained
through a standard administration of the MMPI. This finding held for
both White (n = 114) and African-American (n = 61) Ss. Within each
ethnic group, mean scores were virtually identical across administration
formats. Overall, 94.3% of the veterans were similarly classified on
both administrations of the PTSD scale when the recommended cutoff score
of 30 was applied. The clinical and research uses of the PTSD scale as a
separate instrument are discussed.
_____

Title: Post-traumatic stress disorder in victims of disasters.
Author(s): Green, Bonnie L., Georgetown U School of Medicine, Dept
of Psychiatry, Washington, DC, US;
Lindy, Jacob D.
Source: Psychiatric Clinics of North America, Vol 17(2), Jun 1994. pp. 301-309.
Publisher: Netherlands: Elsevier Science
Abstract: Presents a model of how various factors may combine to
influence adaptation to natural and human-caused disaster events. The
literature is reviewed on mental health aspects of disaster and the
extent to which posttraumatic stress disorder (PTSD) has been found in
disaster survivors, along with how many people are likely to be affected
and how long these symptoms may last. It is also noted which individuals
are at risk following these events and what characteristics might be
helpful in recovery. Various ways in which mental health professionals
might intervene with disaster survivors are outlined.
_____

Title: PTSD among Israeli former prisoners of war and soldiers with
combat stress reaction: A longitudinal study.
Author(s): Solomon, Zahava, Tel-Aviv U, School of Social Work, Ramat-Aviv, Israel; Neria, Yuval; Ohry, Abraham; Waysman, Mark; et al.
Source: American Journal of Psychiatry, Vol 151(4), Apr 1994. pp. 554-559.
Publisher: US: American Psychiatric Assn
Abstract: Assessed the long-term impact of war captivity and
combat stress reaction (CSR) on rates of posttraumatic stress disorder
(PTSD) in Israeli veterans of the 1973 Yom Kippur war. 164 former
prisoners of war (POWs), 112 veterans who had had CSR, and 184 combat
veteran comparison Ss filled out a self-report scale based on the
Diagnostic and Statistical Manual of Mental Disorders-III-Revised
(DSM-III-R) criteria for PTSD. 37% of the Ss who had had CSR, 23% of the
former POWs, and 14% of the comparison Ss had had diagnosable PTSD at
some time in the past; the current rates were 13%, 13%, and 3%,
respectively. Almost two-thirds of the Ss with CSR who had had PTSD in
the past recovered, while less than one-half of the POW group showed
this improvement. The different recovery rates in the 2 groups may
reflect differences in duration and severity of stressors and impact of
immediate intervention on long-term adjustment, or both.
_____

Title: Psychological symptoms and psychiatric diagnoses in Operation
Desert Storm troops serving graves registration duty.
Author(s): Sutker, Patricia B., Veterans Affairs Medical Ctr, Psychology Service, New Orleans, LA, US; Uddo, Madeline; Brailey, Kevin; Allain, Albert N.; et al.
Source: Journal of Traumatic Stress, Vol 7(2), Apr 1994. pp. 159-171.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Describes symptoms of psychological and physical
distress and psychiatric disorders in 24 Army Reservists (aged 20-44
yrs) who served war-zone graves registration duty in support of
Operation Desert Storm. Troops underwent comprehensive assessment for
evidence of psychopathology that might be associated with war zone duty
as one component of a debriefing protocol scheduled during regular drill
exercises 8 mo after their return to the US. Ss endorsed items
suggestive of high war zone stress exposure; common symptoms of anxiety,
anger, and depression; and multiple health and somatic concerns. Almost
half of the Ss met criteria for posttraumatic stress disorder (PTSD),
and diagnosis of this disorder was strongly associated with evidence of
depressive and substance abuse disorders. The gruesome aspects of body
recovery and identification in a war zone setting were cited as stressor
elements of significant negative impact.
_____

Title: Long-term therapy treatment and strategies.
Author(s): Walker, Lenore E. A., Walker & Associates, Denver, CO, US
Source: Abused women and survivor therapy: A practical guide for the
psychotherapist. Walker, Lenore E. A.; pp. 411-440. Washington, DC, US:
American Psychological Association, 1994. xx, 529 pp. Abstract: (from the chapter) This chapter focuses on the
development of a treatment plan and highlights of various issues that
frequently arise when a victim of violence is in therapy for a
substantial period of time. There are some differences for women who
come into therapy soon after the trauma compared with those who are
unable to deal with the abuse issues for a long time afterward. In this
chapter, differences are noted that occur because of the woman's social
context, such as economic status; racial, ethnic, or cultural
identification group; sexual orientation; and physical abilities.
Although there are certain issues that are more common to one subgroup
of abused women than to others, such as an expected crisis period that
occurs when an incest victim begins to deal with buried memories, most
women who have been abused have similar needs in therapy. In this
chapter the general principles that are helpful in treating abused women
are outlined. When the client is no longer in a crisis state but is
still in need of therapy, several things should be settled before
embarking on long-range treatment plans. This chapter examines the
possible use of hypnosis, relaxation therapy, guided imagery, systematic
desensitization, reframing, EMT, and other therapies.
_____

Title: Posttraumatic stress disorder in victimization-related traumata.
Series Title: New directions for mental health services, No; 64
Author(s): Astin, Millie C., U Missouri, Ctr for Trauma Recovery, St Louis, MO, US;
Layne, Christopher M.; Camilleri, Angela J.; Foy, David W.
Source: Assessing and treating victims of violence. Briere, John (Ed); pp. 39-51. San Francisco, CA, US: Jossey-Bass, 1994. 107 pp.
Abstract: (from the chapter) symptom manifestations of
posttraumatic stress disorder (PTSD) are explained in light of current
research findings / assessment methods for evaluating PTSD and trauma
exposures are presented and implications for treatment are discussed
_____

Title: Empathic strain and countertransference.
Author(s): Wilson, John Preston, Cleveland State U, Cleveland, OH, US; Lindy, Jacob D.
Source: Countertransference in the treatment of PTSD. Wilson, John
Preston (Ed); Lindy, Jacob D. (Ed); pp. 5-30. New York, NY, US: Guilford
Press, 1994. xxv, 406 pp.
Abstract: (from the book) introduce 2 poles of a
countertransference continuum--Type I (avoidance, counterphobia,
distancing, detachment) and Type II (overidentification,
overidealization, enmeshment, excessive advocacy) processes / consider
these forms of countertransference to be expectable, indigenous,
reactive processes in post-traumatic therapy
when the continuum of Type I and Type II CTRs [countertransference
reactions] are considered in conjunction with objective (normative)
reactions to the client's trauma story or subjective (personalized)
reactions, those reflecting unresolved conflicts from the therapist's
life, it is possible to derive 4 distinct modes of empathic strain /
identified these modes as empathic withdrawal, empathic repression,
empathic enmeshment, and empathic disequilibrium
present a schema that demonstrates how countertransference can impact on
the stress recovery process
_____

Title: Post-traumatic stress disorder in myocardial infarction
patients: Prevalence study.
Author(s): Kutz, Ilan, Shalvata Psychiatric Ctr, Hod Hasharon, Israel; Shabtai, Hamutal; Solomon, Zahava;
Neumann, Micha; et al.
Source: Israel Journal of Psychiatry & Related Sciences, Vol 31(1),
1994. pp. 48-56.
Publisher: Israel: Gefen Publishing House
Abstract: Assessed prevalence of posttraumatic stress disorder
(PTSD) following myocardial infarction (MI), identified PTSD risk
factors in MI patients, and evaluated the impact of PTSD on MI patients'
recovery and life quality. 100 Israeli post-MI patients were assessed
via an adaption of the PTSD Inventory. 16% of the Ss were suffering from
chronic PTSD, and 9% had suffered from acute PTSD. Ethnic origin (Asian
or African) and a history of cardiac hospitalization, MI, and PTSD were
associated with post-MI PTSD. About 50% of Ss who repeatedly sought
emergency medical help after sensing a recurrent attack were found to be
suffering from PTSD. Work and social dysfunction were strongly
associated with post-MI PTSD. Findings support the primary role of
psychological symptoms in MI rehabilitative failures.
_____

Title: "Negative psychometric outcomes: Self-report measures and a
follow-up telephone survey": Comment.
Author(s): Karen, Robert M., Rhode Island Dept of Corrections, US
Source: Journal of Traumatic Stress, Vol 7(1), Jan 1994. pp. 135-140.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Comments on the article by Z. Solomon et al (see record
1992-43943-001) on the "Koach" project for the treatment of
combat-related posttraumatic stress disorder (PTSD). The project, it is
argued, falls short of its goals because it is directed toward returning
individuals to combat service, fails to recognize the narcissistic
failure among PTSD victims, and fails to treat the consequent shame,
guilt, and depression that result when a warrior did not or could not
become the warrior he or she had hoped to be.
_____

Title: "Negative psychometric outcomes: Self-report measures and a
follow-up telephone survey": Response.
Author(s): Solomon, Zahava, Israeli Defense Forces Medical Corps, Dept of Mental Health, Israel;
Wozner, Yahanan; Waysman, Mark
Source: Journal of Traumatic Stress, Vol 7(1), Jan 1994. pp. 141-144.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Responds on a point-by-point basis to R. M. Karen's comment on the article by Z. Solomon et al (see
record 1992-43943-001) on the "Koach" project for the treatment of
combat-related posttraumatic stress disorder (PTSD). Controlled studies
and clinical observations suggest that PTSD can be extremely resistant
to treatment. The lack of success with traditional (primarily
psychodynamic and pharmacological) approaches led to the hope that a new
and different approach, based on different premises, might be more successful.
_____

Title: Physical and psychological outcomes of partner violence.
Author(s): Koss, Mary P., U Arizona, Coll of Medicine, Tuscon, AZ, US;
Goodman, Lisa A., U Maryland, Psychology Dept, College Park, MD, US;
Browne, Angela, Better Home Foundation, Newton Centre, MA, US;
Fitzgerald, Louise F., U Illinois, Urbana-Champaign, Urbana, IL, US;
Keita, Gwendolyn Puryear, American Psychological Association, Public
Interest Directorate, Washington, DC, US;
Russo, Nancy Felipe, Arizona State U, AZ, US
Source: No safe haven: Male violence against women at home, at work, and
in the community. Koss, Mary P.; Goodman, Lisa A.; et al; pp. 69-93.
Washington, DC, US: American Psychological Association, 1994. xviii, 344
pp. Publisher URL: http://www.apa.org/books
Abstract: (from the chapter) Reviews the physical and
psychological outcomes of male partner violence toward women. The
authors begin with a description of injury patterns (e.g., repeated and
multiple injuries to the breasts, chest, or abdomen, bruises, cuts,
black eyes, concussions, broken bones, and other permanent injuries)
that should alert clinicians to the presence of physical violence. They
then discuss specific injuries presented to medical settings, describing
the comparative risk of injury for women and men and the lethal outcomes
of partner violence. Abused women's reposes to this type of trauma and
their recovery process are also described. The authors investigate the
idea of psychopathology versus trauma in the concept of battered woman
syndrome and the concept of learned helplessness; they also investigate
the applicability of posttraumatic stress disorder to women victims of partner abuse.
_____

Title: Individual and community responses to trauma and disaster: The
structure of human chaos.
Author(s): Ursano, Robert J., (Ed), Uniformed Services U of the
Health Sciences, Dept of Psychiatry, Bethesda, MD, US;
McCaughey, Brian G., (Ed); Fullerton, Carol S., (Ed)
Source: New York, NY, US: Cambridge University Press, 1994. xvi, 422 pp.
Abstract: (from the book) The aims of this book are twofold--to
improve understanding of the human experience of trauma at the
individual and community levels, and to help the victims of trauma. . .
. The editors have sought to impart understanding, order, and
predictability to the experience of trauma and disasters in the belief
that the way to recovery is through the mastery and structuring of chaotic events.
The contributors . . . present observational reports and empirical
studies which range from responses to individual acts of violence to the
effects of well-known disasters affecting hundreds or thousands of
people. Distinctions are drawn between responses to manmade and natural
disasters, and the particular needs of rescue and disaster workers are considered.
The emphasis throughout this book is on preparedness, prevention and
care through psychiatric and other interventions in both civilian and
military settings. This is a book which will inform clinicians,
administrators and research workers who recognize that, if disaster
plans do not consider the psychological effects of trauma, the
consequences will overwhelm all available services and resources,
exhausting rescue workers as well as victims.
_____

Title: Symptoms of posttraumatic stress disorder following recovery of
war dead.
Author(s): McCarroll, James E., Walter Reed US Army Inst of
Research, Dept of Military Psychiatry, Washington, DC, US; Ursano, Robert J.; Fullerton, Carol S.
Source: American Journal of Psychiatry, Vol 150(12), Dec 1993. pp. 1875-1877.
Publisher: US: American Psychiatric Assn
Abstract: Compared 116 persons who handled human remains in
Operation Desert Storm with 118 persons who did not handle remains on
symptoms of posttraumatic stress disorder (PTSD). Ages in both groups
ranged from 17 to 58 yrs. Ss who handled remains reported more intrusive
and avoidant symptoms than other Ss. Ss who were inexperienced at
handling remains had more symptoms than those who were experienced.
Within the experienced group, there was a significant correlation
between the number of remains handled and level of symptoms reported.
_____

Title: Psychological responses of children to natural and human-made
disasters: I. Children's psychological responses to disasters.
Author(s): Vogel, Juliet M., Long Island Jewish Medical Ctr,
Schneider Children's Hospital Div of Developmental & Behavioral Pediatrics, New Hyde Park, NY, US;
Vernberg, Eric M.
Source: Journal of Clinical Child Psychology, Vol 22(4), Dec 1993. pp. 464-484.
Publisher: US: Lawrence Erlbaum
Abstract: Reviews children's psychological responses to disasters
and puts relevant work in historical perspective. Common responses
include specific fears, separation difficulties, sleep problems, and
symptoms associated with posttraumatic stress disorder (PTSD). After
severe exposure, diagnosable PTSD, anxiety, and depression may occur.
Factors influencing responses include disaster characteristics (exposure
severity, extent of bereavement and other losses, separation from
significant others), children's age and sex, and characteristics of
family and community. Symptoms typically decrease rapidly, and recovery
generally is complete by 16 mo to 3 yrs except after severe life-threat
or long-term family and community disruption.
_____

Title: Treating post-traumatic stress disorder among Vietnam combat
veterans: An existential perspective.
Author(s): Harmand, John, Mobile Veterans Ctr, AL, US;
Ashlock, Larry E.; Miller, Thomas W.
Source: Journal of Contemporary Psychotherapy, Vol 23(4), Win 1993. pp. 281-291.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Described the use of existential framework to treat
patients with posttraumatic stress disorder (PTSD). Four areas of a
Vietnam combat veteran's condition are discussed that can be addressed
by an existential therapy approach: the anguish of being, the inherence
of freedom and responsibility, the need for meaning, and the ongoing
process of recovery. The goal of the therapist is to bring understanding
to the present and to make the experience of the past meaningful to the
survivor in the present. The ascription of meaning to the past event
leads to the integration of the traumatic experience on the part of the
survivor, and meaning becomes an essential component of the survivor's
whole sense of being. This approach has validity in both individual and group therapy.
_____

Title: Reassessing war stress: Exposure and the Persian Gulf War.
Author(s): Wolfe, Jessica, Veterans Affairs Medical Ctr, National Ctr for PTSD Women's Health Sciences Div, Boston, MA, US; Brown, Pamela J.; Kelley, John M.
Source: Journal of Social Issues, Vol 49(4), Win 1993. pp. 15-31.
Publisher: United Kingdom: Blackwell Publishing
Abstract: Reviews existing parameters in the traditional
measurement of war-zone exposure and considers conceptual and
methodological limitations in these approaches. Empirical data from a
cohort of 2,344 Persian Gulf War veterans (2,136 men) that support the
utility of a broader conceptualization of war trauma are presented. Data
from the Fort Devens Operation Desert Storm Reunion Survey were used to
examine how gender may be differentially associated with some dimensions
of war-zone stress and psychological outcome following deployment.
Exposure scores did not differ significantly between men and women, and
postwar psychological adjustment was predicted. Findings indicate that
women were more symptomatic in response to certain wartime stressors.
Identifying diverse dimensions of war-zone stress may enhance efforts to
understand veterans' initial and long-range wartime recovery.
_____

Title: Violence, trauma, and post-traumatic stress disorder among women drug users.
Author(s): Fullilove, Mindy T., Columbia U, New York State
Psychiatric Inst, HIV Ctr for Clinical & Behavioral Studies, US; Fullilove, Robert E.; Smith, Michael; Winkler, Karen; et al.
Source: Journal of Traumatic Stress, Vol 6(4), Oct 1993. pp. 533-543.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Examined the association between the experience of
violent events, trauma, and posttraumatic stress disorder (PTSD) among
105 female drug users (mean age 32 yrs) in treatment for addictive
disorders. 104 Ss reported trauma in 1 or more of 14 categories of
traumatic events, 59% of whom reported symptoms consistent with a
diagnosis of PTSD. Among Ss with PTSD, 97% reported 1 or more violent
traumas as compared with 73% of those without PTSD. The likelihood of
PTSD was strongly associated with the number of violent traumas
reported. Women in recovery from drug addiction are likely to have a
history of violent trauma and are at high risk for PTSD; screening
should become part of the diagnostic and treatment routine.
_____

Title: The trauma of war: Homecoming after Afghanistan.
Author(s): Coalson, Bob, American Lake Veterans Affairs Medical
Ctr, Northwest Post Traumatic Stress Treatment Program, Tacoma, WA, US
Source: Journal of Humanistic Psychology, Vol 33(4), Fal 1993. Special
issue: Trauma and transcendence. pp. 48-62.
Publisher: US: Sage Publications
Abstract: Describes the experiences of several Vietnam veterans
who journeyed to the USSR and joined efforts with a group of Afghantsi
(veterans of the war in Afghanistan) to heal the emotional wounds of
war. The article accentuates the potential of war trauma survivors to
collaborate and aid each other's recovery on an international scale.
Treatment implications for the Afghantsi are highlighted, and a snapshot
of how 1 Soviet program approaches treatment of posttraumatic stress
disorder (PTSD) is provided.
_____

Title: Abortion trauma: Application of a conflict model.
Author(s): Erikson, Robert C., Ctr for Stress Recovery,
Brecksville, OH, US
Source: Journal of Prenatal & Perinatal Psychology & Health, Vol 8(1),
Fal 1993. Special issue: Abortion and unwanted pregnancy. pp. 33-42.
Publisher: US: Association for Pre-and Perinatal Psychology and Health (APPPAH)
Abstract: Argues that elective abortion can be a traumatic event
leading to development of a posttraumatic state. Postabortion trauma
conforms to the diagnostic criteria for posttraumatic stress disorder
(PTSD) and can be explained by a conflict model of trauma. The existence
of the developing object in utero requires an adaptation in the mother's
internal psychological world, involving the construction of a
representation of an attachment object. Destruction of the fetal child
assaults the stability of the corresponding internal structure. The
conflict between life and death is then played out internally, with all
the accompanying anguish of PTSD symptoms. Clinical case material on 3
women (aged 22-34 yrs) illustrates the reality of postabortion trauma
arising from a conflictual situation.
_____

Title: A mental health relief programme in Armenia after the 1988
earthquake: Implementation and clinical observations.
Author(s): Goenjian, Armen, Alondra Crest Hosp, Belflower, CA, US
Source: British Journal of Psychiatry, Vol 163, Aug 1993. pp. 230-239.
Publisher: United Kingdom: Royal College of Psychiatrists
Abstract: An international mental health relief program for
children and adults was implemented in Soviet Armenia after the December
7, 1988, Spitak earthquake. This paper presents (1) essential steps in
the selection, preparation, and support of mental health workers for the
relief work; (2) a method that facilitated the screening and treating of
students in classrooms; and (3) the rate of posttraumatic stress
disorder (PTSD) and of major depressive disorder (74% and 22%,
respectively) of 582 victims clinically evaluated before entering
treatment 3-6 mo after the earthquake. Clinical observations of
significant psychological problems that may be overlooked in brief
crisis-orientated psychotherapy are discussed, as are multiple severe
post-earthquake adversities that contributed to psychological problems
of the victims and delayed their recovery. Finally, the extension of the
program to an advisory one to other relief organizations is considered.
_____

