PTSD and Consciousness
PTSD and Neglect
PTSD I
PTSD II
PTSD III
PTSD Post 911
PTSD and Trauma
PTSD DID EMDR (defined)
PTSD and Resiliency
PTSD and Recovery
PTSD and Narcissism
PTSD and Mass Trauma
PTSD and DID II
PTSD and DID |
 |
Psychological
and
Physiological
Trauma
Research
Seize Your Journeys
_______________________
Traumatic stress is found in many competent, healthy, strong, good people.
No one can completely protect themselves from traumatic experiences.
Many people have long-lasting problems following exposure to trauma.
Up to 8% of persons will have PTSD at some time in their lives. People who
react to traumas are not going crazy. What is happening to them is
part of a set of common symptoms and problems that are connected with being
in a traumatic situation, and thus, is a normal reaction to abnormal events
and experiences. Having symptoms after a traumatic event is
NOT a sign of personal weakness. Given exposure to a trauma that is
bad enough, probably all people would develop PTSD.
By understanding trauma
symptoms better, a person can become less fearful of them and better able to
manage them. By recognizing the effects of trauma and knowing more about
symptoms, a person will be better able to decide about getting treatment.
_______________________
PTSD, DID, and EMDR
Posttraumatic Stress Disorder
"The essential feature of Posttraumatic Stress Disorder us the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criteria A1). The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2). The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F).
Traumatic events that are experienced directly include, but are not limited to, military combat, violent personal assault (sexual assault, physical attack, robbery, mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness. For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury. Witnessed events include, but are not limited to, observing the serious injury or unnatural death of another person due to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts. Events experienced by others that are learned about include, but are not limited to, violent personal assault, serious accident, or serious injury experienced y a family member or a close friend; learning about the sudden, unexpected death of a family member or a close friend; or learning that one's child has a life threatening disease. The disorder may be especially sever or long lasting when the stressor is of human design (e.g., torture, rape). the likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase.
The traumatic event can be reexperienced in various ways. Commonly the person has recurrent and intrusive recollections of the event (Criterion B1) or recurrent distressing dreams during which the event can be replayed or otherwise represented (Criterion B2). In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment (Criterion B3). These episodes, often referred to as "flashbacks," are typically brief but can be associated with prolonged distress and heightened arousal. Intense psychological distress (Criterion B4) or physiological reactivity (Criterion B5) often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event (e.g., anniversaries of the traumatic event; cold, snowy weather or uniformed guards for survivors of death camps in cold climates; hot, humid weather for combat veterans of the South Pacific; entering any elevator for an woman who was reaped in an elevator).
Stimuli associated with the trauma are persistently avoided. The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who around recollections of it (Criterion C2). This avoidance of reminders may include amnesia for an important aspect of the traumatic event (Criterion C3). Diminished responsiveness to the external work, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event. The individual may complain of having markedly diminished interest or participation in previously enjoyed activities (Criterion C4), of feeling detached or estranged from other people (Criterion C5), or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality) (Criterion C6). The individual may have a sense of a foreshortened future (e.g., not expecting to have a career, marriage, children, or a normal life span) (Criterion C7).
The individual has persistent symptoms of anxiety or increased arousal that were not present before the trauma. these symptoms may include difficulty falling or staying asleep that may be to recurrent nightmares during which the traumatic event is relived (Criterion D1), hypervigilance (Criterion D4), and exaggerated startle response (Criterion D5). Some individuals report irritability or outburst of anger (Criterion D2) or difficulty concentrating or completing tasks (Criterion D3)."
Dissociative Identity Disorder (DID)
"The essential feature of Dissociative identity Disorder is the presence of two or more distinct identities or personality states (Criterion A) that recurrently take control of behavior (Criterion B). There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (Criterion C). The disturbance is not due tot eh direct physiological effects of a substance or a general medical condition (Condition D.). In children, the symptoms cannot be attributed to imaginary playmates or other fantasy play.
Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness. Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name. Usually there is a primary identity that carries the individual's given name and is passive, dependent, guilty, and depressed. The alternate identities frequently have different names and characteristics that contrast with the primary identity (e.g., are hostile, controlling, and self-destructive). Particular identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect. Alternate identities are experienced as taking control in sequence, ore at the expense of the other, and may deny knowledge of one another, be critical of one another, or appear to be in open conflict. Occasionally, one or more powerful identities allocate time to the others. Aggressive or hostile identities may at times interrupt activities or place the others in uncomfortable situations.