Title: The role of self-continuity in Vietnam combat veterans' recovery
from trauma.
Author(s): Cohen, Robert Paul, U Michigan, US
Source: Dissertation Abstracts International, Vol 54(2-B), Aug 1993. pp.
1090.
Publisher: US: Univ Microfilms International
_____

Title: The psychological impact of rape.
Author(s): Resick, Patricia A., U Missouri, Ctr for Trauma
Recovery, St Louis, US
Source: Journal of Interpersonal Violence, Vol 8(2), Jun 1993. pp. 223-255.
Publisher: US: Sage Publications
Abstract: Reviews the literature on the psychological impact of
rape on adult female victims. Typical patterns of recovery, types of
symptoms, and variables affecting recovery are addressed. Among the
problems discussed are fear and anxiety, posttraumatic stress disorder
(PTSD), depression, poor self-esteem, social adjustment issues, and
sexual dysfunctions. The moderating variables that are reviewed are
pre-assault variables such as prior psychological functioning and life
stressors; within-assault variables such as acquaintanceship status,
level of violence, and within-crime victim reactions; and postassault
variables such as social support and participation in the criminal
justice system. The pattern of reactions emerging from the research
indicates that rape is a life event that causes great upheaval in a
victim's psychological functioning for a considerable period of time,
perhaps for the victim's entire life.
_____

Title: Use of hypnosis in pain management and post-traumatic stress disorder.
Author(s): Jiranek, Danielle
Source: Australian Journal of Clinical & Experimental Hypnosis, Vol
21(1), Spec Issue, May 1993. pp. 75-84.
Publisher: Australia: Australian Society of Hypnosis
Abstract: Pain management techniques, guided imagery,
self-hypnosis, and anxiety resolution were used with a 34-yr-old married
woman who had been involved in an industrial accident and was suffering
posttraumatic stress disorder (PTSD) and pain. Hypnotic intervention was
used as a powerful adjunct to the more traditional interventions used to
resolve anxiety disorders. While behavioral and cognitive approaches
alone might have been equally successful, the provision of hypnosis
allowed for a more rapid and less traumatic recovery.
_____

Title: Post-traumatic stress disorder following medical events.
Author(s): Shalev, Arieh Y., Hadassah University Hosp, Dept of Psychiatry, Jerusalem, Israel;
Schreiber, Shaul; Galai, Tamar; Melmed, Raphael N.
Source: British Journal of Clinical Psychology, Vol 32(2), May 1993. pp. 247-253.
Publisher: United Kingdom: British Psychological Society
Abstract: Presents the case histories of 4 patients who developed
characteristic symptoms of posttraumatic stress disorder (PTSD)
following medical and surgical events. The patients are a 45-yr-old man,
a 23-yr-old woman, a 43-yr-old man, and a 30-yr-old woman. Posttraumatic
symptomatology was associated with poor recovery, a tendency to avoid
further medical treatment, and life-threatening behavior. The authors
provide clinical guidelines for the diagnosis of PTSD among patients
whose medical conditions or treatment are highly stressful and discuss
the need for prompt diagnosis and treatment of specific mental disorders among the medically ill.
_____

Title: Group therapy with WWII ex-POW's: Long term posttraumatic
adjustment in a geriatric population.
Author(s): Boehnlein, James K., Oregon Health Sciences U, Portland, US; Sparr, Landy F.
Source: American Journal of Psychotherapy, Vol 47(2), Spr 1993. pp. 273-282.
Publisher: US: Assn for the Advancement of Psychotherapy
Abstract: Describes the 2-yr process of group therapy in a
geriatric population of World War II former POWs (aged 66-76 yrs). Four
Ss met Diagnostic and Statistical Manual of Mental Disorders-III-Revised
(DSM-III-R) criteria for chronic posttraumatic stress disorder (PTSD).
Three Ss had residual PTSD symptoms, and 1 had a diagnosis of major
depression. Therapeutic conduct and content are considered, including
themes of grief, trust, mortality, and socialization. Recovery from PTSD
is a social process that involves support, education, and a forum to
work through suppressed thoughts and emotions. Interpersonal validation
of the legitimacy of normal emotional reactions is a key component in
the recovery process. Changes in self-esteem and social interaction may
be achieved through a group environment that fosters cognitive reorganization and social reintegration.
_____

Title: An integrative-sequential treatment model for posttraumatic
stress disorder: A case study of the Japanese American internment and
redress.
Author(s): Loo, Chalsa M., U Hawaii, Honolulu, US
Source: Clinical Psychology Review, Vol 13(2), 1993. pp. 89-117.
Publisher: Netherlands: Elsevier Science
Abstract: Presents a clinical model that integrates classical
victimization symptoms with multiple treatment

interventions into a
coherent process of recovery from trauma. The model serves to reduce the
fragmentation of the posttraumatic stress disorder (PTSD) literature,
clarify existing treatment modalities in terms of their respective
contributions to recovery, and suggest principles underlying the
sequencing and/or concurrence of specific interventions for trauma due
to intentional, external human design. Parallels are made between
symptoms experienced by Vietnam veterans with PTSD and those experienced
by Japanese Americans (JAs) who were interned in US concentration camps
during World War II. The psychological and historic events of the JA
redress and reparation movement are chronicled to exemplify the
interventions delineated in the clinical model.
_____

Title: Acute versus chronic post-traumatic stress disorder.
Author(s): Rahe, Richard H.
Source: Integrative Physiological & Behavioral Science, Vol 28(1), Jan-Mar 1993. pp. 46-56.
Publisher: US: Transaction Publishers
Abstract: Presents a photographic lens and filter model that
outlines 6 steps between a person's perception of stressful life event
and the possible eventual development of an illness. Persons developing
acute posttraumatic stress disorder (PTSD) differ markedly in their
processing of early steps in the model compared to those who go on to
suffer from chronic PTSD. Persons with the acute disorder, with high
likelihood of recovery, generally have had enriching early life
experiences, use psychological defenses to a moderate degree, and
demonstrate ample coping capabilities. Those going on to the chronic
disorder, who frequently don't recover, often report impoverished early
life experiences, use psychological defenses to an extreme degree, and
show a paucity of coping skills.
_____

Title: A 12-step recovery program for victims of traumatic events.
Series Title: The Plenum series on stress and coping
Author(s): Brende, Joel Osler, Martin Army Community Hosp, Fort
Benning, GA, US
Source: International handbook of traumatic stress syndromes. Wilson,
John Preston (Ed); Raphael, Beverley (Ed); pp. 867-877. New York, NY, US: Plenum Press, 1993. xxxiii, 1011 pp.
Abstract: (from the chapter) I have built a nontraditional
recovery program for survivors of posttraumatic stress disorder (PTSD) /
this 12-step program of stress recovery builds on the tradition of
self-help support groups and can be readily applied by individuals who
may not be able to access traditional mental health systems or who would
prefer such an alternative approach to alleviating the painful symptoms
associated with traumatic stress syndrome
posttraumatic symptoms, recovery, and religious beliefs [cross-cultural
and pantheistic views of stress recovery, role of surrender in recovery
from addictions] / the 12-steps of Alcoholics Anonymous: parallels for
stress recovery / twelve themes and spiritual steps: a practical guide
for survivors of traumatic events
_____

Title: Post-traumatic stress disorder: Cross-cultural aspects.
Author(s): de Silva, Padmal, U London, Inst of Psychiatry, England
Source: International Review of Psychiatry, Vol 5(2-3), 1993. pp. 217-229.
Publisher: United Kingdom: Taylor & Francis
Abstract: Discusses the impact of culture on the incidence and
characteristics of posttraumatic stress disorder (PTSD). Reactions to
natural disasters (e.g., floods, earthquakes) and man-made disasters
(e.g., industrial accidents, imprisonment, torture) are described. The
importance of culture in determining an individual's reactions to
stressful situations and in influencing recovery from PTSD is emphasized.
_____

Title: Impact of sexual abuse on children: A review and synthesis of
recent empirical studies.
Author(s): Kendall-Tackett, Kathleen A., Wellesley Coll, Stone Ctr for Developmental Services & Studies, MA, US;
Williams, Linda M.; Finkelhor, David
Source: Psychological Bulletin, Vol 113(1), Jan 1993. pp. 164-180.
Publisher: US: American Psychological Assn
Abstract: A review of 45 studies clearly demonstrates that
sexually abused children have more symptoms than nonabused children,
with abuse accounting for 15-45% of the variance. Fears, posttraumatic
stress disorder (PTSD), behavior problems, sexualized behaviors, and
poor self-esteem occurred most frequently among a long list of symptoms
noted, but no one symptom characterized a majority of sexually abused
children. Some symptoms were specific to certain ages, and approximately
one-third of victims had no symptoms. Penetration, the duration and
frequency of the abuse, force, the relationship of the perpetrator to
the child, and maternal support affected the degree of symptomatology.
About two-thirds of the victimized children showed recovery during the
1st 12-28 mo. The findings suggest the absence of any specific syndrome
in children who have been sexually abused and no single traumatizing process.
_____

Title: Combat stress reaction: The enduring toll of war.
Series Title: The Plenum series on stress and coping
Author(s): Solomon, Zahava, Israeli Defense Forces Medical Corps, Tel Aviv, Israel
Institutional Author(s): Federman Foundation;
Israeli Ministry of Defense, Israel
Source: New York, NY, US: Plenum Press, 1993. xvi, 284 pp.
Abstract: (from the jacket) "Combat Stress Reaction" is [an]
exploration of the effects of war and psychic trauma on combat veterans
that documents the impact of combat stress reaction (CSR) on mental and
physical health and family, work, social, and military functioning. [The
author] addresses the many perplexing issues related to CSR through her
analysis of the findings of an exhaustive ten-year series of studies on
Israeli veterans of the 1982 Lebanon war. . . . [The book offers] fresh
insights into the many unanswered questions facing traumatic stress
researchers, including: what is the scope, nature, and duration of CSR;
what happens to CSR casualties after the fighting ends; does war leave
stress residues among combatants who do not sustain CSR; which soldiers
are predisposed to CSR; does the exposure to more than one war decrease
or increase a soldier's chances of sustaining CSR; what factors aid or
inhibit recovery from CSR [and] how is the course of the disorder
affected by continuing exposure to military stimuli?
_____

Title: International handbook of traumatic stress syndromes.
Series Title: The Plenum series on stress and coping
Author(s): Wilson, John Preston, (Ed), Cleveland State U, Dept of Psychology, Cleveland, OH, US;
Raphael, Beverley, (Ed)
Source: New York, NY, US: Plenum Press, 1993. xxxiii, 1011 pp.
Abstract: (from the preface) The development of the "International
Handbook of Traumatic Stress Syndromes" grew out of the recognition that
a standard reference volume was needed to organize the subareas of study
in the field. . . . These contributions span the breadth and depth of
the field at this time concerning theory, research methodology, and
treatment considerations across a number of survivor and victim
populations. . . . It is our hope that this "Handbook" will stimulate
additional research, encourage the discovery of new techniques of
treatment, and ultimately help to alleviate the pain and suffering of
traumatized persons, their families, and their loved ones.
_____

Title: Rape--A hazard to health.
Author(s): Dahl, Solveig
Source: Oslo, Norway: Scandinavian University Press, 1993. xi, 154 pp.
Abstract: (from the jacket) The author investigates rape as a
psychological stressor by exploring the traumatic events of rape, and
seeks to identify the elements of the ordeal that are felt as particularly stressful to the victim.
She examines the nature of the health problems which can develop after
exposure to rape [focusing on posttraumatic stress disorder (PTSD)],
both in the acute phase and in the long term.
By studying individual differences in coping within the victim group, as
well as the relationship between coping strategy and recovery, she shows
how psychological reaction to rape can influence the victim's perception
of herself and her relationship to others.
_____

Title: The trauma response: Treatment for emotional injury.
Author(s): Everstine, Diana Sullivan, Mental Research Inst, Research Fellow, Palo Alto, CA, US;
Everstine, Louis
Source: New York, NY, US: W. W. Norton & Co, Inc, 1993. x, 229 pp.
Abstract: (from the jacket) The phrases "shell-shock" and
"posttraumatic stress disorder" have been in the vernacular for decades;
still, we do not have a comprehensive understanding of trauma. This book
proposes the groundbreaking concept of "the trauma response" as a
reaction to emotional injury rather than as a course of illness.
Part One provides us with a thorough background in trauma. The authors
include several trauma questionnaires that are invaluable for assessing
trauma. These inventories are more than mere laundry lists of possible
stressors--they are designed instead to illuminate and identify the
degree and kind of trauma suffered, as perceived by the victim. This is
an important element in their model: Trauma is a result of the complex
relationship between an event and a person's perception of and reaction to that event.
The heart of the authors' concept of trauma and method of treatment is
presented in Part Two, which deals with the trauma recovery cycle. This
model demonstrates that healing begins soon after shock ends and
describes how this process can be facilitated. The authors explain how
traditional modes of therapy need to be altered to suit the specific needs of trauma victims.
In Part Three we are introduced to different aspects of trauma: hidden
trauma, assessment and treatment of trauma in children and adolescents,
and trauma involving the family. These special systems require differing
methods of treatment.
The last two chapters deal with these problems and offer advice to
professionals about how to guide clients through the workers'
compensation and legal systems while avoiding retraumatization.
The strength of this book lies in its applicability to many different
kinds of trauma. And, while it is intended primarily for therapists,
caretakers in other fields will find its concepts accessible and its
treatment strategies useful.
_____

Title: Negative psychometric outcomes: Self-report measures and a
follow-up telephone survey.
Author(s): Solomon, Zahava, Israel Defense Forces Medical Corps, Dept of Mental Health, Israel;
Shalev, Arik; Spiro, Shimon E.; Dolev, Aliza; et al.
Source: Journal of Traumatic Stress, Vol 5(2), Apr 1992. pp. 225-246.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Examined the effectiveness of the Koach project in 2
groups of Ss, the 40 Koach participants and 40 posttraumatic stress
disorder (PTSD) veterans who served as controls. The self-report
measures focused on PTSD symptomatology, posttraumatic intrusion and
avoidance, general psychiatric symptomatology, social functioning, and
perceived self-efficacy in combat. Participation in Koach led to
improvement in 1 area only: perceived self-efficacy in combat. The
measures of emotional distress and psychiatric symptomatology indicate
that Ss treated in Koach fared worse than untreated PTSD conrols. To
assess the long-term impact of the program, 36 Koach Ss were surveyed by
phone 2 yrs after the residential stage of the project. Findings
indicate that most of the Ss had not returned to their prewar level of functioning.
_____

Title: Cognitive treatment of a crime-related post-traumatic stress disorder.
Author(s): Resick, Patricia A., U Missouri, Dept of Psychology, St Louis, MO, US
Source: Aggression and violence throughout the life span. Peters, Ray DeV. (Ed); McMahon, Robert Joseph (Ed); et al; pp. 171-191. Thousand
Oaks, CA, US: Sage Publications, Inc, 1992. xiv, 346 pp.
Abstract: (from the chapter) review the prevalence of
post-traumatic stress disorder (PTSD) in crime victims and . . .
describe recovery patterns typically seen / discuss recent theories of
PTSD / [describes and presents results from] a new therapy for
crime-related PTSD, cognitive processing therapy (CPT)
_____

Title: Survivors of disasters: How can they best be helped?
Series Title: Oxford medical publications
Author(s): Hodgkinson, Peter E., Ctr for Crisis Psychology,
Chartered Clinical Psychologist, Skipton, England
Source: Practical problems in clinical psychiatry. Hawton, Keith (Ed);
Cowen, Philip J. (Ed); pp. 211-221. London,: Oxford University Press, 1992. x, 258 pp.
Abstract: (from the chapter) the problems of disaster survivors
fall into two categories: first, is the nature of their experiences;
secondly, is the nature of their attitudes to help / [describes] main
components [of posttraumatic stress disorder (PTSD)]
what influences recovery / what helps disaster survivors / clinical guidelines
_____

Title: Long night's journey into day: The treatment of sexual abuse
among substance-abusing women.
Author(s): Bollerud, Kathleen, Private Practice, Keene, NH, US
Source: Sexual trauma and psychopathology: Clinical intervention with
adult survivors. Shapiro, Shanti; Dominiak, George M.; pp. 143-159. New
York, NY, US: Lexington Books/Macmillan, Inc, 1992. xiii, 192 pp.
Abstract: (from the chapter) suggests a model to guide the
outpatient treatment of sexually abused, chemically dependent women who
diagnostically fit within the range of post-traumatic or dissociative
disorders / the model . . . is a multimodal approach to recovery that
incorporates twelve-step programs, individual psychotherapy, and
short-term specialized group treatment
_____

Title: Holding on to humanity--The message of Holocaust survivors: The Shamai Davidson papers.
Author(s): Davidson, Shamai, Inst on the Holocaust & Genocide, Cofounder, Jerusalem, Israel;
Charny, Israel W., (Ed)
Source: New York, NY, US: New York University Press, 1992. xxvii, 243 pp.
Abstract: (from the jacket) The effects of the Holocaust on those
who survived it are immeasurable. How can one experience the trauma of
the concentration camps . . . how can one survive this and remain the
same? In many ways the holocaust has drastically affected those who
survived, and in "Holding on to Humanity" Shamai Davidson explores the
complex results of this dehumanizing experience.
As a psychiatrist and psychoanalyst practicing in Israel, Davidson spent
thirty years working with this special group, trying to understand the
nature of their experience. Uniquely skillful in evoking from survivors
their most silenced stories, Davidson concentrated on giving them voice
and recorded memory.
_____

Title: Trauma and recovery.
Author(s): Herman, Judith Lewis, Harvard Medical School, Associate
Clinical Professor of Psychiatry, Boston, MA, US
Source: New York, NY, US: Basic Books, Inc, 1992. xi, 276 pp.
Abstract: (from the jacket) The first part of the book outlines
the spectrum of human adaptation to the full range of traumatic events.
Challenging established diagnostic categories, which simply do not fit
survivors of extreme situations and have thus impeded rather than aided
treatment, Herman proposes a new name for the psychological disorder
found in survivors of prolonged abuse, a label that doesn't blame the
victim. The second part of the book develops an overview of the healing
process and offers a new conceptual framework for psychotherapy with
traumatized people. This framework applies equally to the experiences of
domestic and sexual life--the traditional sphere of women--and to the
experiences of war and political life--the traditional sphere of men.
Herman's analyses and conclusions challenge most conventional wisdom:
for example, she shows how private experiences like incest and public
trauma such as terrorism share fundamental similarities of
disempowerment and denial; and she describes how childhood abuse has far
more profound effects on personality than has been believed. At the
heart of the book is a unique approach to recovery that demands that the
therapist depart from a stance of moral neutrality, working slowly
toward integration rather than catharsis.
_____

Title: Evaluating the effects of disasters.
Author(s): Green, Bonnie L., Georgetown U Medical Ctr, Dept of Psychiatry, Washington, DC, US
Source: Psychological Assessment, Vol 3(4), Dec 1991. pp. 538-546.
Publisher: US: American Psychological Assn
Abstract: Reviews the assessment of posttraumatic stress disorder
(PTSD) and other disaster-related psychopathology following natural and
human-made disasters. A brief history of disaster research is provided,
and instruments used in recent studies are discussed. Data from the
author's research on the relationships of several of these measures to
clinically assessed PTSD are provided. The importance of multimethod
assessment of PTSD and related symptoms is emphasized. Other factors
potentially contributing to the development and maintenance of PTSD that
should be assessed (i.e., stressors, individual factors, recovery environment) are also noted.
_____

Title: Postpsychosis posttraumatic stress disorder.
Author(s): Shaner, Andrew, Veterans Affairs Medical Ctr-West Los Angeles, CA, US; Eth, Spencer
Source: Journal of Nervous & Mental Disease,

Vol 179(10), Oct 1991. pp. 640.
Publisher: US: Lippincott Williams & Wilkins
Abstract: Refutes the statement that P. D. McGorry et al (see
record 1991-27559-001) were the 1st to describe posttraumatic stress
disorder (PTSD) following psychotic episodes. This syndrome was
previously reported by A. Shaner and S. Eth (see record 1990-14867-001).
_____

Translated Title: Pre-morbid personality factors in sustaining and
recovering from Combat Stress Reactions.
Author(s): Bernat, I, Israeli Defense Forces- Dept. for Behavioral Research, Israel
Source: Psychologia: Israel Journal of Psychology, Vol 2(2), Sep 1991. pp. 162-170.
Publisher: Israel: Israel Psychological Assn
Abstract: The combat data on 18 soldiers who suffered from acute
or chronic Combat Stress Reaction (CSR) during the 1982 Lebanon War were
compared with those of two groups of non-CSR controls in order to
investigate the role of personality in the risk of and recovery from
this disorder. None of the personality features investigated
significantly differentiated the CSR subjects from the controls,
suggesting that the pre-morbid personality is not involved in the onset
of CSR. Significant differences were found, however, in the pre-morbid
data of the acute and chronic subjects. Those who recovered quickly from
their combat stress reactions had significantly stronger belief in their
ability to control the environment, more confidence in the availability
of social support, and better ego functioning than those with chronic stress. (English abstract)
_____

Title: Brief dynamic psychotherapy of post-traumatic stress disorder.
Author(s): Marmar, Charles R., Veterans Affairs Medical Ctr, Post-Traumatic Stress Disorder Program, San Francisco, CA, US
Source: Psychiatric Annals, Vol 21(7), Jul 1991. pp. 405-414.
Publisher: US: SLACK
Abstract: Presents a model for brief dynamic psychotherapy of
posttraumatic stress disorder (PTSD) that helps the patient who has been
derailed from a normal psychological recovery process to return to an
adaptive working-through during and after brief therapy. Brief therapy
is most applicable for individuals who present with PTSD several years
after traumatic stress events. The success of brief therapy depends on
the ability of the patient and therapist to enter quickly into a
collaborative working process. The impact of a traumatic event on the
PTSD patient's self-concept serves as an organizer for treatment.
Working through problematic weak and strong self-concepts and
countertransference responses to traumatized patients are discussed,
along with termination. Case examples illustrate these issues.
_____

Title: Posttraumatic stress disorder and Vietnam veterans.
Author(s): Helwig, Andrew A., U Colorado, Div of Counseling
Psychology & Counselor Education, Denver, US;
Assa, Roberta
Source: Journal of Employment Counseling, Vol 28(2), Jun 1991. pp. 49-56.
Publisher: US: American Counseling Assn
Abstract: Reviews the causes, diagnostic criteria, and symptoms of
posttraumatic stress disorder (PTSD) among Vietnam veterans. PTSD may be
characterized by intrusive thoughts manifested by flashbacks, often in
response to a particular stimulus. Other features may include
self-destructive behaviors, psychic numbing, hyperalertness, or
difficulty in solving problems. An acute trauma response model,
comprising shock, impact, and resolution and recovery stages, is
presented. Guidelines for employment counselors in referring veterans
with PTSD are discussed.
_____

Title: Posttraumatic stress disorder following recent-onset psychosis:
An unrecognized postpsychotic syndrome.
Author(s): McGorry, Patrick D., Royal Park Hosp, NHMRC
Schizophrenia Research Unit, Parkville, Vict, Australia;
Chanen, Andrew; McCarthy, Elizabeth; Van Riel, Raphael; et al.
Source: Journal of Nervous & Mental Disease, Vol 179(5), May 1991. pp. 253-258.
Publisher: US: Lippincott Williams & Wilkins
Abstract: Clinical experience with psychotic patients early in the
course of their illness suggested that symptoms of posttraumatic stress
disorder (PTSD) may not be uncommon after recovery from an acute
psychotic episode. 36 patients recovering from an acute psychotic
episode within 2-3 yrs of onset of their illness were assessed as
inpatients and followed up on 2 occasions during the year after
discharge. The prevalence of PTSD was 46% at 4-mo follow-up and 35% at
11-mo follow-up, as measured by a questionnaire linked to Diagnostic and
Statistical Manual of Mental Disorders (DSM-III) criteria. The
relationships between negative symptomatology and PTSD symptoms and
between depressive symptomatology and PTSD symptoms were also examined;
a significant correlation was found only for the latter.
Psychopathological, preventive, and therapeutic implications of the
findings are discussed.
_____

Title: Trauma focus group therapy for Vietnam veterans with PTSD.
Author(s): Rozynko, Vitali, California Dept of Corrections, US; Dondershine, Harvey E.
Source: Psychotherapy: Theory, Research, Practice, Training, Vol 28(1),
Spr 1991. Special issue: Psychotherapy with victims. pp. 157-161.
Publisher: US: Division of Psychotherapy (29), American
Psychological Association
Abstract: Outlines the steps one might take in developing a
therapy group for treating Vietnam veterans with posttraumatic stress
disorder (PTSD) and suggests some useful treatment procedures. Essential
therapy components include (1) the analysis in context of combat with
recovery of dissociated memories and affects; (2) the teaching of
techniques that allow strong emotions to be tolerated without resort to
neurotic escape; and (3) the discovery of "acceptable" meanings for the
combat experience. A 4th component is the realization that trauma is as
much a process as a disorder and, as a process, it is comprehensible,
manageable, and compatible with leading a relatively normal life. Many
combat veterans can be treated for PTSD using a specialized therapy
group such as the one described above so long as the group is accurately
perceived as competent, compassionate, and safe.
_____

Title: Strategies for assessing the potential for positive adjustment
following trauma.
Author(s): Lyons, Judith A., Dept of Veterans Affairs Medical Ctr, Trauma Recovery Program, Jackson, MS, US
Source: Journal of Traumatic Stress, Vol 4(1), Jan 1991. pp. 93-111.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Discusses the complex interplay of variables that may
influence posttrauma adjustment. The subset of survivors who show
resilience rather than pathology following trauma is frequently
overlooked in empirical studies and theoretical discussions of
posttraumatic stress disorder (PTSD). Susceptibility to dysfunction is
clearly not a simple function of individual fortitude. The study of
variability among survivors must address differences in 4 domains:
events, individuals, recovery environments, and time. Assessment
instruments that may be useful in future research on PTSD are suggested.
_____

Title: Individual, group, and family crisis counseling following a hurricane: Case of Heather, age 9.
Author(s): Joyner, Cathy Dodds, CAMH, Child & Adolescent Services, Charleston, SC, US
Source: Play therapy with children in crisis: A casebook for
practitioners. Webb, Nancy Boyd (Ed); pp. 396-415. New York, NY, US: Guilford Press, 1991. xviii, 460 pp.
Abstract: (from the chapter) the following case is a composite of
many children seen over a period of months in Charleston County
[following Hurricane Hugo] / the posttraumatic stress reactions displayed are not universal but were frequently seen in latency-age
children / the approach utilized in this composite case involves one-to-one sessions, group work, and work with the child's family resistance to mental health services / the philosophy of outreach / the
phases of recovery: grieving the loss / typical responses of children in disaster / assessment in a disaster / play therapy materials
_____

Title: The rape victim: Clinical and community interventions (2nd ed.).
Series Title: Sage library of social research; Vol. 185
Author(s): Koss, Mary P., U Arizona, Coll of Medicine, Professor of Psychiatry, Tucson, AZ, US; Harvey, Mary R.
Source: Thousand Oaks, CA, US: Sage Publications, Inc, 1991. xiv, 313 pp.
Abstract: (from the cover) Rape--it's an all too familiar event in
many women's lives. But what is being done to prevent its occurrence?
How do victims deal with the trauma of rape? How are local agencies
dealing with the increasing number of victims? How effective are
available treatment programs? From the causes of rape to its lingering
effects, from disclosure to treatment, "The Rape Victim" offers the most
complete examination to date on this most heinous crime. The authors
address the trauma of rape, prevention, rape as a community issue, rape
crisis centers, date rape, clinical treatment of rape victims, and group
treatment for survivors. Psychologists, mental health professionals,
social workers, criminologists, nurses, and counselors will benefit from the wealth of information contained in this impressive volume.
_____

Title: Natural disasters and post-traumatic stress disorder: Short-term
versus long-term recovery in two disaster-affected communities.
Author(s): Steinglass, Peter, Ackerman Inst for Family Therapy, New York, NY, US; Gerrity, Ellen
Source: Journal of Applied Social Psychology, Vol 20(21, Pt 1), Dec 1990. Special issue: Traumatic stress: New perspectives in theory, measurement, and research: II. Research findings. pp. 1746-1765.
Publisher: US: Bellwether Publishing
Abstract: Investigated posttraumatic stress disorder (PTSD) in 115
adults from 2 communities following disaster-precipitated family
relocation in a longitudinal study of family and individual response to
natural disasters. Psychosocial adjustment was measured at 4 mo and 16
mo after the disaster. Instruments used for assessing stress-related
symptomatology included an impact of event scale and the Diagnostic
Interview Schedule. Levels of short-term stress symptomatology and
diagnosable PTSD were substantial in both communities, and significant
decrements in these levels occurred by 16 mo postdisaster. Substantial
gender differences (greater levels for women) were apparent in both
short- and long-term PTSD response rates. Patterns and levels of PTSD
symptoms were different in the 2 communities.
_____

Title: The prisoner of war.
Author(s): Ursano, Robert J., Uniformed Services U of the Health Sciences, Bethesda, MD, US; Rundell, James R.
Source: Military Medicine, Vol 155(4), Apr 1990. pp. 176-180.
Publisher: US: Assn of Military Surgeons of the US
Abstract: The prisoner of war (POW) experience is greatly
influenced by environmental and sociocultural factors of the particular
captivity setting. Important coping mechanisms are communication,
maintenance of military social structure, and personality flexibility.
Following repatriation some former POWs develop psychiatric disorders,
most commonly (1) medico-psychiatric disorders due to illness, physical
trauma, or nutritional deficit, (2) posttraumatic stress disorder
(PTSD), (3) adjustment disorder, (4) depression, (5) anxiety disorders,
(6) substance use disorders, and (7) family problems. Severity of
captivity and the presence or absence of social supports during and
after the POW experience play major roles in the recovery or illness
that may occur after repatriation.
_____

Title: Post-traumatic demoralization syndrome (PTDS).
Author(s): Parson, Erwin R.
Source: Journal of Contemporary Psychotherapy, Vol 20(1), Spr 1990. pp. 17-33.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Focused on survivors, Vietnam veterans and others, who
appear to suffer from from posttraumatic stress disorder (PTSD) but are
actually suffering from a special form of demoralization. PTDS refers to
a mental, interpersonal, and social dysfunctional state that emerges
from 3 sources: (1) a traumatically stressful event, (2) a
psychologically "nonholding" post trauma environment; and (3) social
historical changes. Central to the therapeutic action facilitating
recovery are confirmation to recognize the threat death poses to inner
value, tranquility, and well being; reordering to transform survivors'
static guilt into animating guilt; and renewal to integrate confirmation
and reordering. Behavioral, cognitive-phenomenological, social therapy,
psychodynamic, and existential approaches are needed to integrate and
overcome PTDS.
_____

Title: Postevent health status of crisis victims.
Author(s): Waigandt, C. Alex, U Missouri, Dept of Health & Physical Education, Columbia, MO, US;
Sheffield, Emilyn A.; Miller, Deborah H.; Drolet, Judy C.
Source: Human stress: Current selected research, Vol. 4. Humphrey, James
H. (Ed); pp. 59-65. New York, NY, US: AMS Press, Inc, 1990. xi, 192 pp.
Abstract: (from the chapter) in the past, catastrophic events were
viewed predominantly as unpredictable "acts of God" that subjected
varying sized groups to destruction of property or death / research
focused upon the health effects of the disaster during the immediate
period of recovery from it / although natural disasters were most often
examined, "man-made" catastrophic events such as war or sexual assault
also result in survivors or "victims" / the intent of this paper is to
determine whether or not victims of "man-made" catastrophic events
suffer similar somatic responses to their respective crisis situations
the results of this study indicate that two seemingly unrelated
groups--Vietnam veterans and sexual assault victims--exhibited similar
illness symptoms and significantly more health problems than matched
control groups / from the literature on stress management and leisure, a
number of strategies can be gleaned to assist victims in the assimilation of the crisis event
_____

Title: A model for the treatment of trauma-related syndromes among
chemically dependent inpatient women.
Author(s): Bollerud, Kathleen, Beech Hill Hosp, Dept of Psychology, Dublin, NH, US
Source: Journal of Substance Abuse Treatment, Vol 7(2), 1990. pp. 83-87.
Publisher: Netherlands: Elsevier Science
Abstract: Describes a model for education and preliminary
treatment of female victims of physical and sexual violence during the
inpatient phase of chemical dependency treatment. The model consists of
patient education, identification of posttraumatic symptoms, brief
individual and group psychotherapy, and aftercare. Case examples of 2
patients (aged 26 and 37 yrs) illustrate treatment using the model. The
importance of addressing addiction and trauma at the outset of substance
abuse recovery is emphasized.
_____

Title: Disaster psychiatry.
Author(s): Numerous contributors.
Source: Wartime medical services: Second International Conference; Stockholm, Sweden, 25-29 June 1990: Proceedings. Lundeberg, Jan-Erik (Ed); Otto, Ulf (Ed); et al; pp. 158-227. Stockholm, Sweden: Försvarets
forskningsanstalt (FOA), 1990. 597 pp.
Abstract: (from the book) [book section covering several chapters]
"Post-Traumatic Stress Reactions in Sailors Exposed to Terror" / Lars
Weisaeth and Terje Lie / presents findings from a pilot study of ships'
crews exposed to terror attacks during the Iran-Iraq war in the Gulf region
"Cognition, Behavior, and Traumatic Stress" / Robert Ursano, Carol S.
Fullerton, Kathleen M. Wright and James E. McCarroll / discuss responses
to mass casualty body handling in two international disasters, and
responses to a simulated chemical and biological warfare environment
"Recovery from Exposure to Death and the Dead: The Buffering Role of
Spouse/Significant Other Support" / Carol S. Fullerton, Kathleen M.
Wright, Robert Ursano, and James E. McCarroll / examine the special role
of support provided by the spouse/significant other to individuals involved in mass-casualty body-handling
"Early Psychiatric Intervention in Hospitalized Survivors of Traumatic
Injury: The Case of the 405 Tel Aviv/Jerusalem Bus" / Arieh Shalev,
Shaul Schreiber and Tamar Galai / [presents] the author's recent
experience in the intensive treatment of injured survivors of a terrorist incident
"Psychological Consequences of a Major Disaster" / Philip Moore
"Group Debriefing following Exposure to Traumatic Stress" / Arieh Shalev
and Robert J. Ursano / present a technique of early intervention in
group exposure to traumatic stress aimed at reducing the immediate and
the long-term consequences of the exposure / namely, 'psychological
group debriefing'
"The Rescue Personnel and the Disaster Stress" / Tom Lundin /
[discusses] the impact of the disaster event on rescue workers
"Post-Traumatic Stress among Rescue Personnel after Danish Rail
Accident" / Anders Korsgaard-Christensen, H. S. Andersen and G. O.
Petersen / the present study seeks to delineate the incidence of
psychiatric morbidity following participation in rescue work after a major Danish rail accident
"Post Traumatic Stress Disorder" / Klaus Siepmann / the symptoms and
course of the disease in patients suffering from PTSD [post traumatic
stress disorder] following a helicopter crash (1986) will be described /
the significance of early stress-management and the importance of
immediate treatment of these patients will be discussed / it will be
shown that group psychotherapy and behavior modification procedures,
such as autogenic training and hypnosis have proven to be successful in such cases
_____

Title: Post-traumatic stress disorder: Some diagnostic and clinical issues.
Author(s): Creamer, Mark, U Melbourne, Vict, Australia
Source: Australian & New Zealand Journal of Psychiatry, Vol 23(4), Dec 1989. pp. 517-522.
Publisher: United Kingdom: Blackwell Publishing
Abstract: Examined the development of posttraumatic stress
disorder (PTSD) in 42 persons exposed to a multiple homicide. The most
commonly reported symptoms were intrusive recollections of the event and
exaggerated startle response. Data show that 74% qualified for a
diagnosis of PTSD using the Diagnostic and Statistical Manual of Mental
Disorders (DSM-III), but only 33% met the criteria from the
DSM-III--Revised (DSM-III--R). In Category C, symptoms most rarely
reported were additions in the DSM-III--R; guilt, which was excluded
from the DSM-III--R, was reported in 38% of the Ss. A recovery program
implemented immediately posttrauma, emphasizing minimization of both
cognitive and behavioral avoidance, may help relieve Category C symptoms.
_____

Title: Cruelty, culture, and coping: Comment on the Westermeyer paper.
Author(s): Ochberg, Frank M., Michigan State U, East Lansing, US
Source: Journal of Traumatic Stress, Vol 2(4), Oct 1989. pp. 537-541.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Compares and contrasts refugee trauma as described by J.
Westermeyer (see record 1990-15237-001) with the constructs of
traumatization and victimization. Exposure to cruelty complicates the
recovery process. It is also suggested that clinicians who treat Vietnam
veterans are good candidates for training programs in cross-cultural
care of Asian refugees because of their experience in dealing with the traumatic loss of culture.
_____

Title: Officers' attitudes toward combat stress reaction:
Responsibility, treatment, return to unit, and personal distance.
Author(s): Inbar, Dan; Solomon, Zahava; Aviram, Uri;
Spiro, Shimon; et al.
Source: Military Medicine, Vol 154(9), Sep 1989. pp. 480-487.
Publisher: US: Assn of Military Surgeons of the US
Abstract: Examined the attitudes of 176 Israel Defense Forces
officers (OFs) toward 4 aspects of combat stress reaction (CSR): (1)
degree of personal responsibility accepted for the treatment of the CSR
casualty; (2) type of treatment viewed as most effective for CSR; (3)
willingness to accept the CSR casualty's return to the unit following
treatment; and (4) personal distance from the phenomenon. The impact of
casualty variables (rank, combat skill, additional physical injury,
symptomatology) and Ss' background was also studied. Ss were more severe
and less tolerant of the CSR casualty who was an OF than toward lower
ranking casualties. OFs were expected to take more responsibility for
their own recovery, support of commanding OFs was seen as less effective
in their treatment, and Ss were less willing to accept OFs back into their units after treatment.
_____

Title: The social context and meaning of trauma in the readjustment
process of Vietnam veterans.
Author(s): Everett, Ronald S., U Pennsylvania, US
Source: Dissertation Abstracts International, Vol 50(1-A), Jul 1989. pp. 263-264.
Publisher: US: Univ Microfilms International
_____

Title: "Posttraumatic stress disorder and the treatment of sexual
abuse": Correction.
Author(s): Patten, Sylvia B., Florida State U, School of Social Work, Tallahassee, FL, US; Gatz, Yvonne K.;
Jones, Berlin; Thomas, Deborah L.
Source: Social Work, Vol 34(4), Jul 1989. pp. 381.
Publisher: US: NASW Press
Abstract: Reports an error in the original article by S. B. Patten
et al (Social Work, 1989[May], Vol 34[3], 197-203). In the "References"
list on page 198 (column 3, line 32), the reference to Frank, 1988
should be Ochberg, F. A. (1988). The full reference is provided in the
correction. (The following abstract of this article originally appeared
in record 76-34269.) Reviews the historical development and gradual
acceptance of posttraumatic stress disorder (PTSD) as a diagnostic
entity by the mental health community. The process, content, and
affective stages of treatment of sexual abuse from the PTSD approach are
presented, and an integrative model for recovery from sexual trauma is
offered to organize these elements. Traumatic effects include traumatic
sexualization, stigmatization, betrayal, and powerlessness. Case
material from 2 sexually abused girls (aged 4 and 11 yrs) is provided to
illustrate clinical application for social workers who treat such clients.
_____

Title: Posttraumatic stress disorder and the treatment of sexual abuse.
Author(s): Patten, Sylvia B., Florida State U School of Social Work, Tallahassee, US; Gatz, Yvonne K.;
Jones, Berlin; Thomas, Deborah L.
Source: Social Work, Vol 34(3), May 1989. pp. 197-203.
Publisher: US: NASW Press
Abstract: Reviews the historical development and gradual
acceptance of posttraumatic stress disorder (PTSD) as a diagnostic
entity by the mental health community. The process, content, and
affective stages of treatment of sexual abuse from the PTSD approach are
presented, and an integrative model for recovery from sexual trauma is
offered to organize these elements. Traumatic effects include traumatic
sexualization, stigmatization, betrayal, and powerlessness. Case
material from 2 sexually abused girls (aged 4 and 11 yrs) is provided to
illustrate clinical application for social workers who treat such clients.
_____