Individuals with this disorder experience frequent gaps in memory for personal history, both remote and recent. The amnesia is frequently asymmetrical. The more passive identities tend to have more constricted memories, whereas the more hostile, controlling, or "protector" identities have more complete memories. An identity that is not in control may nonetheless gain access to consciousness by producing auditory or visual hallucinations (e.g., a voice giving instructions). Evidence of amnesia may be uncovered by reports from others who have witnessed behavior that is disavowed by the individual or by the individual's own discoveries (e.g., finding items of clothing at home that the individual cannot remember having bought). There may be loss of memory not only for recurrent periods of time, but also an overall loss of biographical memory for some extended period of childhood, adolescence, or even adulthood. Transitions among identities are often triggered by psychosocial stress. The time required to switch from one identity to another is usually a matter of seconds, but, less frequently, may b gradual. Behavior that may be frequently associated with identity switches include rapid blinking, facial changes, changes in voice or demeanor, or disruption in the individual's train of thoughts. The number of identities reported ranges from 2 to more than 100. Half of reported cases include the individuals with 10 or fewer identities."
Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association.
EMDR
Eye Movement Desensitization and Reprocessing
"Eye Movement Desensitization and Reprocessing (EMDR)1 integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2. EMDR is an
information processing therapy and uses an eight phase approach.
During EMDR1 the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of
dual attention. This sequence of dual attention and personal association is repeated many times in the session.
Eight Phases of Treatment
The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations.
During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete.
In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions.
After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Athough
eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced.
In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two.
The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system.
After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures."
www.emdr.com
__________________
Major Depressive Disorder
“Diagnostic Features
The essential feature of Major Depressive Disorder is a clinical course that is characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes (Criteria A and C). Episodes of Substance-Induced Mood Disorder (due to the direct physiological effects of a drug of abuse, a medication, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Major Depressive Disorder. In addition, the episodes must not be better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified (Criterion B).
The fourth digit in the diagnostic code for Major Depressive Disorder indicates whether it is a Single Episode (used only for first episodes) or Recurrent. It is sometimes difficult to distinguish between a single episode with waxing and waning symptoms and two separate episodes. For purposes of this manual, an episode is considered to have ended when the full criteria for eh Major Depressive Episode have not been met for at least 2 consecutive months. During this 2-month period, there is either complete resolution of symptoms or the presence of depressive symptoms that no longer meet the full criteria for a Major Depressive Episode (In Partial Remission).
The fifth digit in the diagnostic code for Major Depressive Disorder indicates the current state of the disturbance. If the criteria for a Major Depressive Disorder are met, the severity of the episode is notes as Mild, Moderate, Severe Without Psychotic Features, or Severe With Psychotic Features. If the criteria for a Major Depressive Episode are not currently met, the fifth digit is used to indicate whether the disorder is In Partial Remission or In Full Remission.
If Manic, Mixed, or Hypomanic Episodes develop in the course of Major Depressive Disorder, the diagnosis is changed to a Bipolar Disorder. However, if manic or hypomanic symptoms occur as a direct effect of antidepressant treatment, use of other medications, substance use, or toxin exposure, the diagnosis of Major Depressive Disorder remains appropriate and an addition diagnosis of Substance-induced Mood Disorder, With Manic features (or With Mixed Features), should be noted. Similarly, if manic or hypomanic symptoms occur as a direct effect of a general medical condition, the diagnosis of Major Depressive Disorder remains appropriate and an additional diagnosis of Mood Disorder Due to a General Medical Condition, With Manic Features (or With Mixed Features), should be noted.” p. 369
“Course
Major Depressive Disorder may begin at any age, with an average age at onset in the mid-20s. Epidemiological data suggest that the age at onset is decreasing for those born more recently. The course of Major Depressive Disorder, Recurrent, is variable. Some people have isolated episodes that are separated by many years without any depressive symptoms, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older. Some evidence suggests that the periods of remission generally last longer early in the course of the disorder. The number of prior episodes predicts the likelihood of developing a subsequent Major Depressive Episode. At least 60% of individuals with Major Depresssive Disorder, Single Episode, can be expected to have a second episode. Individuals who have had tow episodes have a 70% chance of having a third, and individuals who have had three episodes have a 90% chance of having a fourth. About 5%-10% of individuals with Major Depressive Disorder, single Episode, subsequently develop a Manic Episode (i.e., develop Bipolar I Disorder).
Major Depressive Episodes may end completely (in about two-thirds of cases), or only partially or not at all (in about one-third of cases). For individuals who have only partial remission, there is a greater likelihood of developing additional episodes and of continuing the pattern of partial interepisode recovery. The longitudinal course specifiers With Full Interepisode Recovery and Without Full Interepisode Recovery may therefore have prognostic value. A number of individuals have pre-existing Dysthymic Disorder prior to the onset of Major Depressive Disorder, single Episode. Some evidence suggests that these individuals are more likely to have additional Major Depressive Episodes, have poorer interepisode recovery, and may require additional acute-phase treatment and a longer period of continuing treatment to attain and maintain a more thorough and longer-lasting euthymic state.