Title: Stability of positive treatment outcome and symptom relapse in post-traumatic stress disorder.
Author(s): Perconte, Stephen T., Highland Drive Veterans
Administration Medical Ctr, Psychology Service, Pittsburgh, PA, US
Source: Journal of Traumatic Stress, Vol 2(2), Apr 1989. pp. 127-135.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Investigated the long-term effects of a hospital
posttraumatic stress disorder (PTSD) treatment program on 10 male
Vietnam combat veterans (aged 35-44 yrs) who experienced improved
symptoms and distress levels as a result of their participation. Results
of a 12-26 mo follow-up show that there had been significant self-report
symptom relapse, although the Ss maintained significant improvement over
pretreatment levels of distress. Despite partial relapse, Ss continued
to show improved functioning in terms of subsequent hospitalization and
employment. A partial list of factors leading to PTSD relapse is presented.
_____

Title: Implosive therapy for the treatment of combat-related PTSD.
Author(s): Lyons, Judith A., Veterans Administration Medical Ctr, Trauma Recovery Program, Jackson, MS, US;
Keane, Terence M.
Source: Journal of Traumatic Stress, Vol 2(2), Apr 1989. pp. 137-152.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Implosive therapy (IT) for the treatment of
posttraumatic stress disorder (PTSD) is based on the principle of
exposing the patient to trauma-related cues until there is a reduction
in the anxiety associated with the cues. Procedural issues are addressed
and guidelines are offered for conducting IT with traumatized combat
veterans. Despite the surrounding controversy, IT remains an effective
clinical technique in the treatment of PTSD.
_____

Title: Trauma, transformation, and healing: An integrative approach to
theory, research, and post-traumatic therapy.
Series Title: Brunner/Mazel psychosocial stress series; No. 14
Author(s): Wilson, John P., Cleveland State U, Cleveland, OH, US
Source: Philadelphia, PA, US: Brunner/Mazel, Inc, 1989. xx, 345 pp.
Abstract: (from the preface) The chapters of the book concern
different aspects of traumatic stress reactions and include discussion
of the psychobiology of trauma, cross-cultural healing rituals, stress
sensitivity, psychometric assessment, prolonged stress effects in Pearl
Harbor survivors, forensic considerations, and issues in treatment and recovery from trauma.
_____

Title: Achieving successful chemical dependency recovery in veteran survivors of traumatic stress.
Author(s): Moyer, Mary A., Vietnam Veterans Readjustment Counseling
Program, Petersburg, VA, US
Source: Alcoholism Treatment Quarterly, Vol 4(4), Win 1988. pp. 19-34.
Publisher: US: Haworth Press
Abstract: Outlines strategies for chemical dependency intervention
with Vietnam veterans. The intake interview ascertains length of
service, type of discharge, when the client arrived in Vietnam, feelings
about Vietnam, and assigned location. Clinicians should assess
posttraumatic stress disorder (PTSD) symptoms, such as nightmares,
flashbacks, or hypervigilance. Once the PTSD symptoms are identified,
the client must cease the use of chemicals/alcohol, and this may require
hospitalization. Clients must be reassured that although PTSD symptoms
may return, they will learn to control them in therapy sessions.
Veterans and their families should be referred for group therapy in conjunction with substance abuse therapy.
_____

Title: Cultural impediments to recovery: PTSD in contemporary America.
Author(s): Young, Mitchell B., Purdue U, Traumatic Stress Research Program, West Lafayette, IN, US;
Erickson, Cassandra A.
Source: Journal of Traumatic Stress, Vol 1(4), Oct 1988. pp. 431-443.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Discusses characteristics of US culture in transition
and implications for the trauma victim. It is suggested that there is an
increase in psychic numbing, alienation, isolation, and difficulties
with intimacy. For victims of traumatic events, cultural stress overlaps
the posttraumatic experience. Trauma victims are therefore affected by
rapid cultural transition through increased vulnerability to developing
posttraumatic stress disorder (PTSD) and reactions as well as increased length of the healing process.
_____

Title: Understanding identity disruption and intimacy: One aspect of post-traumatic stress.
Author(s): Young, Mitchell B., Purdue U, Family Research Inst, West Lafayette, IN, US
Source: Contemporary Family Therapy: An International Journal, Vol 10(1), Spr 1988. pp. 30-43.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Details the change taking place in the mental processes
of trauma victims and the subsequent disruption of identity and
intimacy. It is contended that for those who experience a traumatic
incident, concepts of self and world views may be broken. The psychic
disruption of the symbolic processes attendant to traumatic events may
interfere with recovery. Lacking a strong sense of self and feeling
blameful for what they have experienced, trauma victims may become
unable to sustain intimate relationships and romantic dyads. At the same
time, symbolic processes become impaired and identity is marked by
separation, disintegration, and stasis. Healing occurs when all aspects
of the traumatic incident, cognitive and emotional, are integrated into self-concepts.
_____

Title: Psychological impact of traumatic events: Implications for
employee assistance intervention.
Author(s): Hillenberg, J. Bruce, Multi Resource Ctr, Clinical Programs, Southfield, MI, US;
Wolf, Kenneth L.
Source: Employee Assistance Quarterly, Vol 4(2), 1988. pp. 1-13.
Publisher: US: Haworth Press
Abstract: Contends that the more employee assistance programs
prepare for effective trauma response for its client population, the
greater the psychological safety net to assist in the adjustment to
emotional pain of trauma. The variety of psychological symptoms,
personal issues, and recovery phases that can follow the experience of a
traumatic event are reviewed. While not all people experience severe or
long-lasting stress problems after being directly or indirectly
affected, a majority will experience mild to severe psychological
reactions. The importance of sensitive and effective intervention during
each phase of recovery is critical in preventing prolonged and severe posttraumatic stress disorder (PTSD).
_____

Title: Recovery of memory and repressed fantasy in combat-induced
post-traumatic stress disorder of Vietnam veterans.
Series Title: The Guilford clinical and experimental hypnosis series
Author(s): Kolb, Lawrence C., Veterans Administration Medical Ctr, Albany, NY, US
Source: Hypnosis and memory. Pettinati, Helen M. (Ed); pp. 265-274. New
York, NY, US: Guilford Press, 1988. xiii, 301 pp.
Abstract: (from the chapter) techniques used / narcosynthesis
induction / abreaction and the role of the therapist / cases . . .
presented herein illustrate the powerful process of repression in
impairing memory for both intensively charged life-threatening incidents
in real life and fantasies of life-threatening events connected with the emotion of terror
_____

Title: Helping families of homicide victims: A multidimensional approach.
Author(s): Masters, Rosemary; Friedman, Lucy N.;
Getzel, George
Source: Journal of Traumatic Stress, Vol 1(1), Jan 1988. pp. 109-125.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: The experiences of a New York City pilot program of
outreach and counseling for 1,182 families of Brooklyn homicide victims
suggest that surviving kin undergo the symptoms of posttraumatic stress
disorder (PTSD). Factors that prolong and complicate the recovery of
homicide survivors include knowledge that the perpetrator may be alive
and in some cases unpunished, and repeated confrontations with the
criminal justice system. Survivors are also confronted with loss of (1)
a family member, (2) illusions of safety and invulnerability, (3) a
sense of trust in the surrounding community, and (4) a belief system.
The psychodynamics of the guilt and rage experienced by survivors are
examined. In presenting treatment options for survivors, it is suggested
that professionals need to help clients accept, mourn, and adapt to each
of the different types of loss they have endured.
_____

Title: Healing of the whole person.
Series Title: Brunner/Mazel psychosocial stress series, No; 11
Author(s): Merwin, Mary R., Victimization Research & Training Inst, Vice President, Okemos, MI, US;
Smith-Kurtz, Bonnie
Source: Post-traumatic therapy and victims of violence. Ochberg, Frank
M. (Ed); pp. 57-82. Philadelphia, PA, US: Brunner/Mazel, Inc, 1988. xiv, 370 pp.
Abstract: (from the chapter) discuss what we believe to be a
beneficial format for outpatient work with victims of violence,
stressing five areas to be included in a total approach to recovery:
nutrition, physical activity, spirituality, humor, and stress management
format of post-traumatic therapy
effects of sugar / processed foods / caffeine / dietary review
physiology and management of stress / general adaptation syndrome (GAS)
/ increase eustress, decrease distress / attitude adjustment / coping techniques / sense of coherence
_____

Title: Post-traumatic family therapy.
Series Title: Brunner/Mazel psychosocial stress series, No; 11
Author(s): Figley, Charles R., Purdue U, Traumatic Stress Research Program, Director, Professor of Family Therapy/Studies & Psychology,
West Lafayette, IN, US
Source: Post-traumatic therapy and victims of violence. Ochberg, Frank
M. (Ed); pp. 83-109. Philadelphia, PA, US: Brunner/Mazel, Inc, 1988. xiv, 370 pp.
Abstract: (from the chapter) describes a family-centered treatment
program . . . based on the assumptions that each person experiencing
traumatic stress must be viewed within a social network of supporters,
including family members, and that by focusing attention on this system
of social support, individual and systemic symptoms of post-traumatic disorder become evident
specifies goals and objectives of treatment, the preconditions prior to
treatment, assessment/diagnosis
review the literature on the significance of the family to victim recovery
detecting traumatic stress / confronting the trauma / urging
recapitulation of the catastrophe / facilitating resolution of the conflicts
cost of caring / simultaneous effects / vicarious effects / chiasmal effects: "infecting" the family with trauma
family relations skills / social supportiveness / adaptability/cohesion
building commitment to the therapeutic objectives / framing the problem
/ reframing / developing a healing theory
_____

Title: Rape trauma and treatment of the victim.
Series Title: Brunner/Mazel psychosocial stress series, No; 11
Author(s): Hartman, Carol R., Boston Coll, Graduate Program in
Psychiatric Mental Health Nursing, Professor & Co-ordinator, Chestnut Hill, MA, US; Burgess, Ann Wolbert
Source: Post-traumatic therapy and victims of violence. Ochberg, Frank
M. (Ed); pp. 152-174. Philadelphia, PA, US: Brunner/Mazel, Inc, 1988. xiv, 370 pp.
Abstract: (from the chapter) presents clinical cases with the
intent to prompt dialogue among clinicians regarding the issue of blame and victimization
identify varied response patterns to rape / offer a scheme of phases for
organizing and isolating variables that might have a bearing on recovery
phases / pre-trauma / assault / disclosure / postdisclosure
coping and survival strategies / post-traumatic stress disorder
incest as a silent reaction to rape trauma
_____

Title: The crime victims' movement.
Series Title: Brunner/Mazel psychosocial stress series, No; 11
Author(s): Young, Marlene A., National Organization for Victim Assistance, Executive Director, Washington, DC, US
Source: Post-traumatic therapy and victims of violence. Ochberg, Frank M. (Ed); pp. 319-329. Philadelphia, PA, US: Brunner/Mazel, Inc, 1988. xiv, 370 pp.
Abstract: (from the chapter) review of the first 15 years of the
victims' movement / its grass-roots origins and self-help
characteristics
reasons [why] crime victims today stand a better chance of recovering
from the psychological wounds of victimization than did their
counterparts of 5 or 10 years ago
etiology and treatment of a recognizable disability / network of service programs
describe the current agenda of the movement, including its passion for
jurisprudential reforms that are substantially motivated out of a desire
to aid in the victim's emotional recovery
explore the future of the movement, including its relations with
friends, allies, and teachers in mental health professions
_____

Title: Recent developments in alcoholism, Vol. 6.
Author(s): Galanter, Marc, (Ed), New York U School of Medicine, New York, NY, US
Source: New York, NY, US: Plenum Press, 1988. xxviii, 411 pp.
Abstract: (from the preface) This annual book series is a valuable
resource for the alcoholism field, because it provides critical and
timely reviews of selected areas that have interest to both
practitioners and researchers. It tries to achieve a balance between
psychosocial and biomedical topics and between research and patient-care
activities. Such a mix is offered in Volume 6.
The broadening scope of clinical and scientific interest in alcohol
dependence is reflected in this sixth volume of "Recent Developments in
Alcoholism." It offers valuable reviews on important current issues in
the field, namely, the intertwining of nature and nurture, a continuing
search for predictors and indicators of the disease, and the social
impact of alcoholism on the job and in special populations. This
material should pique the interest of clinicians from all disciplines.
Medical, social, and political planners also need to turn to the expanding body of knowledge in the field of chemical dependence reflected here.
_____

Title: Multiphasic treatment of the Vietnam veterans.
Author(s): Brende, Joel O., Bay Pines Veterans Administration
Medical Ctr, Stress Recovery Program, FL, US;
Parson, Erwin R.
Source: Psychotherapy in Private Practice, Vol 5(2), Sum 1987. pp. 51-62.
Publisher: US: Haworth Press
Abstract: Discusses the phases through which the treatment of
posttraumatic stress disorder usually proceeds. Phase 1 stabilizes the
target symptoms of conditioned emotional and physiological responses.
Phase 2 confronts emotional detachment, smouldering rage, and
self-destructive symptoms. Phase 3 involves both controlling intrusive
recollections and uncovering the original traumatic experiences. Phase 4
focuses on resolving impacted guilt and grief. Reaching Phase 5 means
that integration has been achieved, and Phase 6 means finding atonement
with God, self, and others.
_____

Title: Involving families in the treatment of combat reactions.
Author(s): Levy, Amihay, Tel-Aviv U Sackler School of Medicine,
Shalvata Mental Health Ctr, Hod Hasharon, Israel;
Neumann, Micha
Source: Journal of Family Therapy, Vol 9(2), May 1987. pp. 177-188.
Publisher: United Kingdom: Blackwell Publishing
Abstract: Describes the 1st involvement of Israeli families in the
treatment of several dozen acute combat reaction casualties at a
military installation near the front line. The 3 main treatment
principles--environment, activity, and group attitude--are described. In
a case example, instead of expecting that the soldier would re-adapt in
the army, he was expected to reaffirm himself within his family.
Meetings involving the family were conducted at several levels: The
family met with the therapist, then a small group of patients and their
families met with the therapist during hospitalization and after
discharge. It is concluded that speed and completeness of recovery
appeared to be promoted by family involvement.
_____

Title: Posttraumatic stress disorder among frontline soldiers with
combat stress reaction: The 1982 Israeli experience.
Author(s): Solomon, Zahava; Weisenberg, Matisyohu;
Schwarzwald, Joseph; Mikulincer, Mario
Source: American Journal of Psychiatry, Vol 144(4), Apr 1987. pp. 448-454.
Publisher: US: American Psychiatric Assn
Abstract: One year after the 1982 Lebanon War, the prevalence,
type, and severity of posttraumatic stress disorder (PTSD) among 334
Israeli soldiers (median age 28.5 yrs) who had been treated for combat
stress reactions were assessed. Comparisons were made with a matched
group of soldiers who had fought in the same battles but had not been
treated for this reaction. A higher percentage of Ss with combat stress
reaction (59%) than of Ss without combat stress reaction (16%) developed
PTSD. Age was significantly associated with PTSD. The differential
quality of PTSD among both groups and the factors facilitating recovery
are discussed.
_____

Title: Aftermath of violence: Posttraumatic stress disorder among Vietnam veterans.
Author(s): Hayman, Peter M., Vietnam Veterans Counseling Ctr, Syracuse, NY; Sommers-Flanagan, Rita;
Parsons, John P.
Source: Journal of Counseling & Development, Vol 65(7), Mar 1987.
Special issue: Counseling and violence. pp. 363-366.
Publisher: US: American Counseling Assn
Abstract: Notes that posttraumatic stress disorder (PTSD)
frequently occurs in the aftermath of violence. A comprehensive 4-phase
treatment approach for Vietnam veterans with PTSD is presented. Phases
in the recovery process are assessment, stabilization of symptoms,
working through the trauma, and reintegration into the family and society.
_____

Title: Moral dimensions in treating combat veterans with posttraumatic
stress disorder.
Author(s): Clewell, Richard D., Cleveland VA Medical Ctr, Ctr for Stress Recovery, OH
Source: Bulletin of the Menninger Clinic, Vol 51(1), Jan 1987. pp. 114-130.
Publisher: US: Guilford Publications
Abstract: Describes the moral dimensions crucial to recovery in
treating combat veterans with posttraumatic stress disorder. Issues of
loss of innocence, conscience, guilt, identity, and existential anxiety
are discussed as underlying features of the disorder, which treaters
must address but are often reluctant to confront. The therapeutic
alliance in its sacred quality is highlighted, and the parallel between
the rite of confession and the psychotherapeutic recovery process is
reviewed. Helpers are recommended to account for their own struggle with
these issues in enabling the veteran's resolution process.
_____

Title: Moral dimensions in treating combat veterans with posttraumatic stress disorder.
Author(s): Clewell, Richard D., Cleveland Veterans Administration
Medical Ctr, Ctr for Stress Recovery, Chaplain & Coordinator of
Outpatient Services, Cleveland, OH, US
Source: Military psychiatry: Learning from experience. Menninger, W.
Walter (Ed); pp. 114-130. Topeka, KS, US: The Menninger Foundation, 1987. 130 pp.
Abstract: (from the chapter) issues of loss of innocence,
conscience, guilt, identity, and existential meaning are underlying
features of the disorder [posttraumatic stress disorder] which treaters
must address but are often reluctant to confront
highlights the therapeutic alliance in its sacred quality and discusses
the parallel between the rite of confession and the psychotherapeutic
recovery process
calls on helpers to account for their own struggle with these issues in
enabling the warrior's process of resolution
nature of war and human response
Notes: Published simultaneously in the "Bulletin of the Menninger
Clinic: A Journal for the Mental Health Professions," Vol. 51, No. 1, January 1987.
_____

Title: Ruth: A case description.
Author(s): No authorship indicated.
Source: Women & Therapy, Vol 5(1), Spr 1986. Special issue: A woman's recovery from the trauma of war. pp. 7-11.
Publisher: US: Haworth Press
Abstract: Describes the case of a 39-yr-old alcoholic woman with symptoms of posttraumatic stress disorder due to her experiences as a
nurse in Vietnam. The S was chronically anxious, actively suicidal, and
engaged frequently in self-mutilating behaviors. Her goals in feminist
therapy included reducing and coping with the intrusive symptoms of her
distress; coming to terms with the overt and symbolic meanings of her
life experiences since her service in Vietnam; and maintaining sobriety
to recover from her alcoholism. (0 ref)
_____

Title: From alienation to connection: Feminist therapy with
Post-Traumatic Stress Disorder.
Author(s): Brown, Laura S., Private practice, Seattle, WA
Source: Women & Therapy, Vol 5(1), Spr 1986. Special issue: A woman's
recovery from the trauma of war. pp. 13-26.
Publisher: US: Haworth Press
Abstract: Describes feminist techniques of psychotherapy used in
treating an alcoholic woman suffering from posttraumatic stress disorder
(PSD) due to her experiences as a military nurse in Vietnam (see record
1987-34515-001). As in many PSD cases, the effects of the traumatic
experiences had been exacerbated greatly by sociocultural pressures to
remain silent about the traumatic incidences. The S's Catholic
background, which emphasized women's passive role, and the subservient
position of women in the military added to her inability to discuss the
trauma. Psychotherapy included attempts to lessen the asymmetrical power
structure of the therapist-patient interaction, enhancement of the S's
personal feeling awareness, validation of the S's experiences and
reactions, use of the therapy relationship as a model for relationships
in the S's life, behavioral and fantasy rehearsal of anger, and
development of the S's sense of personal history.

Title: Brief treatment of complicated PTSD and peritraumatic responses
in a client with repeated sexual victimization.
Author(s): Messman-Moore, Terri L., Miami U, Oxford, OH, US, messmat@muohio.edu;

Resick, Patricia A., U Missouri-St Louis, Ctr for Trauma Recovery, St Louis, MO, US
Address: Messman-Moore, Terri L., Miami U, Dept of Psychology, Benton Hall, Oxford, OH, US, messmat@muohio.edu
Source: Cognitive & Behavioral Practice, Vol 9(2), Spr 2002. pp. 89-99.
Publisher: US: Assn for the Advancement of Behavior Therapy
Abstract: Describes brief (22 wks) Cognitive Processing Therapy
(CPT) of a 41 yr old woman with a childhood history of sexual, physical,
and psychological abuse and multiple rapes in adulthood. Treatment
addressed assault-related posttraumatic stress disorder, major
depression, suicidality, compulsive self-harm behaviors, and primary and
secondary dissociative responses. Also addressed were low self-esteem,
social isolation, and helplessness, which had resulted in the client's
failure to implement self-protection strategies. Client symptomatology
was tracked using the PTSD Symptom Scale and the Beck Depression
Inventory over the course of 34 sessions and for 3 mo posttermination.
Treatment strategies are described, including cognitive and behavioral
components of CPT supportive strategies, safety planning in the context
of ongoing threats and victimization, and the importance of the
therapeutic relationship. Particular emphasis is given to adaptation of
the brief treatment to complex symptomatology and patterns of
symptomatic change. Findings indicate that treatment for individuals
with extensive victimization histories does not require different
strategies or a significantly longer period of treatment than does
treatment for those with a single traumatic experience.
_____

Title: Thought field therapy and trauma recovery.
Author(s): Folkes, Crystal E., San Diego State U/Claremont, San
Diego, CA, US, crystalfolkes@hotmail.com
Address: Folkes, Crystal E., P.O. Box 33663, San Diego, CA, US, crystalfolkes@hotmail.com
Source: International Journal of Emergency Mental Health, Vol 4(2), Spr 2002. pp. 99-104.
Publisher: US: Chevron Publishing
Abstract: People who have been repeatedly exposed to traumatic
events are at high risk for Post Traumatic Stress Disorder (PTSD).
Refugees and immigrants can certainly be in this category, but seldom
seek professional therapy due to cultural, linguistic, financial, and
historical reasons. A rapid and culturally sensitive treatment is highly
desirable with communities new to Western-style healing. In this study
of 31 clients (aged 5-48 yrs), a pre-test was given, all participants
received Thought Field Therapy (TFT), and were then post-tested after 30
days. Pre-test and post-test total scores showed a significant drop in
all symptom sub-groupings of the criteria for PTSD. The findings of this
study contrast with the outcomes of other methods of treatment, and are
a significant addition to the growing body of data on refugee mental health.
_____

Title: Schematic integration of traumatic events.
Author(s): Cason, Dana R., U Missouri-St Louis, Ctr for Trauma
Recovery, St. Louis, MO, US, dcason.ae90@gtalumni.org;
Resick, Patricia A.; Weaver, Terri L.
Address: Cason, Dana R., Center for Trauma Recovery, University
of Missouri-St. Louis, Weinman Building, 8001 Natural Bridge Road, St. Louis, MO, US, dcason.ae90@gtalumni.org
Source: Clinical Psychology Review, Vol 22(1), Feb 2002. pp. 131-153.
Publisher: Netherlands: Elsevier Science
Abstract: Across multiple disciplines of psychology, one commonly
used heuristic device, the schema, has often been called upon to
illustrate the integration of an event. This paper is a critical
examination of the literature on schemas and traumatic events. Three
perspectives are identified: process-focused models, content-focused
models, and construct-focused models. Process-focused models most
clearly elucidate the change mechanisms and provide specific treatment
implications in terms of exposure-based interventions. Content-focused
models provide clinicians and researchers with hypothesized thematic
conflicts that may need to be addressed in treatment. Construct-focused
models and methodologies may provide a means by which researchers can
represent and quantify the degree of conceptual integration of a
traumatic event. The concepts of schema formation, activation, and
modification are explored from each perspective. Implications for
assessment and clinical interventions are also discussed.
_____

Title: Preventing traumatic stress: Public health approaches.
Author(s): Sorenson, Susan B., U California, School of Public
Health, Los Angeles, CA, US
Source: Journal of Traumatic Stress, Vol 15(1), Feb 2002. pp. 3-7.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Population-based approaches to the primary prevention of
posttraumatic stress disorder (PTSD) focus on the prevention of the
stressor itself. Policy decisions also consider ways to allocate
resources to best reduce potential damage from traumatic stressors and
to ameliorate any resulting harm. A balance between broad risk
prevention approaches and narrower treatment and recovery strategies can
redistribute the risk of exposure and lead to fewer cases. Understanding
that PTSD and its costs affect not only individuals who seek care, but
also many others whose lives overlap with these individuals as well as
society as a whole, further informs and shapes prevention decisions.
_____

Title: The aetiology of postpsychotic posttraumatic stress disorder following a psychotic episode.
Author(s): Shaw, Katharine, Sunnyside Hosp, Seager Villa, Christchurch, New Zealand;
McFarlane, Alexander C., U Adelaide, Queen Elizabeth Hosp, Dept of
Psychiatry, Woodville South, SA, Australia,
alexander.mcfarlane@adelaide.edu.au;
Bookless, Clara, U Adelaide, Queen Elizabeth Hosp, Dept of Psychiatry, Woodville South, SA, Australia;
Air, Tracy, U Adelaide, Queen Elizabeth Hosp, Dept of Psychiatry, Woodville South, SA, Australia
Address: McFarlane, Alexander C., U Adelaide, Queen Elizabeth
Hosp, Dept of Psychiatry, Woodville, SA, Australia, 5011,
alexander.mcfarlane@adelaide.edu.au
Source: Journal of Traumatic Stress, Vol 15(1), Feb 2002. pp. 39-47.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Examines the aetiology of postpsychotic posttraumatic
stress disorder (PP/PTSD) symptoms in 42 people (aged 16-65 yrs)
hospitalized for a psychotic illness were interviewed during recovery to
investigate whether a psychotic episode was associated with PTSD
symptomatology. Measures included the Composite International Diagnostic
Instrument, a modified Brief Psychiatric Rating Scale, the
Clinician-Administered PTSD Scale, the Stanford Acute Stress Reaction
Questionnaire, and the Impact of Event Scale. All participants found
psychosis and hospitalization highly distressing. PP/PTSD symptoms were
not associated with demographic factors, previous trauma, treatment, or
insight. The PP/PTSD group reported more distress and intrusive memories
associated with illness and treatment experiences and had higher scores
for anxiety and dissociative symptoms. The development of PP/PTSD
phenomenology was associated with the psychological distress of the experience.
_____

Title: Peritraumatic dissociative experiences, trauma narratives, and trauma pathology.
Author(s): Zoellner, Lori A., U Pennsylvania School of Medicine, Dept of Psychiatry, Philadelphia, PA, US, zoellner@u.washington.edu;
Alvarez-Conrad, Jennifer, U Pennsylvania School of Medicine, Dept of Psychiatry, Philadelphia, PA, US;
Foa, Edna B., U Pennsylvania School of Medicine, Dept of Psychiatry, Philadelphia, PA, US
Address: Zoellner, Lori A., U Washington, Dept of Psychology, Box 351525, Seattle, WA, US, zoellner@u.washington.edu
Source: Journal of Traumatic Stress, Vol 15(1), Feb 2002. pp. 49-57.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Peritraumatic dissociation, i.e., dissociation during or
immediately after a traumatic event, has been associated with
persistence of trauma-related pathology. Peritraumatic dissociation may
interfere with encoding of traumatic memories and this style may impede
recovery. This study examines this hypothesis by analyzing trauma
narratives from 28 female sexual and nonsexual assault victims who
reported either high or low peritraumatic dissociation. Interview
measures included the Structured Clinical Interview for DSM-IV, PTSD
Symptom Scale, the Standardized Assault Interview, the Peritraumaic
Dissociative Experiences Questionnaire-Rater Version, and self-report
measures of anxiety and depression. Ss were asked to recount their
assault. Narratives were videotaped, transcribed, and coded. Narratives
of individuals with high peritraumatic dissociation had higher grade
levels and a trend toward lower reading ease than those with low
peritraumatic dissociation. Both higher grade levels and lower reading
ease of prethreat sections of trauma narratives were related to
posttreatment reexperiencing and anxiety symptoms.
_____

Title: Exposure therapy for posttraumatic stress disorder.
Author(s): Rothbaum, Barbara Olasov, Emory U School of Medicine,
Trauma & Anxiety Recovery Program, Atlanta, GA, US, brothba@emory.edu;
Schwartz, Ann C., Emory U School of Medicine, Atlanta, GA, US
Address: Rothbaum, Barbara Olasov, The Emory Clinic, 1365 Clifton
Road, Atlanta, GA, US, brothba@emory.edu
Source: American Journal of Psychotherapy, Vol 56(1), 2002. pp. 59-75.
Publisher: US: Assn for the Advancement of Psychotherapy
Abstract: Exposure therapy is a well-established treatment for
posttraumatic stress disorder (PTSD) that requires the patient to focus
on and describe the details of a traumatic experience. Exposure methods
include confrontation with frightening, yet realistically safe, stimuli
that continues until anxiety is reduced. A review of the literature on
exposure therapy indicates strong support from well-controlled studies
applied across trauma populations. However, there are many
misconceptions about exposure therapy that may interfere with its
widespread use. These myths and clinical guidelines are addressed. It is
concluded that exposure therapy is a safe and effective treatment for
PTSD when applied as directed by experienced therapists.
_____

Title: Active ingredients in trauma-focused brief treatments.
Series Title: Contributions in psychology, no; 39
Author(s): Dietrich, Anne M.
Source: Brief treatments for the traumatized: A project of the Green Cross Foundation. Figley, Charles R. (Ed); pp. 29-55. Westport, CT, US:
Greenwood Press/Greenwood Publishing Group, Inc, 2002. xxiv, 337 pp.
Abstract: (from the chapter) Argues that exposure,
desensitization, and cognitive-emotional processing are active
mechanisms of therapeutic change for symptoms of posttraumatic stress
disorder (PTSD). This chapter also suggests that exposure,
desensitization, and processing are key mechanisms for particularly
chronic and complicated forms of PTSD and associated features; however,
additional mechanisms of change are likely required for complete and
successful treatment. Finally, for individuals who are severely
traumatized and incapacitated by their symptoms, teaching symptom
management skills in combination with medication might be the most that
can be done. To the degree that risk factors function to determine both
the development of PTSD and recovery from trauma, it is plausible that
targeting risk factors may help in treating PTSD and preventing
recurrences. The chapter concludes with suggestions for how to subject
experimental treatment approaches to systematic clinical (case) study,
followed by suggestions for empirical study in relation to the roles of
various etiological pathways and variables. A risk factors checklist and
case study form are appended.
_____

Title: Post traumatic stress disorder and reaction.
Author(s): Esser, June A., U Pittsburgh Medical Ctr, Pittsburgh, PA, US
Source: Children and disasters: A practical guide to healing and recovery. Zubenko, Wendy N. (Ed); Capozzoli, Joseph A. (Ed); pp.
101-123. London,: Oxford University Press, 2002. xii, 183 pp.
Abstract: (from the chapter) The task of this chapter is to
explain posttraumatic stress disorder (PTSD) and posttraumatic stress
reaction (PTSR), as well as to offer useful interventions for youth
exposed to catastrophic events. Topics discussed include wellness
promotion, physical needs, and psychological needs. Case studies are
offered to illustrate some of the concepts that will help children with
symptoms of PTSD to heal.
_____

Title: Posttraumatic stress disorder and substance abuse: Perspectives of women in recovery.
Author(s): Stam, Marjorie K., Massachusetts School Of Professional Psychology, US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 63(6-B), Jan 2002. pp. 3026.
Publisher: US: Univ Microfilms International
Abstract: The purpose of this qualitative study was to understand
women's perspectives about recovery from substance abuse while having
concurrent posttraumatic stress disorder (PTSD). Extensive literature
documents a dynamic relationship between PTSD and abuse of substances in
community and clinical samples. Female substance abusers also have much
higher rates of PTSD than males with the same diagnoses. In an effort to
provide effective treatment, several integrated, cognitive-behavioral
protocols have been developed. The outcome studies were very small, had
high dropout rates, and lacked control groups in some cases. Clinicians
and researchers have neglected the subjective experience of women who
have recovered from substance abuse while having concurrent PTSD. This
study was designed to gather such information. In this study, eight
women between the ages of 21 and 46 were interviewed. All of the women
were substance free and had PTSD, the result of childhood abuse. An
open-ended, semi-structured interview was used to learn about their
recovery from substances. The data obtained from these interviews was
analyzed and common themes were extrapolated. Based on the literature,
recovery was expected to involve the "unlinking" of PTSD from substance
abuse. However, the results indicated that substances were used to
medicate the sequelae of the trauma, PTSD symptoms, as well as the
effects of the childhood abuse on self-development. Recovery included
abstinence from substances and alteration in each woman's self-concept,
a change from a self with low self-esteem to a self that felt valued.
Significantly, the women did not speak of recovery in terms of PTSD
symptoms, the lessening of them or the ability to manage them. The
findings are discussed within the context of trauma theory, attachment
theory and self psychology. Critique of the method, implications for
clinical practice and suggestions for future studies are also presented.
_____

Title: Gender and PTSD treatment: Efficacy and effectiveness.
Author(s): Cason, Dana;
Grubaugh, Anouk, U Missouri, Ctr for Trauma Recovery, St. Louis, MO, US;
Resick, Patricia, U Missouri, Ctr for Trauma Recovery, St. Louis, MO, US
Source: Gender and PTSD. Kimerling, Rachel (Ed); Ouimette, Paige (Ed);
et al; pp. 305-334. New York, NY, US: Guilford Press, 2002. xx, 460 pp.
Abstract: (from the chapter) This chapter is concerned with gender
and research on posttraumatic stress disorder (PTSD) treatment efficacy
and effectiveness. The bulk of this chapter focuses on efficacy
research, because it is far more prevalent in the field. We made
concerted efforts to include all controlled PTSD treatment efficacy
studies satisfying certain methodological considerations. For the
purposes of this chapter, controlled PTSD treatment studies include any
studies in which an active treatment condition is compared to a
wait-list group, a control group for nonspecific treatment effects,
and/or another active treatment. In the research reviewed for this
chapter, efficacy study populations fell into three groups: (1) both men
and women who experienced a variety of traumatic experiences, (2) male
military veterans with combat-related PTSD, and (3) female survivors of
sexual or nonsexual assault. We explore the studies, effect sizes, and
related factors in depth. Following a description of the common
treatment approaches to PTSD, the findings of efficacy studies, along
with possible moderating variables, are discussed. The chapter ends with
a brief description of treatment effectiveness findings.
_____

Title: Hurricanes and earthquakes.
Author(s): La Greca, Annette M., U Miami, Dept of Psychology, Coral Gables, FL, US;
Prinstein, Mitchell J., Yale U, Dept of Psychology, New Haven, CT, US
Source: Helping children cope with disasters and terrorism. La Greca,
Annette M. (Ed); Silverman, Wendy K. (Ed); et al; pp. 107-138.
Washington, DC, US: American Psychological Association, 2002. xvii, 446 pp.
Abstract: (from the chapter) Examines the effects of hurricanes
and earthquakes on children and adolescents, although the authors touch
briefly on the limited literature on other natural disasters, such as
tornadoes, lightning strikes, and volcanoes. The authors present
evidence indicating that many children and adolescents living in heavily
damaged areas experience significant disaster-related symptomatology for
months after the initial disaster and describe initial versions of
manualized intervention materials. These sudden, dramatic, and violent
acts of nature can create widespread damage and high levels of exposure
to life-threatening trauma and may require long periods of
reconstruction and recovery. For children and adolescents caught in
severe hurricanes, earthquakes, or tornadoes, these relatively brief
displays of natural forces can transform a familiar environment into a
jumbled pile of rubble. Normally confident and protective adults may
show terror, shock, and fear. In the most unfortunate circumstances,
children may witness deaths or serious injuries or be injured
themselves. The authors describe early versions of manualized
intervention materials for dealing with the aftermath of hurricanes and
earthquakes.
_____

Title: Hypnotizability and trauma symptoms after burn injury.
Author(s): DuHamel, Katherine N., Mount Sinai School of Medicine, New York, NY, US, katherine.duhamel@mssm.edu;
Difede, JoAnn, The New York Presbyterian Weill Medical Coll of Cornell U, New York, NY, US;
Foley, Frederick, Ferkauf Graduate School of Psychology, US;
Greenleaf, Marcia, Albert Einstein Coll of Medicine, US
Address: DuHamel, Katherine N., Mount Sinai School of Medicine,
Ruttenberg Cancer Ctr, One Gustave L. Levy Place, Box 1130, New York,
NY, US, katherine.duhamel@mssm.edu
Source: International Journal of Clinical & Experimental Hypnosis, Vol 50(1), Jan 2002. pp. 33-50.
Publisher: United Kingdom: Taylor & Francis
Abstract: This study investigated the association of trauma
symptoms and hypnotizability in 43 hospitalized survivors of burn injury
(17 women, 27 men, aged 19-58 yrs). In addition, the relation of trauma
symptoms with treatment and physical and demographic variables was
studied. Three to 17 days after the injury, participants rated the
frequency of intrusive and avoidance symptoms and were interviewed with
the posttraumatic stress disorder module of the Structured Clinical
Interview for the Diagnostic and Statistical Manual of Mental
Disorders-III-R. The Hypnotic Induction Profile also was administered at
the postburn, hospital stage of recovery. Results indicate that when
participants were divided into low, mid-range, and high hypnotizability
categories, high hypnotizability was associated with more intrusive,
avoidance, and arousal symptoms. Although causal relations cannot be
assessed in this cross-sectional study, these results suggest that, as
compared to the low and mid-range categories, high hypnotizables may
experience a greater frequency of trauma symptoms after burn injury.
_____

Title: Post-traumatic symptoms, emotional distress and quality of life
in long-term survivors of breast cancer: A preliminary research.
Author(s): Amir, Marianne, Ben-Gurion U of Negev, Depts of Behavioral Sciences & Social Work, Beer-Sheva, Israel,
mamir@bgumail.bgu.ac.il;
Ramati, Alona, Ben-Gurion U of Negev, Dept of Behavioral Sciences, Beer-Sheva, Israel
Address: Amir, Marianne, Ben-Gurion U of Negev, Depts of Behavioral Sciences & Social Work, 84105, Beer-Sheva, Israel, mamir@bgumail.bgu.ac.il
Source: Journal of Anxiety Disorders, Vol 16(2), 2002. pp. 191-206.
Publisher: Netherlands: Elsevier Science
Abstract: The present study is a preliminary study assessing
long-term psychological effects in female survivors (aged 37-60 yrs) of
breast cancer. 39 long-term female survivors of breast cancer were
compared with 39 matched women who had not been exposed to any chronic
disease regarding post-traumatic stress disorder (PTSD), quality of life
(QoL), emotional distress and coping styles. Survivors revealed
significantly higher rates of full and partial PTSD, scored
significantly higher on emotional distress, scored significantly lower
on physical and psychological QoL and exhibited coping styles
significantly different from those of the control group. PTSD was
associated with the coping style of suppression. Multiple regression
analysis showed that receiving chemotherapy and disease stage, as well
as the interaction between chemotherapy and disease stage, were
significant predictors of hyperarousal. The findings show that
post-traumatic symptoms are a common sequel after recovery from cancer.
Furthermore, findings suggest a conceptual distinction between PTSD
symptoms and QoL in the study of long-term effects of cancer.
_____

Title: Beyond the beveled mirror: Mourning and recovery from childhood
maltreatment.
Series Title: The series in trauma and loss
Author(s): Bloom, Sandra L.
Source: Loss of the assumptive world: A theory of traumatic
loss. Kauffman, Jeffrey (Ed); pp. 139-170. New York, NY, US: Brunner-Routledge, 2002. xii, 246 pp.
Abstract: (from the chapter) This chapter discusses the loss of
the assumptive world due to childhood maltreatment. Adult victims of
child maltreatment find it difficult to form healthy attachments and
this chapter seeks to offer ways to understand how trauma and loss in
childhood affect adult relationships and impact the capacity to grieve.
The chapter details attachment theories, grief models, complex
posttraumatic stress disorder, traumatic grief, unresolved and
stigmatized loss, and bearing witness to childhood loss. The chapter
concludes with an analysis of losses secondary to child maltreatment,
such as the lack of ability to manage emotions, attention,
relationships, and self-esteem.
_____