Follow-up naturalistic studies suggested that 1 year after the diagnosis of a major Depressive Episode, 40% of individuals still have symptoms that are sufficiently severe to meet criteria for a full Major Depressive Episode, roughly 20% continue to have some symptoms that no longer meet full criteria for a Major Depressive Episode (i.e., major Depressive Disorder, In Partial Remission), and 40% have no Mood Disorder. The severity of the initial Major Depressive Episode appears to predict persistence. Chronic general medical conditions are also a risk factor for more persistent episodes.
Episodes of Major Depressive Disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce. Studies suggest that psychosocial events 9stressors) may play a more significant role in the precipitation of the first or second episodes of Major Depressive Disorder and may play less of a role in the onset of subsequent episodes. Chronic general medical conditions and Substance Dependence (particularly Alcohol or Cocaine Dependence) may contribute to the onset or exacerbation of Major Depressive Disorder.
It is difficult to predict whether the first episode of a Major Depressive Disorder in a young person will ultimately evolve into a Bipolar Disorder. Some data suggest that the acute onset of severe depression, especially with psychotic features and psychomotor retardation, in a young person without prepubertal psychopathology is more likely to predict a bipolar disorder. A family history of Bipolar Disorder may also be suggestive of subsequent development of Bipolar Disorder.” p. 372-373
Diagnostic and statistical manual of mental disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association.
________________
Major Depressive Disorder
“Diagnostic
Features
The essential feature
of Major Depressive Disorder is a clinical course that is
characterized by one or more Major Depressive Episodes without a
history of Manic, Mixed, or Hypomanic Episodes (Criteria A and
C). Episodes of Substance-Induced Mood Disorder (due to the
direct physiological effects of a drug of abuse, a medication,
or toxin exposure) or of Mood Disorder Due to a General Medical
Condition do not count toward a diagnosis of Major Depressive
Disorder. In addition, the episodes must not be better
accounted for by Schizoaffective Disorder and are not
superimposed on Schizophrenia, Schizophreniform Disorder,
Delusional Disorder, or Psychotic Disorder Not Otherwise
Specified (Criterion B).
The
fourth digit in the diagnostic code for Major Depressive
Disorder indicates whether it is a Single Episode (used only for
first episodes) or Recurrent. It is sometimes difficult to
distinguish between a single episode with waxing and waning
symptoms and two separate episodes. For purposes of this
manual, an episode is considered to have ended when the full
criteria for eh Major Depressive Episode have not been met for
at least 2 consecutive months. During this 2-month period,
there is either complete resolution of symptoms or the presence
of depressive symptoms that no longer meet the full criteria for
a Major Depressive Episode (In Partial Remission).
The fifth
digit in the diagnostic code for Major Depressive Disorder
indicates the current state of the disturbance. If the criteria
for a Major Depressive Disorder are met, the severity of the
episode is notes as Mild, Moderate, Severe Without Psychotic
Features, or Severe With Psychotic Features. If the criteria
for a Major Depressive Episode are not currently met, the fifth
digit is used to indicate whether the disorder is In Partial
Remission or In Full Remission.
If Manic,
Mixed, or Hypomanic Episodes develop in the course of Major
Depressive Disorder, the diagnosis is changed to a Bipolar
Disorder. However, if manic or hypomanic symptoms occur as a
direct effect of antidepressant treatment, use of other
medications, substance use, or toxin exposure, the diagnosis of
Major Depressive Disorder remains appropriate and an addition
diagnosis of Substance-induced Mood Disorder, With Manic
features (or With Mixed Features), should be noted. Similarly,
if manic or hypomanic symptoms occur as a direct effect of a
general medical condition, the diagnosis of Major Depressive
Disorder remains appropriate and an additional diagnosis of Mood
Disorder Due to a General Medical Condition, With Manic Features
(or With Mixed Features), should be noted.” p. 369
“Course
Major Depressive Disorder may begin at any
age, with an average age at onset in the mid-20s.
Epidemiological data suggest that the age at onset is decreasing
for those born more recently. The course of Major Depressive
Disorder, Recurrent, is variable. Some people have isolated
episodes that are separated by many years without any depressive
symptoms, whereas others have clusters of episodes, and still
others have increasingly frequent episodes as they grow older.
Some evidence suggests that the periods of remission generally
last longer early in the course of the disorder. The number of
prior episodes predicts the likelihood of developing a
subsequent Major Depressive Episode. At least 60% of
individuals with Major Depresssive Disorder, Single Episode, can
be expected to have a second episode. Individuals who have had
tow episodes have a 70% chance of having a third, and
individuals who have had three episodes have a 90% chance of
having a fourth. About 5%-10% of individuals with Major
Depressive Disorder, single Episode, subsequently develop a
Manic Episode (i.e., develop Bipolar I Disorder).