Title: Difficultés et effets a-6 long terme d'une catastrophe en milieu
rural: Étude combinant les approches qualitative et quantitative.
Translated Title: A qualitative and quantitiative study of the
long-term psychological effects of a natural disaster on a rural
community.
Author(s): Maltais, Danielle, U du Québec à Chicoutimi, département
des Sciences Humaines, Chicoutimi, PQ, Canada, danielle_maltais@uqac.ca;
Lachance, Lise, U du Québec à Chicoutimi, Chicoutimi, PQ, Canada;
Brassard, Audrey, U du Québec à Chicoutimi, Chicoutimi, PQ, Canada;
Picard, Louis, U du Québec à Chicoutimi, Chicoutimi, PQ, Canada
Address: Maltais, Danielle, Departement des sciences humaines,
Universite du quebec a Chicoutimi,, 555, boul. de l'Universite,,
Chicoutimi, PQ, Canada, danielle_maltais@uqac.ca
Source: Revue Quebecoise de Psychologie, Vol 23(3), 2002. pp. 197-217.
Publisher: Canada: Revue Quebecoise de Psychologie
Abstract: Studied qualitatively and quantitatively the problems
and emotions experienced by 122 male and female adults (mean age 48.4
yrs), victims of floods in rural areas in France in 1996, and 117 male
and female adults living in an area unaffected by the flooding. Data on
sociodemographic variables and physical, social, and mental symptoms
experienced during the emergency phase and the recovery process were
obtained by semistructured interview, conducted 3 yrs after the flood.
The Impact of Event Scale (M. J. Horowitz et al, 1979), the Beck
Depression Inventory, the General Health Questionnaire, and the Affect
Balance Scale (N. M. Bradburn, 1969) were used. The results indicate
that the health status is more delicate and financial situations more
unstable among subjects affected by the flood than by those subjects not
affected by the flood. Implications for developing intervention methods
for victims of natural disasters are discussed.
_____

Title: Use of object relations and self-psychology as treatment for sex
addiction with a female borderline patient.
Author(s): Valenti, Suaye Anna Maria, The Meadows, Wickenburg, AZ,
US, Anna@Valenti.com
Address: Valenti, Suaye Anna Maria, The Meadows, 1655 North
Tegner Street, Wickenburg, AZ, US, Anna@Valenti.com
Source: Sexual Addiction & Compulsivity, Vol 9(4), 2002. Special issue:
Women and sexual addiction. pp. 249-262.
Publisher: United Kingdom: Taylor & Francis
Abstract: Object relations and self-psychology were utilized in an
outpatient setting with an adult female patient who initially presented
with a diagnosis of posttraumatic stress and borderline personality
disorders and exhibited compulsive sexual thoughts and behaviors. The
patient engaged in self-defeating behaviors in an attempt to survive, to
cope with, or to avoid painful emotions associated with original trauma.
She reenacted sexual and physical traumatic themes, and further endured
mistreatment by professionals unaware of how to address her collateral
sexual compulsivity. Longer recovery was obtained only when a therapist
provided a consistent holding environment.
_____

Title: Short-term treatment of simple and complex PTSD.
Author(s): Tinnin, Louis, Trauma Recovery Inst, Morgantown, WV, US;
Bills, Lyndra, The Sanctuary, Quakertown, PA, US;
Gantt, Linda, Trauma Recovery Inst, Morgantown, WV, US
Source: Simple and complex post-traumatic stress disorder: Strategies
for comprehensive treatment in clinical practice. Williams, Mary Beth
(Ed); Sommer, John F. Jr. (Ed); pp. 99-118. Binghamton, NY, US: Haworth
Maltreatment and Trauma Press/The Haworth Press, Inc, 2002. xxiii, 408 pp.
Abstract: (from the chapter) This chapter presents a brief
treatment method that uses video technology as a therapeutic tool in
in-session treatment procedures and as homework. This approach permits
controlled, nonabreactive processing of traumatic memories. It protects
the patient from retraumatization and allows the trauma work to commence
without undue delay. Video-assisted therapy uses recursive reviews of
the treatment sessions. Every session is videotaped--including those
sessions reviewing previous tapes--and the patient owns the tapes. The
patient conducts much of the therapy independently by studying the tapes
at home. This treatment also uses video recording and replay in video
dialogue, a specific to procedure to diminish dissociation, and permits
externalization of an individual's inner dialogue. The principles of
video-assisted trauma therapy can be applied without video recording,
but using the video camera, if the treatment is to be brief, is
recommended.
_____

Title: Trauma services to war veterans.
Author(s): Flora, Charles M.
Source: Simple and complex post-traumatic stress disorder: Strategies
for comprehensive treatment in clinical practice. Williams, Mary Beth (Ed); Sommer, John F. Jr. (Ed); pp. 325-348. Binghamton, NY, US: Haworth
Maltreatment and Trauma Press/The Haworth Press, Inc, 2002. xxiii, 408 pp.
Abstract: (from the chapter) Notes that first and foremost, a
veteran's recovery from the psychological wounds of war is predicated on
the idea that posttraumatic reactions have a natural history and are the
consequence to previously well-functioning individuals exposed to the
extreme life-and-death threatening stresses of war. The therapeutic
relationship helps to anchor the veteran to traumatic war memories, a
past that has often been defensively split off from everyday life, and
facilitates a recovery environment, which is primarily embodied by the
therapist whose authentic interest and empathy have been established. In
time, the veteran is helped to embed his or her war experiences in
widening circles of narrative significance, by placing them in the
larger contexts of his or her life history and the history of his or her
war. The author discusses treatment in terms of community outreach and
psychotherapy for war trauma using case examples. These examples
illustrate the process of psychotherapy for war-related PTSD: the
telling of the story before, during, and after the traumatic event or
events. Important adjuncts to psychotherapy are understanding and
intervening in the community on behalf of the veteran and engaging the
veteran's family in the treatment process.
_____

Title: A primer on interviewing victims.
Author(s): Ochberg, Frank, Dart Foundation, Okemos, MI, US
Source: Simple and complex post-traumatic stress disorder: Strategies
for comprehensive treatment in clinical practice. Williams, Mary Beth
(Ed); Sommer, John F. Jr. (Ed); pp. 351-360. Binghamton, NY, US: Haworth
Maltreatment and Trauma Press/The Haworth Press, Inc, 2002. xxiii, 408 pp.
Abstract: (from the chapter) Whenever a reporter meets a survivor
of traumatic events, there is a chance that the journalist will
witness--and may even precipitate--post-traumatic stress disorder.
Therefore, it is important that working journalists (including grizzled
veterans) anticipate PTSD, recognize it, and report it, while earning
the respect of the public and those interviewed. It is argued that an
understanding of post-traumatic stress disorder is vital to journalists
in their coverage of the way in which victims experience emotional
wounds, particularly wounds that are deliberately and cruelly inflicted.
A relatively new area of clinical science, traumatic stress studies,
teaches that victims of violence have several distinguishable patterns
of emotional response. These patterns are easily recognized once their
outlines are understood. Seeing the logic in a set of psychological
consequences rehumanizes and dignifies a person who may feel dehumanized
and robbed of dignity. A sensitive explanation of the traumatic stress
response aids recovery. Journalists can report on victims, help victims
as multidimensional human beings, and possibly, just possibly, reduce
the impulse toward vengeance in the process.
_____

Title: Working with survivors and the news media.
Author(s): Maxson, Janice, U Washington, Seattle, WA, US;
Simpson, Roger, U Washington, Journalism & Trauma Program, School of Communications, Seattle, WA, US
Source: Simple and complex post-traumatic stress disorder: Strategies
for comprehensive treatment in clinical practice. Williams, Mary Beth
(Ed); Sommer, John F. Jr. (Ed); pp. 371-384. Binghamton, NY, US: Haworth
Maltreatment and Trauma Press/The Haworth Press, Inc, 2002. xxiii, 408 pp.
Abstract: (from the chapter) This chapter describes how trauma
professionals can help victims understand and respond constructively to
the demands and methods of the news media. The planning and effective
actions that can be taken immediately after a traumatic event and in the
ensuing recovery period are described. First, it must be emphasized that
some unconventional assumptions have been made. For example, it is rare
for therapists and other trauma professionals to act as intermediaries
between victims and the press. It also is rare for mental health
professionals to cooperate in citywide or regionwide programs to help
victims respond to media. Needless to say, such individual and community
efforts are encouraged, and these suggestions are offered as a blueprint
for such initiatives. The news media can help both victims and
communities face trauma and loss. Some reporters and editors are
bringing about major changes in their newsrooms in the interests of
victims and survivors. The active interest of mental health
professionals in how the news media report about trauma and victims will
spur even more positive change.
_____

Title: Emotionally focused couple therapy with trauma survivors:
Strengthening attachment bonds.
Series Title: The Guilford family therapy series
Author(s): Johnson, Susan M., U Ottawa, Ottawa, Canada
Source: New York, NY, US: Guilford Press, 2002. xii, 228 pp.
Abstract: (from the jacket) This work suggests that couple therapy
can play an important role in recovery for individual trauma survivors
at the same time it addresses trauma-related issues in the relationship
as a whole. The author presents a systematic intervention approach
designed to modify the interactional patterns that maintain traumatic
stress and foster positive, healing attachments among survivors and
their partners. Combining theoretical innovation, evidence-based
techniques, and wisdom gleaned from decades of front-line clinical
experience, it is a vital resource for practitioners in a wide range of settings.
Part I presents current theory and research on posttraumatic stress
disorder (PTSD), attachment, and emotionally focused couple therapy,
integrating these three areas into a comprehensive treatment model. The
process of intervention is outlined stage by stage and specific guidance
is offered on assessment. Part II, organized around detailed case
examples, demonstrates the approach in action.
_____

Title: The PTSD workbook: Simple, effective techniques for overcoming
traumatic stress symptoms.
Author(s): Williams, Mary Beth, Trauma Recovery Education & Counseling Ctr, Warrenton, VA, US;
Poijula, Soili, Oy Synolon Ltd., Ctr for Trauma Psychology, Finland
Source: Oakland, CA, US: New Harbinger Publications, Inc., 2002. viii, 237 pp.
Abstract: (from the cover) Two psychologists and trauma experts
gather together techniques and interventions used by posttraumatic
stress disorder experts from around the world to offer trauma survivors
tools to conquer their most distressing trauma-related symptoms. The
workbook provides information on learning to determine the type of
trauma experienced, identifying symptoms, and learning the most
effective strategies to overcome them.
_____

Title: Long term course of chronic posttraumatic stress disorder in
traffic accident victims: A three-year prospective follow-up study.
Author(s): Koren, Danny, Rambam Medical Center, Dept of Psychiatry, Haifa, Israel; Arnon, I.;
Klein, Ehud, e_klein@rambam.health.gov.il
Address: Koren, Danny, Department of Psychiatry, Rambam Medical
Center, Haifa, Israel, e_klein@rambam.health.gov.il
Source: Behaviour Research & Therapy, Vol 39(12), Dec 2001. pp. 1449-1458.
Publisher: Netherlands: Elsevier Science
Abstract: The purpose of the present study was to gather
prospective longitudinal data on the long-term course and outcome of
chronic posttraumatic stress disorder (PTSD). The target population for
this study was 74 injured traffic accident victims who had been
previously followed-up for one year after the trauma. Nineteen of the
original 24 PTSD subjects (mean age 26.2 yrs) and 39 of the original 50
Non-PTSD subjects (mean age 28.8 yrs) were available for this study,
which took place during the fourth year after the accident. Our results
show that 10 of the 19 patients with PTSD at one-year still suffered
from PTSD after another two-year follow-up interval, while 9 recovered
from PTSD during this follow-up period. Only 2 of the 39 without PTSD at
one year developed delayed onset PTSD. The best predictor of recovery
from chronic PTSD was the initial level of posttraumatic reaction
immediately after the accident. These results demonstrate that
spontaneous recovery from PTSD can occur even among patients who are
currently considered chronic. Severity of initial reaction to the trauma
appears to be a major risk factor for non-remitting chronic PTSD.
_____

Title: Community as a context of healing.
Author(s): Farwell, Nancy, U Washington, School of Social Work, Seattle, WA, US, nfarwell@u.washington.edu;
Cole, Jamie B., International Rescure Committee, Seattle, WA, US
Address: Farwell, Nancy, U Washington, School of Social Work, 4101 15th Avenue NE, Seattle, WA, US, nfarwell@u.washington.edu
Source: International Journal of Mental Health, Vol 30(4), Win 2001-2002. pp. 19-41.
Publisher: US: ME Sharpe
Abstract: In this paper the authors advocate for a conceptual
approach to research and intervention with children exposed to war and
political violence that is inclusive of community as a nexus for
healing. The clinical concept of posttraumatic stress disorder (PTSD) as
the sole organizing framework for research, assessment, and intervention
is too narrow for this purpose. Contemporary conflicts target community;
thus, the sociopolitical context is a key element in both trauma and
recovery. With this in mind, we here discuss the nature of trauma and
conceptual approaches for incorporating "community" as context and
outcome in healing. Finally, essential elements of community
mobilization and two examples of interventions exemplifying recovery and
reintegration within the context of community are presented.
_____

Title: Cognitive therapy for posttraumatic stress disorder.
Author(s): Resick, Patricia A., U Missouri, St Louis, MO, US
Address: Resick, Patricia A., Ctr for Trauma Recovery, Weinman Building, U Missouri-St. Louis, 8001 Natural Bridge Road, St. Louis, MO, US
Source: Journal of Cognitive Psychotherapy, Vol 15(4), Win 2001. Special issue: Review of cognitive behavioral therapy. pp. 321-329.
Publisher: US: Springer Publishing
Abstract: Examines 7 controlled studies that included at least a
component of cognitive therapy for posttraumatic stress disorder (PTSD).
Two studies specifically focused on early intervention to treat PTSD and
included both cognitive therapy and exposure therapy. Three studies
examined cognitive processing therapy, which is predominantly cognitive
therapy. Two other studies compared pure cognitive therapy with exposure
therapy. The author maintains that overall, cognitive therapy for PTSD
appears to be highly effective compared to no-treatment, relaxation, or
supportive counseling, and similar to exposure treatments. Treatment
effects appear to continue through follow-up periods of up to 1 yr.
However, little is known about who benefits best with cognitive therapy
or predictors of treatment outcome.
_____

Title: A "cure" for chronic combat-related posttraumatic stress
disorder secondary to a right frontal lobe infarct: A case report.
Author(s): Freeman, Thomas W., North Little Rock VAMC, North Little Rock PTSD Program, North Little Rock, AR, US;
Kimbrell, Tim
Source: Journal of Neuropsychiatry & Clinical Neurosciences, Vol 13(1), Win 2001. pp. 106-109.
Publisher: US: American Psychiatric Assn
Abstract: A 48-year-old combat veteran sustained a right frontal
cerebral infarct at the age of 45 years. The patient's family reports
that prior to the infarct he had a preoccupation with memories of
combat, as well as nightmares, avoidance of reminders, and multiple
arousal symptoms. Since his recovery from the infarct, the patient and
his family continue to relate significant arousal symptoms but deny any
continued history of preoccupation with traumatic memories, reminder
avoidance, or nightmares. The resolution of a limited number of symptoms
in this patient following damage to the right frontal cortex suggests
that some of the symptoms of posttraumatic stress disorder may be
amenable to current biological interventions.
_____

Title: The course of post-traumatic stress disorder after the Oklahoma City bombing.
Author(s): North, Carol S., Washington U School of Medicine, Dept of Psychiatry, St. Louis, MO, US, northc@psychiatry.wustl.edu
Address: North, Carol S., Washington U School of Medicine, Dept
of Psychiatry, 660 S. Euclid, Campus Box 8134, St. Louis, MO, US, northc@psychiatry.wustl.edu
Source: Military Medicine, Vol 166(12,Suppl 2), Dec 2001. pp. 51-52.
Publisher: US: Assn of Military Surgeons of the US
Abstract: Oklahoma City bombing survivors (182 persons who had
been in the direct path of the bomb blast) were studied 6 mo
post-bombing; 141 Ss were reassessed approximately 1 yr later to
determine the longitudinal course of posttraumatic stress disorder
(PTSD) and other psychiatric disorders. The Diagnostic Interview
Schedule assessed lifetime, current, predisaster, and post-bombing
psychiatric diagnoses at both assessment points. One-third of the
Oklahoma City bombing survivors had PTSD at index, and similar rates
were diagnosed at follow-up. More recovery from depression was apparent
than from PTSD. No delayed onset PTSD was observed, and all PTSD was
chronic. Avoidance and numbing symptoms were dominant in defining the
development of PTSD. Early onset and chronicity of PTSD indicate need
for prompt and long-term intervention after disasters. Focus on
avoidance and numbing symptoms may aid in identification of individuals
needing intervention and monitoring the course of PTSD.

_____

Title: A follow-up study of posttraumatic stress disorder, anxiety, and
depression in Australian victims of domestic violence.
Author(s): Mertin, Peter, U South Australia, School of Psychology, Adelaide, SA, Australia;
Mohr, Philip B., U South Australia, School of Psychology, Adelaide, SA, Australia
Address: Mertin, Peter, U South Australia, School of Psychology, North Terrace, Adelaide, SA, Australia, 5000
Source: Violence & Victims, Vol 16(6), Dec 2001. pp. 645-654.
Publisher: US: Springer Publishing
Abstract: Notes that although posttraumatic stress disorder
(PTSD), anxiety, and depression are acknowledged consequences of
domestic violence, little information is available on the course of
recovery over time and factors that may mediate positive outcome. 59
women were assessed for the presence of PTSD and levels of anxiety and
depression at time of shelter residence and again 1 yr later. Results at
follow-up indicate a significant reduction in the incidence of PTSD,
although a substantial number of women continued to report a range of
posttrauma symptoms. There were also significant reductions in the
levels of anxiety and depression over the 12-mo period. Findings
indicate the particular importance of safety and the presence of social
support as prerequisites for recovery.
_____

Title: Substance abuse as a symptom of childhood sexual abuse.
Author(s): Teusch, Rita, Boston University School of Medicine, Dept of Psychiatry, MA, US
Address: Teusch, Rita, 129 Mt. Auburn Street, Cambridge, MA, US
Source: Psychiatric Services, Vol 52(11), Nov 2001. pp. 1530-1532.
Publisher: US: American Psychiatric Assn
Abstract: The recovery process of a 37-yr-old woman with adult
onset posttraumatic stress disorder (PTSD) is presented. The patient had
suffered childhood sexual abuse and had self-medicated for many years
with drugs and alcohol to maintain the dissociation of memories of abuse
and to facilitate interpersonal functioning. Upon onset of PTSD, the
patient's substance abuse became a full-blown addiction that was highly
resistant to treatment. It became evident that her substance abuse
symbolically repeated her traumatization. In reexperiencing the affects
associated with her earlier trauma (despair, denial, shame, and
helplessness) as part of her substance abuse and in the transference,
the patient was able to gain mastery over these affects and,
subsequently, was able to achieve a stable recovery from both illnesses.
_____

Title: Posttraumatic stress disorder in a general psychiatric inpatient population.
Author(s): McFarlane, Alexander C., U Adelaide, Queen Elizabeth
Hosp, Dept of Psychiatry, Woodville, SA, Australia;
Bookless, Clara, clara.bookless@adelaide.edu.au;
Air, Tracy
Address: Bookless, Clara, U Adelaide, Queen Elizabeth Hosp, 1st
Floor, Maternity Building, Woodville Road, Woodville, SA, Australia, 5011, clara.bookless@adelaide.edu.au
Source: Journal of Traumatic Stress, Vol 14(4), Oct 2001. pp. 633-645.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: This study examined the incidence of traumatic
experiences and prevalence of lifetime posttraumatic stress disorder
(PTSD) in a sample of 141 general hospital psychiatric inpatients (mean
age 35.34 yrs). 61% of the patients reported at least one traumatic
event during their lifetime and 28% met the formal Diagnostic and
Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) criteria
for a lifetime diagnosis of PTSD. A high degree of comorbidity between
PTSD and other psychiatric disorders was found, but PTSD was the
incident disorder in at least 50% of cases. The experience of trauma and
its associated complex patterns of symptomatology suggest that PTSD
complicates the process of recovery from another disorder.
_____