Major
Depressive Episodes may end completely (in about two-thirds of
cases), or only partially or not at all (in about one-third of
cases). For individuals who have only partial remission, there
is a greater likelihood of developing additional episodes and of
continuing the pattern of partial interepisode recovery. The
longitudinal course specifiers With Full Interepisode Recovery
and Without Full Interepisode Recovery may therefore have
prognostic value. A number of individuals have pre-existing
Dysthymic Disorder prior to the onset of Major Depressive
Disorder, single Episode. Some evidence suggests that these
individuals are more likely to have additional Major Depressive
Episodes, have poorer interepisode recovery, and may require
additional acute-phase treatment and a longer period of
continuing treatment to attain and maintain a more thorough and
longer-lasting euthymic state.
Follow-up
naturalistic studies suggested that 1 year after the diagnosis
of a major Depressive Episode, 40% of individuals still have
symptoms that are sufficiently severe to meet criteria for a
full Major Depressive Episode, roughly 20% continue to have some
symptoms that no longer meet full criteria for a Major
Depressive Episode (i.e., major Depressive Disorder, In Partial
Remission), and 40% have no Mood Disorder. The severity of the
initial Major Depressive Episode appears to predict
persistence. Chronic general medical conditions are also a risk
factor for more persistent episodes.
Episodes
of Major Depressive Disorder often follow a severe psychosocial
stressor, such as the death of a loved one or divorce. Studies
suggest that psychosocial events 9stressors) may play a more
significant role in the precipitation of the first or second
episodes of Major Depressive Disorder and may play less of a
role in the onset of subsequent episodes. Chronic general
medical conditions and Substance Dependence (particularly
Alcohol or Cocaine Dependence) may contribute to the onset or
exacerbation of Major Depressive Disorder.
It is
difficult to predict whether the first episode of a Major
Depressive Disorder in a young person will ultimately evolve
into a Bipolar Disorder. Some data suggest that the acute onset
of severe depression, especially with psychotic features and
psychomotor retardation, in a young person without prepubertal
psychopathology is more likely to predict a bipolar disorder. A
family history of Bipolar Disorder may also be suggestive of
subsequent development of Bipolar Disorder.” p. 372-373
Diagnostic and
statistical manual of mental disorders. 2000. 4th
ed. Washington, D.C.: American Psychiatric Association.
________________
DID-PTSD-EMDR
Dissociative Identity Disorder (DID)
"The essential feature of Dissociative identity
Disorder is the presence of two or more distinct identities or
personality states (Criterion A) that recurrently take control
of behavior (Criterion B). There is an inability to recall
important personal information, the extent of which is too great
to be explained by ordinary forgetfulness (Criterion C). The
disturbance is not due tot eh direct physiological effects of a
substance or a general medical condition (Condition D.). In
children, the symptoms cannot be attributed to imaginary
playmates or other fantasy play.
Dissociative Identity Disorder reflects a failure
to integrate various aspects of identity, memory, and
consciousness. Each personality state may be experienced as if
it has a distinct personal history, self-image, and identity,
including a separate name. Usually there is a primary identity
that carries the individual's given name and is passive,
dependent, guilty, and depressed. The alternate identities
frequently have different names and characteristics that
contrast with the primary identity (e.g., are hostile,
controlling, and self-destructive). Particular identities may
emerge in specific circumstances and may differ in reported age
and gender, vocabulary, general knowledge, or predominant
affect. Alternate identities are experienced as taking control
in sequence, ore at the expense of the other, and may deny
knowledge of one another, be critical of one another, or appear
to be in open conflict. Occasionally, one or more powerful
identities allocate time to the others. Aggressive or hostile
identities may at times interrupt activities or place the others
in uncomfortable situations.
Individuals with this disorder experience
frequent gaps in memory for personal history, both remote and
recent. The amnesia is frequently asymmetrical. The more
passive identities tend to have more constricted memories,
whereas the more hostile, controlling, or "protector" identities
have more complete memories. An identity that is not in control
may nonetheless gain access to consciousness by producing
auditory or visual hallucinations (e.g., a voice giving
instructions). Evidence of amnesia may be uncovered by reports
from others who have witnessed behavior that is disavowed by the
individual or by the individual's own discoveries (e.g., finding
items of clothing at home that the individual cannot remember
having bought). There may be loss of memory not only for
recurrent periods of time, but also an overall loss of
biographical memory for some extended period of childhood,
adolescence, or even adulthood. Transitions among identities
are often triggered by psychosocial stress. The time required
to switch from one identity to another is usually a matter of
seconds, but, less frequently, may b gradual. Behavior that may
be frequently associated with identity switches include rapid
blinking, facial changes, changes in voice or demeanor, or
disruption in the individual's train of thoughts. The number of
identities reported ranges from 2 to more than 100. Half of
reported cases include the individuals with 10 or fewer
identities."
Diagnostic and Statistical Manual of Mental
Disorders.
2000. 4th ed. Washington, D.C.: American Psychiatric
Association.
PTSD, DID, and EMDR
Posttraumatic Stress Disorder
"The essential feature of Posttraumatic Stress
Disorder us the development of characteristic symptoms following
exposure to an extreme traumatic stressor involving direct
personal experience of an event that involves actual or
threatened death or serious injury, or other threat to one's
physical integrity; or witnessing an event that involves death,
injury, or a threat to the physical integrity of another person;
or learning about unexpected or violent death, serious harm, or
threat of death or injury experienced by a family member or
other close associate (Criteria A1). The person's response to
the event must involve intense fear, helplessness, or horror (or
in children, the response must involve disorganized or agitated
behavior) (Criterion A2). The characteristic symptoms resulting
from the exposure to the extreme trauma include persistent
reexperiencing of the traumatic event (Criterion E), and the
disturbance must cause clinically significant distress or
impairment in social, occupational, or other important areas of
functioning (Criterion F).
Traumatic events that are experienced directly
include, but are not limited to, military combat, violent
personal assault (sexual assault, physical attack, robbery,
mugging), being kidnapped, being taken hostage, terrorist
attack, torture, incarceration as a prisoner of war or in a
concentration camp, natural or manmade disasters, severe
automobile accidents, or being diagnosed with a life-threatening
illness. For children, sexually traumatic events may include
developmentally inappropriate sexual experiences without
threatened or actual violence or injury. Witnessed events
include, but are not limited to, observing the serious injury or
unnatural death of another person due to violent assault,
accident, war, or disaster or unexpectedly witnessing a dead
body or body parts. Events experienced by others that are
learned about include, but are not limited to, violent personal
assault, serious accident, or serious injury experienced y a
family member or a close friend; learning about the sudden,
unexpected death of a family member or a close friend; or
learning that one's child has a life threatening disease. The
disorder may be especially sever or long lasting when the
stressor is of human design (e.g., torture, rape). the
likelihood of developing this disorder may increase as the
intensity of and physical proximity to the stressor increase.
The traumatic event can be reexperienced in
various ways. Commonly the person has recurrent and intrusive
recollections of the event (Criterion B1) or recurrent
distressing dreams during which the event can be replayed or
otherwise represented (Criterion B2). In rare instances, the
person experiences dissociative states that last from a few
seconds to several hours, or even days, during which components
of the event are relived and the person behaves as though
experiencing the event at that moment (Criterion B3). These
episodes, often referred to as "flashbacks," are typically brief
but can be associated with prolonged distress and heightened
arousal. Intense psychological distress (Criterion B4) or
physiological reactivity (Criterion B5) often occurs when the
person is exposed to triggering events that resemble or
symbolize an aspect of the traumatic event (e.g., anniversaries
of the traumatic event; cold, snowy weather or uniformed guards
for survivors of death camps in cold climates; hot, humid
weather for combat veterans of the South Pacific; entering any
elevator for an woman who was reaped in an elevator).
Stimuli associated with the trauma are
persistently avoided. The person commonly makes deliberate
efforts to avoid thoughts, feelings, or conversations about the
traumatic event (Criterion C1) and to avoid activities,
situations, or people who around recollections of it (Criterion
C2). This avoidance of reminders may include amnesia for an
important aspect of the traumatic event (Criterion C3).
Diminished responsiveness to the external work, referred to as
"psychic numbing" or "emotional anesthesia," usually begins soon
after the traumatic event. The individual may complain of
having markedly diminished interest or participation in
previously enjoyed activities (Criterion C4), of feeling
detached or estranged from other people (Criterion C5), or of
having markedly reduced ability to feel emotions (especially
those associated with intimacy, tenderness and sexuality)
(Criterion C6). The individual may have a sense of a
foreshortened future (e.g., not expecting to have a career,
marriage, children, or a normal life span) (Criterion C7).
The individual has persistent symptoms of anxiety
or increased arousal that were not present before the trauma.
these symptoms may include difficulty falling or staying asleep
that may be to recurrent nightmares during which the traumatic
event is relived (Criterion D1), hypervigilance (Criterion D4),
and exaggerated startle response (Criterion D5). Some
individuals report irritability or outburst of anger (Criterion
D2) or difficulty concentrating or completing tasks (Criterion
D3)."
EMDR
Eye Movement Desensitization and Reprocessing
"Eye Movement Desensitization and Reprocessing
(EMDR)1 integrates elements of many effective
psychotherapies in structured protocols that are designed to
maximize treatment effects. These include psychodynamic,
cognitive behavioral, interpersonal, experiential, and
body-centered therapies2. EMDR is an
information
processing therapy
and uses an eight phase approach.