Title: Trauma-related sleep disturbance and self-reported physical
health symptoms in treatment-seeking female rape victims.
Author(s): Clum, Gretchen A., U Missouri, Ctr for Trauma Recovery, St Louis, MO, US; Nishith, Pallavi;

Source: Journal of Nervous & Mental Disease, Vol 189(9), Sep 2001. pp. 618-622.
Publisher: US: Lippincott Williams & Wilkins
Abstract: The purpose of the study was to assess the relationship
between trauma-related sleep disturbance and physical health symptoms in
treatment-seeldng female rape victims. A total of 167 participants (aged
18-70 yrs) were assessed for posttraumatic stress disorder (PTSD)
symptoms, depression, sleep disturbance, and frequency of self-reported
health symptoms. Results demonstrated that trauma-related sleep
disturbance predicted unique variance in physical health symptoms after
other PTSD and depression symptoms were controlled. The findings suggest
that trauma-related sleep disturbance is one potential factor
contributing to physical health symptoms in rape victims with PTSD.
_____

Title: Patterns of recovery from trauma: The use of intraindividual analysis.
Author(s): Gilboa-Schechtman, Eva, Bar-Ilan U, Dept of Psychology, Ramat Gan, Israel, gilboae@mail.biu.ac.il;
Foa, Edna B.
Source: Journal of Abnormal Psychology, Vol 110(3), Aug 2001. pp. 392-400.
Publisher: US: American Psychological Assn
Abstract: Patterns of recovery from sexual and nonsexual assault
were examined. Two studies containing data from female victims of these
assaults were analyzed. In Study 1, victims (N = 101) underwent 12
weekly assessments with measures of posttraumatic stress disorder
(PTSD), depression, and state anxiety. In Study 2, victims (N = 108)
underwent monthly assessments on the same measures. The authors examined
the effects of type of trauma and time of peak reaction on long-term
recovery using intraindividual analysis of change. In both studies,
initial and peak reactions of rape victims were more severe than were
those of nonsexual assault victims on all measures of psychopathology.
Victims with delayed peak reaction exhibited more severe pathology at
the final assessment than did victims with early peak reaction. Results
of Study 2 indicated a slower recovery rate from sexual than nonsexual
assault; in Study 1 a similar pattern of recovery emerged. The
advantages of an individual-focused, longitudinal approach to recovery
from a trauma are discussed.
_____

Title: Sleep difficulties and alcohol use motives in female rape
victims with posttraumatic stress disorder.
Author(s): Nishith, Pallavi, U Missouri-St Louis, Dept of
Psychology, Ctr for Trauma Recovery, St Louis, MO, US, pnishith@umsl.edu; Resick, Patricia A.; Mueser, Kim T.
Address: Nishith, Pallavi, U Missouri-St Louis, Ctr for Trauma Recovery, U-8 Weinman Building, 8001 Natural Bridge Road, St Louis, MO, US, pnishith@umsl.edu
Source: Journal of Traumatic Stress, Vol 14(3), Jul 2001. pp. 469-479.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Assessed the relationship between sleep difficulties and
drinking motives in female rape victims with posttraumatic stress
disorder (PTSD). 74 participants (aged 18-72 yrs) were assessed for PTSD
symptoms, depression, sleep difficulties, and drinking motives. Results
demonstrate that neither PTSD symptoms nor depression are related to any
motives for using alcohol. On the other hand, after controlling for
education, sleep difficulties are significantly related to drinking
motives for coping with negative affect, but not pleasure enhancement or
socialization. The findings suggest that sleep difficulties may be an
important factor contributing to alcohol use in rape victims with PTSD.
_____

Title: Dreams and exposure therapy in PTSD.
Author(s): Rothbaum, Barbara Olasov, Emory U, School of Medicine, Dept of Psychiatry & Behavioral Sciences, Atlanta, GA, US, brothba@emory.edu;
Mellman, Thomas Alan
Address: Rothbaum, Barbara Olasov, Emory Clinic, Dept of Psychiatry & Behavioral Sciences, 1365 Clifton Road, Atlanta, GA, US, brothba@emory.edu
Source: Journal of Traumatic Stress, Vol 14(3), Jul 2001. pp. 481-490.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: Exposure therapy is a well-established treatment for
posttraumatic stress disorder (PTSD) that requires the patient to focus
on and describe the details of a traumatic experience. Nightmares that
refer to or replicate traumatic experiences are prominent and
distressing symptoms of PTSD and appear to exacerbate the disorder. With
this apparent paradox in mind, exposure therapy and the literature on
sleep and PTSD are reviewed in the context of the relationship between
therapeutic exposure and exposure to trauma-related stimuli that occurs
in dreams. It is concluded that nightmares that replay the trauma and
disrupt sleep do not meet requirements for therapeutic exposure, whereas
other dreaming may aid in the recovery from trauma.
_____


Title: The effect of relocation after a natural disaster.
Author(s): Najarian, Louis M., North Shore U Hosp-NYU School of
Medicine, Dept of Psychiatry, Div of Child & Adolescent Psychiatry, Manhasset, NY, US; Goenjian, Armen K.; Pelcovitz, David; Mandel, Francine; Najarian, Berj
Address: Najarian, Louis M., 324 Park Avenue, Manhasset, NY, US
Source: Journal of Traumatic Stress, Vol 14(3), Jul 2001. pp. 511-526.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: 25 women remaining in a city devastated by an earthquake
were compared with 24 relocated survivors and 25 comparison women (mean
age range 36-38 yrs). The women were administered a structured
posttraumatic stress disorder (PTSD) interview, the Hamilton Depression
Scale, and Symptom Checklist-90-R (SCL-90-R). The women in both exposed
groups showed significantly more symptoms of avoidance, arousal, and
total PTSD than the comparison group. The women in the relocated city
had significantly higher depression scores than the women in the
earthquake city. On the SCL-90-R, relocated women were most symptomatic
and comparison group women were least symptomatic. Relocation after a
disaster appears to be associated more with risk for depression than
with PTSD in situations where recovery is delayed following the trauma.
_____

Title: Cognitive and emotional reactions to traumatic events:
Implications for short-term intervention.
Author(s): Brewin, Chris R., U Coll London, Subdepartment of
Clinical Health Psychology, London, England
Source: Advances in Mind-Body Medicine, Vol 17(3), Sum 2001. pp. 163-168.
Publisher: US: InnoVision Communications
Abstract: Discusses normal vs pathological immediate and
short-term responses to the experience of trauma, and what this means
for crisis intervention. Emotional responses to a traumatic event are
divided into primary emotions, or immediate responses to the event
(fear, helplessness, horror), and secondary emotions, which occur after
the immediate threat is over. The duration of the traumatic event has an
important influence on the experience of emotion. A variety of
short-term cognitive responses may accompany these emotions, including
fear of death, mental defeat and increased threat sensitivity. Effects
on memory are discussed, including a dual representation theory of
posttraumatic stress disorder (PTSD) that involves verbally and
situationally accessible memory. Proposals for the existence of
hippocampal and neocortical memory systems are discussed as allowing
integration of new information slowly, similar to emotional processing
in psychotherapy. The author suggests that short-term intervention
should not interfere with early normal recovery processes, and proposes
a strategy entitled "Screen and Treat", which involves monitoring of
symptoms and referral for treatment only when symptoms fail to subside
naturally at about 4-6 wks posttrauma.
_____

Title: Treating low-income and African American women with
posttraumatic stress disorder: A case series.
Author(s): Feske, Ulrike, U Pittsburgh School of Medicine,
Pittsburgh, PA, US, FeskeU@msx.upmc.edu
Address: Feske, Ulrike, Western Psychiatric Inst & Clinic, 3811 O'Hara Street, Pittsburgh, PA, US, FeskeU@msx.upmc.edu
Source: Behavior Therapy, Vol 32(3), Sum 2001. pp. 585-601.
Publisher: US: Assn for the Advancement of Behavior Therapy
Abstract: The present uncontrolled case series was designed to
examine the feasibility of prolonged exposure (PE) for posttraumatic
stress disorder (PTSD) with low-income and African-American women. Five
of 10 eligible women completed PE and showed significant improvements in
symptoms of PTSD, general anxiety, and depression. Clinical observations
suggest that the addition of interventions aimed at improving
interpersonal problems might lead to a more complete recovery in this
population of women with complex trauma and psychiatric histories and
that a priming intervention focused on teaching affect-regulation skills
might enhance the effectiveness of PE. The removal of structural
barriers (e.g., lack of transportation and child care) appears to be
necessary in order to boost the benefits of traditional treatment
interventions in disadvantaged women.
_____

Title: Posttraumatic stress disorder patients' readiness to change
alcohol and anger problems.
Author(s): Rosen, Craig S., National Ctr for Posttraumatic Stress Disorder, Menlo Park, CA, US, crosen@stanford.edu; Murphy, Ronald T.; Chow, Helen C.; Drescher, Kent D;  Ramirez, Gil; Ruddy, Robyn; Gusman, Fred
Address: Rosen, Craig S., National Ctr for PTSD, 795 Willow Road,
352-117, Menlo Park, CA, US, crosen@stanford.edu
Source: Psychotherapy: Theory, Research, Practice, Training, Vol 38(2),
Sum 2001. pp. 233-244.
Publisher: US: Division of Psychotherapy (29), American
Psychological Association
Abstract: Notes that recovery from combat-related posttraumatic
stress disorder (PTSD) is often complicated by unacknowledged problems
with alcohol and anger. 102 males combat veterans (aged 42-63 yrs)
entering a residential PTSD rehabilitation program completed University
of Rhode Island Change Assessment and process-of-change questionnaires
based on J. O. Prochaska and C. C. DiClemente's transtheoretical model
(TTM; J. O. Prochaska et al, 1992). Separate assessments were made for
alcohol abuse and anger control. Four motivational subtypes were
identified for both problems. Motivation to change alcohol problems was
independent of that for anger. Relative to less-motivated peers highly
motivated patients were more like to spontaneously identify alcohol or
anger as problems in their life and made greater use of change
strategies specified by the TTM. These results support extension of the
TTM to anger management and to PTSD management. Treatment implications are discussed.
_____

Title: Predictors of posttraumatic stress among victims of motor vehicle accidents.
Author(s): Dougall, Angela Liegey, U Pittsburgh, Pittsburgh, PA, US; Ursano, Robert J.; Posluszny, Donna M.; Fullerton, Carol S.; Baum, Andrew
Source: Psychosomatic Medicine, Vol 63(3), May-Jun 2001. pp. 402-411.
Publisher: US: Lippincott Williams & Wilkins
Abstract: Identified factors that predict individual vulnerability
to psychological trauma by examining the relationships among situation
and person variables and symptoms of posttraumatic stress disorder
(PTSD) 1, 6 and 12 mo after a serious motor vehicle accident (MVA).
Background characteristics, exposure variables (i.e., injury severity
and accident characteristics), and psychosocial variables (i.e.,
perceived loss of control, social support, and coping) were used to
predict symptoms of PTSD and recovery in 115 injured MVA victims (aged
18-64 yrs). All participants were injured during the MVA and provided
data prospectively over the course of a year after the accidents. Along
with background and exposure variables, use of wishful thinking coping
distinguished between victims with and without symptoms of PTSD.
Psychosocial variables such as wishful thinking coping can be used to
identify MVA victims who are at risk of developing chronic posttraumatic
stress and warrant further investigation.
_____

Title: Effect of timing of critical incident stress debriefing (CISD)
on posttraumatic symptoms.
Author(s): Campfield, Kerrianne M., U Western Sydney, School of
Psychology, Campbelltown, NSW, Australia;
Hills, Adelma M.
Source: Journal of Traumatic Stress, Vol 14(2), Apr 2001. pp. 327-340.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: 77 civilian employees (aged 18-32 yrs) who were victims
of robbery were randomly assigned to either an immediate (<10 hrs) or
delayed (>48 hrs) debriefing group, using the J. Mitchell (1983)
Critical Incident Stress Debriefing protocol. Scores on the
Posttraumatic Stress Diagnostic Scale were obtained at 4 time intervals:
debrief, 2 and 4 days post-debrief, and 2 wks postrobbery. The number
and severity of symptoms did not differ at debrief, but were lower for
the immediate than for the delayed group at each subsequent time
interval. The number and severity of symptoms declined across time
intervals; however, although this reduction was pronounced for the
immediate group it was minimal for the delayed group. The results
support the use of immediate debriefing with this type of incident and victim.
_____

Title: Teaching group process to mentally ill adult clients: Effect on
client ratings of self-esteem and psychological well-being.
Author(s): Barr, Kyran, Nichols Coll, Dudley, MA, US;
Emer, Denise; Keller, Peggy
Source: Journal for Specialists in Group Work, Vol 26(1), Mar 2001. pp. 48-65.
Publisher: United Kingdom: Taylor & Francis
Abstract: Mentally ill clients spend a considerable amount of time
in groups. Understanding the dynamics of group process could provide
clients with a greater sense of mastery over their own recovery. This
study compared the development of self-esteem and psychological
well-being in 10 clients who participated in an experimental course on
group process with 10 control Ss who did not participate in such a
group. Ss' diagnoses included schizoaffective disorder, major
depression, bipolar disorder, posttraumatic stress disorder, and
schizophrenia. Results suggest that clients who were taught group
process showed greater increases along these variables than did those
who did not participate in the course. Implications for the importance
of helping clients understand the process of group therapy are
discussed.
_____

Title: Natural course of symptoms in Cambodia veterans: A follow-up study.
Author(s): de Vries, M., University Medical Ctr St Radboud, Dept of
Medical Psychology, Nijmegen, Netherlands;
Soetekouw, P. M. M. B.; Van Der Meer, J. W. M.;
Bleihenberg, G.
Source: Psychological Medicine, Vol 31(2), Feb 2001. pp. 331-338.
Publisher: US: Cambridge Univ Press
Abstract: Evaluated the natural course of symptoms in Dutch
servicemen who had been deployed in the 1992-93 peace operation in
Cambodia in a prospective study. At 18-mo follow-up, a questionnaire was
completed by 227 veterans who met a set case definition for symptoms in
Cambodia veterans or who had sub-threshold scores. Initial measurement
of fatigue severity, psychological well-being, depression, posttraumatic
stress disorder (PTSD), trait-anxiety, self-efficacy, and causal
attributions was used to evaluate predictors for self-reported
improvement and low levels of fatigue at follow-up. 19% of the Ss
reported complete recovery, 20% felt much better, 57% had the same
complaints and 4% had become worse compared with their initial
assessment. Self-reported improvement and less severe fatigue at
follow-up were predicted by less severe fatigue at initial assessment
and more perceived control over symptoms. Self-reported improvement was
reported in a considerable percentage of Ss, whereas another substantial
percentage of Ss continued to suffer with severe levels of fatigue and
related symptoms. Predictors of improvement in Cambodia veterans and
patients with chronic fatigue syndrome show similarities and also may
bear importance for Gulf War veterans.
_____

Title: Ambulance personnel and critical incidents: Impact of accident
and emergency work on mental health and emotional well-being.
Author(s): Alexander, David A., U Aberdeen, Medical School, Dept of
Mental Health, Aberdeen, Scotland; Klein, Susan
Source: British Journal of Psychiatry, Vol 178, Jan 2001. pp. 76-81.
Publisher: United Kingdom: Royal College of Psychiatrists
Abstract: Identified the prevalence of psychopathology among
ambulance personnel and its relationship to personality and exposure to
critical incidents. Data were gathered from 110 ambulance personnel by
means of an anonymous questionnaire and standardized measures: the
28-item General Health Questionnaire (GHQ-28; D. Goldberg & V. F.
Hillier, 1979); Impact of Event Scale (M. Horowitz et al., 1979);
Maslach Burnout Inventory; 45-item version of the Hardiness Scale (P. T.
Bartone et al., 1989); Job Satisfaction subscale of the Pressure
Management Indicator (S. Williams & C. L. Cooper, 1996); and Coping
Methods Checklist (D. A. Alexander & A. Wells, 1991). Approximately a
third of Ss reported high levels of general psychopathology, burnout and
posttraumatic symptoms. Burnout was associated with less job
satisfaction, longer time in service, less recovery time between
incidents, and more frequent exposure to incidents. Burnout and GHQ-28
caseness were more likely in those who had experienced a particularly
disturbing incident in the previous 6mo. Concerns about confidentiality
and career prospects deter staff from seeking personal help. The mental
health and emotional well-being of ambulance personnel appear to be
compromised by accident and emergency work.
_____

Title: Impact of sexual abuse on children: A review and synthesis of
recent empirical studies.
Series Title: Essential readings in developmental psychology
Author(s): Kendall-Tackett, Kathleen A., Wellesley Coll, Stone Ctr
for Developmental Services & Studies, Wellesley, MA, US;
Williams, Linda Meyer; Finkelhor, David
Source: Children and the law: The essential readings. Bull, Ray (Ed); pp. 31-76. Malden, MA, US: Blackwell Publishers, 2001. xiii, 432 pp.
Abstract: (from the chapter) This reprinted article originally
appeared in Psychological Bulletin, 1993(Jan), Vol 113(1), 164-180. (The
following abstract of the original article appeared in record
1993-17922-001.) A review of 45 studies clearly demonstrates that
sexually abused children have more symptoms than nonabused children,
with abuse accounting for 15-45% of the variance. Fears, posttraumatic
stress disorder (PTSD), behavior problems, sexualized behaviors, and
poor self-esteem occurred most frequently among a long list of symptoms
noted, but no one symptom characterized a majority of sexually abused
children. Some symptoms were specific to certain ages, and approximately
one-third of victims had no symptoms. Penetration, the duration and
frequency of the abuse, force, the relationship of the perpetrator to
the child, and maternal support affected the degree of symptomatology.
About two-thirds of the victimized children showed recovery during the
1st 12-28 mo. The findings suggest the absence of any specific syndrome
in children who have been sexually abused and no single traumatizing process.
_____

Title: Evidence that a single exposure to aversive stimuli triggers
long-lasting effects in the hypothalamus-pituitary-adrenal axis that
consolidate with time.
Author(s): Martí, Octavi, Universitat Autònoma de Barcelona,
Departament de Biologia Cellular, Fisiologia i Immunologia, Unitat de
Fisiologia Animal, Facultat de Ciències, Barcelona, Spain,
Antonio.Armario@cc.uab.es; García, Arantxa; Vellès, Astrid; Harbuz, Michael S.; Armario, Antonio
Address: Martí, Octavi, Universitat Autònoma de Barcelona,
Departament de Biologia Cellular, Fisiologia i Immunologia, Unitat de
Fisiologia Animal, Facultat de Ciències, 08193, Barcelona, Spain,
Antonio.Armario@cc.uab.es
Source: European Journal of Neuroscience, Vol 13(1), Jan 2001. pp. 129-136.
Publisher: United Kingdom: Blackwell Publishing
Abstract: Because of its use as a negative reinforcer in animal
studies and its potential pathological impact (e.g. post-traumatic
stress disorder and depression), exposure to aversive stimuli is a
relevant model for studying CNS plasticity. The authors present evidence
that a single exposure to 2 emotional stressors [restraint in tubes and
immobilization on wooden boards (IMO)] can modify the response of the
hypothalamo-pituitary-adrenal (HPA) axis to a subsequent exposure to the
same stressor days later. Two-month-old male Sprague-Dawley rats were
used in the study. Using IMO, it was demonstrated that the effect of a
previous single exposure to the stressor (a) increased with days elapsed
between the 2 exposures; (b) was specific for the previously experienced
stressor; and (c) was mediated via central-mediated effects. Data
suggest that animals retain memory about a single experience with
stressors, resulting in an acceleration of the poststress recovery of
the HPA axis. The extent to which the present data are relevant
regarding post-traumatic stress disorders is unclear, but the study of
the HPA response to severe stressors may be suitable for the study of
the neurobiological basis of the progressive consolidation of learning
over a long period of time.
_____