During EMDR1 the client attends to
past and present experiences in brief sequential doses while
simultaneously focusing on an external stimulus. Then the client
is instructed to let new material become the focus of the next
set of
dual attention.
This sequence of dual attention and personal association is
repeated many times in the session.
Eight Phases of Treatment
The first phase is a history taking session
during which the therapist assesses the client's readiness for
EMDR and develops a treatment plan. Client and therapist
identify possible targets for EMDR processing. These include
recent distressing events, current situations that elicit
emotional disturbance, related historical incidents, and the
development of specific skills and behaviors that will be needed
by the client in future situations.
During the second phase of treatment, the
therapist ensures that the client has adequate methods of
handling emotional distress and good coping skills, and that the
client is in a relatively stable state. If further stabilization
is required, or if additional skills are needed, therapy focuses
on providing these. The client is then able to use stress
reducing techniques whenever necessary, during or between
sessions. However, one goal is not to need these techniques once
therapy is complete.
In phase three through six, a target is
identified and processed using EMDR procedures. These involve
the client identifying the most vivid visual image related to
the memory (if available), a negative belief about self, related
emotions and body sensations. The client also identifies a
preferred positive belief. The validity of the positive belief
is rated, as is the intensity of the negative emotions.
After this, the client is instructed to focus on
the image, negative thought, and body sensations while
simultaneously moving his/her eyes back and forth following the
therapist's fingers as they move across his/her field of vision
for 20-30 seconds or more, depending upon the need of the
client. Athough
eye movements
are the most commonly used external stimulus, therapists often
use auditory tones, tapping, or other types of tactile
stimulation. The kind of dual attention and the length of each
set is customized to the need of the client. The client is
instructed to just notice whatever happens. After this, the
clinician instructs the client to let his/her mind go blank and
to notice whatever thought, feeling, image, memory, or sensation
comes to mind. Depending upon the client's report the clinician
will facilitate the next focus of attention. In most cases a
client-directed association process is encouraged. This is
repeated numerous times throughout the session. If the client
becomes distressed or has difficulty with the process, the
therapist follows established procedures to help the client
resume processing. When the client reports no distress related
to the targeted memory, the clinician asks him/her to think of
the preferred positive belief that was identified at the
beginning of the session, or a better one if it has emerged, and
to focus on the incident, while simultaneously engaging in the
eye movements. After several sets, clients generally report
increased confidence in this positive belief. The therapist
checks with the client regarding body sensations. If there are
negative sensations, these are processed as above. If there are
positive sensations, they are further enhanced.
In phase seven, closure, the therapist asks the
client to keep a journal during the week to document any related
material that may arise and reminds the client of the
self-calming activities that were mastered in phase two.
The next session begins with phase eight,
re-evaluation of the previous work, and of progress since the
previous session. EMDR treatment ensures processing of all
related historical events, current incidents that elicit
distress, and future scenarios that will require different
responses. The overall goal is produce the most comprehensive
and profound treatment effects in the shortest period of time,
while simultaneously maintaining a stable client within a
balanced system.
After EMDR processing, clients generally report
that the emotional distress related to the memory has been
eliminated, or greatly decreased, and that they have gained
important cognitive insights. Importantly, these emotional and
cognitive changes usually result in spontaneous behavioral and
personal change, which are further enhanced with standard EMDR
procedures."
www.emdr.com
1Shapiro,
F. (2001).
Eye Movement Desensitization and Reprocessing: Basic Principles,
Protocols and Procedures (2nd ed.). New York: Guilford Press.
2Shapiro,
F. (2002).
EMDR as an Integrative Psychotherapy Approach: Experts of
Diverse Orientations Explore the Paradigm Prism. Washington, DC:
American Psychological Association Books.
|
|
Psychological Trauma
Posttraumatic Stress Disorder and Trauma
Title: Complex Trauma in Children and Adolescents.
Author(s): Cook, Alexandra, National Center on Family Homelessness,
Justice Resource Institute, The Trauma Center, Boston, MA, US
Spinazzola, Joseph, National Center on Family Homelessness, Justice
Resource Institute, The Trauma Center, Boston, MA, US,
spinazzola@traumacenter.org
Ford, Julian, University of Connecticut Health Center, Department of
Psychiatry, Farmington, CT, US
Lanktree, Cheryl, Miller Children's Abuse and Violence Intervention
Center, Long Beach, CA, US
Blaustein, Margaret, National Center on Family Homelessness, Justice
Resource Institute, The Trauma Center, Boston, MA, US
Cloitre, Marylene, New York University Child Study Center Institute for
Urban Trauma & Stress, New York, NY, US
DeRosa, Ruth, North Shore University Hospital Adolescent Trauma
Treatment Development Center, Manhasset, NY, US
Hubbard, Rebecca, Directions for Mental Health, Clearwater, FL, US
Kagan, Richard, Parsons Child Trauma Study Center, Albany, NY, US
Liautaud, Joan, Heartland Health Outreach: International FACES, Chicago,
IL, US
Mallah, Karen, Mental Health Center of Denver, Family Trauma Treatment
Program, Denver, CO, US
Olafson, Erna, Cincinnati Children's Hospital, Child Abuse Trauma
Treatment Replication Center, Cincinnati, OH, US
van der Kolk, Bessel, Boston University Medical School, Boston, MA, US
Address: Spinazzola, Joseph, The Trauma Center at Justice
Resource Institute, 545 Boylston St., Boston, MA, US,
spinazzola@traumacenter.org
Source: Psychiatric Annals, Vol 35(5), May 2005. pp. 390-398.
Publisher: US: SLACK
Abstract: The immediate and long-term consequences of children's
exposure to maltreatment and other traumatic experiences are
multifaceted. Emotional abuse and neglect, sexual abuse, and physical
abuse, as well as witnessing domestic violence, ethnic cleansing, or
war, can interfere with the development of a secure attachment within
the caregiving system. Complex trauma exposure results in a loss of core
capacities for self-regulation and interpersonal relatedness. Children
exposed to complex trauma often experience lifelong problems that place
them at risk for additional trauma exposure and cumulative impairment
(e.g., psychiatric and addictive disorders; chronic medical illness;
legal, vocational, and family problems). These problems may extend from
childhood through adolescence and into adulthood. This article describes
a new theoretical framework for understanding complex trauma in
children, explains how to apply the new framework to assessment of
traumatized children and families, and discusses intervention models
designed specifically for traumatized children and their families.
_____
Title: Treatment Implications of Altered Affect Regulation and
Information Processing Following Child Maltreatment.
Author(s): Ford, Julian D., University of Connecticut Health
Center, Department of Psychiatry, Farmington, CT, US
Address: Ford, Julian D., Department of Psychiatry, MC1410,
University of Connecticut Health Center, 263 Farmington Ave.,
Farmington, CT, US
Source: Psychiatric Annals, Vol 35(5), May 2005. pp. 410-419.
Publisher: US: SLACK
Abstract: The purpose of this article is to (1) identify the
affect regulation processes that may be affected by childhood
maltreatment, (2) discuss how information processing may be altered by
childhood maltreatment, and (3) describe how psychiatric diagnosis or
treatment can be enhanced by assessing dysregulation of emotion or
information processing in survivors of maltreatment. Research is needed
to further deconstruct and define the neurobiological substrates of
specific components of self-regulation in relation to early childhood
trauma-related PTSD. Brain activation patterns related to dissociation
have been investigated preliminarily and similar studies are needed to
provide greater specificity than that provided by categorical diagnoses
(e.g., PTSD). Self-regulation can provide a basis for theoretical models
and interventions that focus on posttraumatic resilience. Future success
in developing effective treatments for children and adults who
experience complex biopsychosocial impairments following exposure to
early life "developmentally adverse interpersonal trauma" (DAIT) depends
upon continued dialogue between scientists and clinicians who share a
focus on the nature, neurobiology, and development of affective and
cognitive self-regulation.
_____
Title: Comprehensive Care for Traumatized Children.
Author(s): Saxe, Glenn N., Boston University Medical Center,
Department of Child and Adolescent Psychiatry, Boston, MA, US,
glenn.saxe@bmc.org
Ellis, B. Heidi, Boston University Medical Center, Department of Child
and Adolescent Psychiatry, Boston, MA, US
Fogler, Jason, Boston University Medical Center, Department of Child and
Adolescent Psychiatry, Boston, MA, US
Hansen, Susan, Ulster County, Family and Child Unit, Mental Health
Department, NY, US
Sorkin, Barbara, Ulster County, Department of Social Services, NY, US
Address: Saxe, Glenn N., Department of Child and Adolescent
Psychiatry, Dowling 1 North, One Boston Medical Center Place, Boston,
MA, US, glenn.saxe@bmc.org
Source: Psychiatric Annals, Vol 35(5), May 2005. pp. 443-448.
Publisher: US: SLACK
Abstract: One of the primary challenges in the development of
effective interventions for traumatized children is that the same
factors that place a child at risk for exposure to traumatic events also
contribute to an unstable social environment. Traumatized children
frequently live in environments characterized by domestic violence,
child maltreatment, parental mental illness, and substance
abuse--conditions that have been demonstrated to be detrimental to child
development. This article describes the results of an open trial of an
innovative model of care for traumatized children, trauma systems
therapy (TST). TST is designed to address both a child's trauma-related
symptoms and the perpetuating factors in the social environment.