Title: Experiential avoidance and post-traumatic stress disorder: A
cognitive mediational model of rape recovery.
Author(s): Boeschen, Laura E., Arizona Prevention Ctr, Tucson, AZ, US;
Koss, Mary P., mpk@u.arizona.edu;
Figueredo, Aurelio José; Coan, James A.
Source: Journal of Aggression, Maltreatment & Trauma, Vol 4(2), 2001. pp. 211-245.
Publisher: US: Haworth Press
Abstract: Does experiential avoidance predict posttraumatic stress
disorder (PTSD) severity among rape survivors? The authors tested a
hypothesized model where causal attributions, cognitive schemas, and
memory characteristics mediated the relationship between experiential
avoidance and PTSD. Experiential avoidance was measured as a cognitive
coping strategy; women scoring high on this measure did not try to
integrate or make meaning of their rape experiences, but rather
attempted to block out memories of their rapes or minimize or
rationalize their rape experiences in some way. Data were
cross-sectional. Participants were rape survivors (N = 139; mean age 39
yrs). Results included a measurement model of social cognitive factors
and PTSD and the structural model. Two sets of pathways were delineated,
both exacerbated PTSD. Overall, 60% of the variance in PTSD was
explained. The results suggested that the effects of experiential
avoidance on psychological outcomes were detrimental, but small.
Re-experiencing was the only memory characteristic to mediate the
rape-PTSD relationship. Causal attributions and maladaptive belief
changes were far more powerful than any other predictors in explaining
prolonged distress. Neither was strongly affected by levels of avoidance.
_____

Title: From hate to healing: Sexual assault recovery.
Author(s): Resnick, Jaquelyn L., U Florida, Counseling Ctr,
Gainesville, FL, US
Address: Resnick, Jaquelyn L., U Florida, Counseling Ctr, PO Box 114100, Gainesville, FL, US, resnick@cousel.ufl.edu
Source: Journal of College Student Psychotherapy, Vol 16(1-2), 2001. pp. 43-63.
Publisher: US: Haworth Press
Abstract: Presents the case of a White female university student
(aged 19 yrs) with posttraumatic stress disorder (PTSD) associated with
a vicious sexual assault during a dating relationship. Treatment goals
included a decrease of PTSD symptoms, a separation of feelings of anger
towards perpetrator from feelings of anger towards all males, improved
self-esteem, and improved parental relations. 12 sessions of therapy
addressed issues of empowerment, relationship boundaries, self-blame,
vulnerability, power, control, and relationships with men.
_____

Title: Recovery from post-traumatic stress disorder in children
following road traffic accidents: The role of talking and feeling
understood.
Author(s): Stallard, Paul, Royal United Hosp, Dept of Child & Family Psychiatry, Bath, England; Velleman, Richard; Baldwin, Sarah
Source: Journal of Community & Applied Social Psychology, Vol 11(1), Jan-Feb 2001. pp. 37-41.
Publisher: US: John Wiley & Sons
Abstract: Reports an exploratory study investigating factors
associated with persistent posttraumatic stress disorder (PTSD). 40
children (mean age 15.33 yrs) were assessed with the Clinician
Administered PTSD Scale for Children 6 wks and 8 mo after involvement in
a road traffic accident. A semi-structured interview was also
undertaken. 10 of the 21 children suffering PTSD at 6 wks continued to
fulfill diagnostic criteria at 8 mo. There was no evidence of delayed
onset of PTSD in children who had not developed this condition at 6 wks.
Talking about the accident and feeling understood were associated with
recovery. It is concluded that providing children with opportunities to
talk about their accident may be helpful in preventing or reducing
psychological distress.
_____

Title: Mixed handedness and trauma symptoms in disaster-exposed
adolescents.
Author(s): Chemtob, Claude M., National Ctr for Posttraumatic
Stress Disorder, Pacific Islands Div, Honolulu, HI, US;
Taylor, Kristen B.; Woo, Lia; Coel, Marc N.
Source: Journal of Nervous & Mental Disease, Vol 189(1), Jan 2001. pp. 58-60.
Publisher: US: Lippincott Williams & Wilkins
Abstract: A number of psychological disorders have been associated
with personal and familial left-handedness. However, it has also been
suggested that mixed lateral preference, rather than left-handedness in
and of itself, may be a risk factor for some psychological disorders.
The authors studied 203 students (mean age 15.59 yrs) who completed
questionnaires designed to assess their reactions to a hurricane, as
part of a larger project aimed at assisting students with psychological
recovery. Ss completed The Impact of Events Scale (IES), which is used
to measure trauma symptoms. Disaster-exposed adolescents with mixed
handedness had significantly higher IES intrusion and IES total scores
than did adolescents reporting consistent handedness. Although this
study focused on trauma symptoms rather than on PTSD diagnosis, the
author's findings are consistent with the results of B. Spivak et al,
(1998) who showed increased susceptibility to PTSD in mixed-handedness
individuals. Notably, avoidance scores on the IES were not related to
participants' consistency of hand use. This suggests that further
investigations of the relationship between mixed-handedness and PTSD
should evaluate these components of PTSD separately.
_____

Title: Coping with trauma: Urban adolescents and community violence.
Author(s): Beaver, Alisa S., U Massachusetts, US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 60(2-B), Aug 1999. pp. 0818.
Publisher: US: Univ Microfilms International
Abstract: Adolescents exposed to violence and life threat often
experience symptoms of post traumatic stress disorder (PTSD). One would
think that adolescent males are exposed to more violence and therefore
would demonstrate higher rates of PTSD, however, higher rates of PTSD
and distress symptoms have been found in females. Rates of exposure,
psychological factors and cognitive style may mediate the experience of
violence in children and adolescents. Attention to these variables might
help to clarify whether there is a difference across sex in the
experience of PTSD. This study examined a sample of male and female
adolescents who reported exposure to community violence, in order to
determine whether the males in the sample report more exposure to
violence and less PTSD symptomatology, and to explore the contribution
of coping strategies, cognitive developmental style, and type of
victimization to differential experience of PTSD symptoms. Results
indicate that male adolescents may not experience greater exposure to
violence, and they meet criteria for PTSD less often than female
adolescents. Differences across sex in coping strategies appear to be
related to this phenomenon. The data failed to support the idea that
differential experience of sexual victimization across sex is related to
the difference in PTSD diagnostic status; however, this area deserves
further study. Support for a relationship between cognitive style and
sex as a factor in differential experience of PTSD was neither supported
nor invalidated. Initial data indicate a range of cognitive styles. more
sophisticated research regarding trauma recovery process is required to
further explore these phenomena.
_____

Title: Workplace violence: Prevention, response, and recovery.
Author(s): Miller, Laurence
Source: Psychotherapy: Theory, Research, Practice, Training, Vol 36(2),
Sum 1999. pp. 160-169.
Publisher: US: Division of Psychotherapy (29), American
Psychological Association
Abstract: Describes a model of collaboration between business
leaders and mental health clinicians in developing programs and
strategies to prevent violence, handle acute crises, and cope with
recovery and rebuilding in the aftermath of a workplace violence
incident. Sections address the following: (1) demographics, costs, and
risk factors and warning signs of workplace violence; (2) workplace
violence prevention policies, including hiring, discipline, and
termination practices; (3) responses to emergencies, such as potentially
dangerous situations, violent episodes, and guns or weapons in the
workplace; and (4) strategies for recovery following workplace violence
that involve mental health and law enforcement mobilization, dealing
with the media, assisting employees and families, legal issues,
identification and treatment of posttraumatic stress disorder (PTSD),
and follow-up procedures.
_____

Title: Validation: The missing link in recovery from childhood sexual
abuse? (sexual abuse).
Author(s): Wollenzien-Daniels, Jill M., Walden U., US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 59(11-B), May 1999. pp. 6082.
Publisher: US: Univ Microfilms International
Abstract: This study considered whether validation through
corroborative evidence (an outside source affirming the abuse) is
necessary for remediation of symptoms in women survivors of childhood
sexual abuse (CSA) who have varying degrees of PTSD. It utilized
multiple case studies, in a mixed qualitative-quantitative design, to
gain a better understanding of the role of validation in the recovery
process. Two groups of adult female survivors with varying degrees of
PTSD were compared: those who had validation of their abuse experiences
through corroborative evidence (n = 12), and those who did not (n = 13).
They were queried about their belief in the importance of validation
through corroborative evidence and its possible impact on the
remediation of their PTSD-like symptoms. This was operationalized by
examining the differences in the frequency/intensity and quality of the
following variables: dissociation, the current impact of their childhood
sexual abuse(s), and their levels of self-esteem. These variables were
assessed by using Bernstein and Putnam's Dissociative Experiences
Scale/DES-II (1986), Horowitz et al.'s Impact of Event Scale/IES (1979),
Nugent and Thomas' Self-Esteem Rating Scale/SERS (1993), and a
semistructured, personal interview. A MANOVA was conducted on the data
from the tests instruments (DES-II, IES, SERS) and no significance was
found (a possible Type II error, with the sample being too small to
detect an effect). Contrary to this, the data from the personal
interviews were quantified using descriptive statistics (frequency
counts with percentages), and many substantial differences were
discovered: Nonvalidated participants reported more
dissociated/repressed and somatic memories; had a higher incidence of
negative self-statements and beliefs (e.g., believed selves to be
"crazy," "bad," "evil"); and currently had more intrusive PTSD symptoms
than validated participants. This supports the theory that validation
through corroborative evidence of CSA does make a difference in how
survivors heal from their abuse. An unexpected and important finding was
that mother's support and validation was viewed by the survivors as
being of great importance, and that for the majority of them, this
validation was not given.
_____

Title: The PSA 182 airflight disaster twenty years later: What have we
learned about disaster response and recovery?
Author(s): Davis, Joseph A., Ctr for Applied Forensic & Behavioral Sciences, US; Stewart, Lisa M.
Source: Human Performance in Extreme Environments, Vol 4(1), Apr 1999. pp. 30-34.
Publisher: US: Society for Human Performance in Extreme
Environments
Abstract: Discusses the aftermath of the Pacific Southwest
Airlines Flight 182 disaster. Many disaster assistance, public safety,
and emergency workers developed a variety of psychological problems and
emotional or behavioral symptoms when returning to work or their
families after the intensive week-long clean up effort. Acute crisis
reaction, intense stress, and job related impairment were found to be
quite common. Post-traumatic stress reactions are discussed, and
critical incident stress debriefing and defusing are presented as
effective methods in decreasing the severity of the effects. The authors
suggest eight key points to incorporate into the debriefing process used
when providing assistance to a traumatized community, victim, first-aid
responder, or deployed disaster emergency rescue worker, and a case
study from a first responder to the scene is presented. A community-wide
outreach critical incident stress intervention program and referral
network for ongoing continued care and support for all disaster response
workers during the immediate aftermath is recommended.
_____

Title: Effects of attribution of responsibility for motor vehicle
accidents on severity of PTSD symptoms, ways of coping, and recovery
over six months.
Author(s): Hickling, Edward J., State U of New York, Sage Colls, Albany, NY, US; Blanchard, Edward B.; Buckley, Todd C.; Taylor, Ann E.
Source: Journal of Traumatic Stress, Vol 12(2), Apr 1999. pp. 345-353.
Publisher: Netherlands: Kluwer Academic Publishers
Abstract: In light of D. L. Delahanty et al's (1997)
identification of attribution of responsibility for a motor vehicle
accident (MVA) as a powerful determinant of initial level of distress
from the trauma and of early remission of PTSD, we reexamined data from
E. B. Blanchard and E. J. Hickling's (1997) prospective follow-up of 158
MVA survivors. Despite differences between the 2 samples (Delahanty
sample recruited from hospitals 2-3 wks post-MVA and predominantly male;
our sample recruited from outpatient care 1-4 mo post-MVA and
predominantly female), we replicated Delahanty's findings: those with
PTSD who blame themselves for the MVA are less symptomatic initially and
recover more rapidly in the first 6 mo than those with PTSD who blame
another party for the accident.
_____

Title: Cognitive behavioral treatment of posttraumatic stress disorder
subsequent to a motor vehicle accident: A case example.
Author(s): Kline, John P., Eastern Washington U, Cheney, WA, US; Franklin, Martin E.
Source: Cognitive & Behavioral Practice, Vol 6(2), Spr 1999. pp. 120-125.
Publisher: US: Assn for the Advancement of Behavior Therapy
Abstract: A high-functioning 27-year-old male with no prior
psychiatric history developed posttraumatic stress disorder (PTSD) and
marital problems subsequent to a motor vehicle accident. His treatment
with exposure-based behavior therapy was augmented by involving his wife
in exposure homework assignments. The additional inclusion of marital
sessions that focused on increasing intimacy levels appeared to
facilitate recovery. Upon completion of treatment, the patient returned
to baseline levels of functioning. At 16-wk follow-up, the patient
remained asymptomatic. Treatment implications for the interconnection
between PTSD symptoms and relationship difficulties are discussed.
_____

Title: Posttraumatic stress disorder in a national sample of female and
male Vietnam veterans: Risk factors, war-zone stressors, and
resilience-recovery variables.
Author(s): King, Daniel W., National Ctr for Posttraumatic Stress
Disorder, Boston Veterans Affairs Medical Ctr, Behavioral Science Div, Boston, MA, US; King, Linda A.; Foy, David W.; Keane, Terence M.; Fairbank, John A.
Source: Journal of Abnormal Psychology, Vol 108(1), Feb 1999. pp. 164-170.
Publisher: US: American Psychological Assn
Abstract: Relationships among pretrauma risk factors (e.g., family
instability, childhood antisocial behavior), war-zone stressors (e.g.,
combat, perceived threat), posttrauma resilience-recovery variables
(e.g., hardiness, social support), and posttraumatic stress disorder
(PTSD) symptom severity were examined. Data from a national sample of
432 female and 1,200 male veterans were analyzed using structural
equation modeling. For both genders, direct links to PTSD from
pretrauma, war-zone, and posttrauma variable categories were found;
several direct associations between pretrauma and posttrauma variables
were documented. Although war-zone stressors appeared preeminent for
PTSD in men, posttrauma resilience-recovery variables were more salient
for women. Researchers, policymakers, and clinicians are urged to take a
broad view on trauma and its sequelae, especially regarding possible
multiple exposures over time and the depletion and availability of
important resources.
_____

Title: Trauma and recovery among adults highly exposed to a community disaster.
Author(s): Tucker, Phebe, U Oklahoma, Health Sciences Ctr, Dept of
Psychiatry & Behavioral Sciences, Oklahoma City, OK, US;
Pfefferbaum, Betty; Nixon, Sara Jo; Foy, David W.
Source: Psychiatric Annals, Vol 29(2), Feb 1999. pp. 78-83.
Publisher: US: SLACK
Abstract: Describes trauma and recovery among 3 segments of adults
highly exposed to the bombing of Oklahoma City's Alfred P. Murrah
Federal Building. Three adults who survived the explosion are described
as they received clinical treatment for emotional sequelae. Community
members who obtained mental health intervention and who were mostly in
the nearby downtown area during the blast were surveyed to identify risk
factors for development of posttraumatic stress disorder (PTSD)
symptoms. A group heavily involved in recovery efforts, body handlers in
the medical examiner's office, recounted short- and long-term
consequences of their tasks. Many of these adults experienced varying
symptoms of anxiety, depression, and PTSD, as well as work impairment.
For some who were traumatized, emotional repercussions have diminished
over time with and without treatment. For others, symptoms have
persisted regardless of treatment status.
_____

Title: Perceptions of control and long-term recovery from rape.
Author(s): Regehr, Cheryl, Wilfrid Laurier U, Faculty of Social Work, Waterloo, ON, Canada; Cadell, Susa;
Jansen, Karen
Source: American Journal of Orthopsychiatry, Vol 69(1), Jan 1999. pp. 110-115.
Publisher: US: American Orthopsychiatric Association, Inc.
Abstract: Examined the relationship between perceptions of control
and symptoms of both long-term depression and post-traumatic stress
following rape. The subjects were 71 female victims (aged 17-47 yrs) of
rape or attempted rape during adulthood. The perceptions of control
examined encompassed those specific to the rape experience (attributions
of causality), and global perceptions (self-efficacy and locus of
control). It was hypothesized that long-term beliefs about personal
competence and ability to control events in the world would be more
strongly associated with long-term recovery from rape than would
attributions specific to the rape. Enduring beliefs of personal
competence and control were found to be associated with lower rates of
depression and stress and to be stronger predictors of long-term
recovery than were rape-specific attributions. Implications for clinical practice are discussed.
_____

Title: Cognitive-behavioral theory and treatment of posttraumatic stress disorder.
Series Title: Clinical practice;; 45
Author(s): Foa, Edna B., Allegheny U of Health Sciences, Dept of Psychiatry, Ctr for Treatment & Study of Anxiety, Philadelphia, PA, US; Jaycox, Lisa H.
Source: Efficacy and cost-effectiveness of psychotherapy. Spiegel, David
(Ed); pp. 23-61. Washington, DC, US: American Psychiatric Publishing, Inc., 1999. xv, 199 pp.
Abstract: (from the chapter) Discusses psychological theories of
trauma and presents a comprehensive theory called emotional processing
theory, which attempts to explain why some trauma victims recover and
others develop chronic psychopathology. Within this theory, the authors
have integrated findings about factors associated with natural recovery
and recovery via cognitive-behavioral treatment. It is suggested that
the mechanisms responsible for successful emotional processing of a
trauma are identical to those underlying successful treatment outcome.
_____

Title: Organic and psychosomatic aftereffects of concentration camp
imprisonment.
Series Title: Essential papers in psychoanalysis
Author(s): Eitinger, Leo
Source: Essential papers on posttraumatic stress disorder. Horowitz,
Mardi J. (Ed); pp. 107-115. New York, NY, US: New York University Press, 1999. vii, 548 pp.
Abstract: (from the chapter) Briefly describes some of the changes
that were found in a group of Norwegian concentration camp prisoners.
214 men and 13 women (most of whom were aged 20-30 yrs at the time of
arrest and half of whom were aged 50+ yrs at the time of the
examination) were investigated thoroughly by a medical commission. A
chronic brain syndrome was found in a majority of the Ss. This could be
attributed to the stress suffered during imprisonment. Head injuries,
torture, severe malnutrition, and hard captivity conditions in general
seemed to be the most important etiological factors. In most cases
several factors probably worked together. Both these and other factors
during captivity seem to have provoked psychic disturbances during
imprisonment, especially anxiety, leading to personality changes of a
deeply penetrating and generalized nature with few tendencies to recovery.
_____

Title: Family as a group treatment for PTSD.
Series Title: The series in trauma and loss
Author(s): Catherall, Don R., Northwestern U, Medical School,
Chicago, IL, US
Source: Group treatments for post-traumatic stress disorder. Young,
Bruce H. (Ed); Blake, Dudley D. (Ed); pp. 15-34. Philadelphia, PA, US:
Brunner/Mazel, Inc, 1999. xix, 237 pp.
Abstract: (from the book) Describes family group treatment for
trauma survivors. For many traumatized individuals, the family may be a
source of support; for others, trauma-induced psychosocial impairment
may adversely affect family relations and exacerbate the traumatized
person's symptoms. The author summarize a family model for group therapy
that emphasizes the impact of trauma on the family and the group and
relational processes that are manifest in family work with posttraumatic
stress disorder (PTSD). The author also describes how the effects of
traumatization often stir up long-standing family conflicts, how the
management of shameful feelings and other emotions becomes a central
clinical issue, and how family members can resort to blaming and
interpersonal distancing as they attempt to manage the effects of
trauma. Finally the author provides a summary of the recovery process
for working with families whose members have been exposed to trauma. A
case example of a family in therapy because one son had severe
difficulties that required home care is provided to illustrate these points.
_____

Title: Behavior therapy.
Author(s): Weaver, Terri L., Ctr for Trauma Recovery, St Louis, MO, US; Resnick, Heidi S.; Glynn, Shirley M.; Foy, David W.
Source: Handbook of comparative interventions for adult disorders (2nd
ed.). Hersen, Michel (Ed); Bellack, Alan S. (Ed); pp. 433-461. New York,
NY, US: John Wiley & Sons, Inc, 1999. xii, 708 pp.
Abstract: (from the chapter) This chapter on behavior therapy for
posttraumatic stress disorder (PTSD) is intended to provide a practical
overview of cognitive behavioral methods that are currently in use or
under intensive development for treating psychological problems
experienced by survivors of extreme or traumati