_____
Title: Do personality traits predict post-traumatic stress?: A
prospective study in civilians experiencing air attacks.
Author(s): Knezevic, Goran, Psychosocial Centre and Centre for
Rehabilitation of Torture Victims, International Aid Network, Belgrade,
Serbia and Montenegro
Opacic, Goran, Psychosocial Centre and Centre for Rehabilitation of
Torture Victims, International Aid Network, Belgrade, Serbia and
Montenegro
Savic, Danka, Psychosocial Centre and Centre for Rehabilitation of
Torture Victims, International Aid Network, Belgrade, Serbia and
Montenegro
Priebe, Stefan, Unit for Social and Community Psychiatry, Barts and the
Royal London School of Medicine, Queen Mary, University of London,
London, United Kingdom, s.priebe@qmul.ac.uk
Address: Priebe, Stefan, Unit for Social & Community Psychiatry,
Academic Unit, Newham Centre for Mental Health, London, United Kingdom,
E13 8SP, s.priebe@qmul.ac.uk
Source: Psychological Medicine, Vol 35(5), May 2005. pp. 659-663.
Publisher: US: Cambridge Univ Press
Abstract: Background: Previous studies have suggested an
association between personality traits and posttraumatic stress. These
studies either focused exclusively on military veterans or assessed
personality traits after the traumatic event. This study investigates to
what extent personality traits as assessed before the traumatic
experience predict post-traumatic stress in civilians experiencing air
attacks at the end of the exposure to stressful events and 1 year later.
Method: The revised version of the NEO Personality Inventory was
administered to 70 students in Belgrade, Yugoslavia. In 1999, 1 or 2
years after the assessment, all students were exposed to air attacks for
11 weeks. At the end of the attacks and 1 year later post-traumatic
stress was measured on the Impact of Event Scale. Results: Pre-trauma
personality predicted 13% of the variance of intrusion scores 1 year
after the attacks. There was no significant correlation between
personality traits and subsequent avoidance scores at any point of time.
Conclusions: Personality traits that are assessed before a traumatic
event can, to a limited extent, predict intrusive symptoms in a
non-clinical sample of civilians. Pre-trauma assessments of personality
might be less strongly associated with post-traumatic stress than
personality traits obtained after the traumatic event.
_____
Title: Long-term behavioural alterations in female rats after a single
intense footshock followed by situational reminders.
Author(s): Louvart, Hèléne, Laboratory of Perinatal Stress,
University of Lille 1, Villeneuve d'Ascq, France
Maccari, Stefania, Laboratory of Perinatal Stress, University of Lille
1, Villeneuve d'Ascq, France
Ducrocq, François, Department of Psychiatry, School of Medicine,
University of Lille 2, Lille, France
Thomas, Pierre, Department of Psychiatry, School of Medicine, University
of Lille 2, Lille, France
Darnaudéry, Muriel, Laboratory of Perinatal Stress, University of Lille
1, Villeneuve d'Ascq, France, muriel.darnaudery@univ-lille1.fr
Address: Darnaudéry, Muriel, Laboratory of Perinatal Stress,
University of Lille 1, JE 2365, Bat SN4-1, 59655, Villeneuve d'Ascq,
France, Cedex, muriel.darnaudery@univ-lille1.fr
Source: Psychoneuroendocrinology, Vol 30(4), May 2005. pp. 316-324.
Publisher: Netherlands: Elsevier Science
Abstract: Post-traumatic stress disorder (PTSD) affects a
vulnerable sub-population of individuals exposed to a traumatic event.
This psychopathology induces long-lasting hypothalamo-pituitary-adrenal
(HPA) axis hypoactivity, hyperarousal and avoidance of trauma-like
situation. PTSD also manifests a high co-morbidity with anxiety
disorders. The aim of the present study was to characterise long-term
biobehavioural alterations in female rats in an animal model of PTSD
consisting in an intense footshock (2 mA, 10s) followed by three weekly
situational reminders. This procedure induced several long-term
alterations: increased anxiety behaviour, reduced time spent in an
'aversive-like' context, altered social behaviour and blunted
corticosterone response to stress. These results demonstrate that
exposure to an intense footshock associated with repeated situational
reminders elicited long-term disturbances which lasted more than 1 month
after the footshock administration. Our findings suggest that this
paradigm could provide a useful animal model of PTSD.
_____
Title: PTSD symptoms predict waking salivary cortisol levels in police
officers.
Author(s): Neylan, Thomas C., Department of Psychiatry, University
of California, San Francisco, CA, US, neylan@itsa.ucsf.edu
Brunet, Alain, Department of Psychiatry, McGill University, Montréal,
PQ, Canada
Pole, Nnamdi, Department of Psychology, University of Michigan, Ann
Arbor, MI, US
Best, Suzanne R., Northern California Institute for Research and
Education, San Francisco, CA, US
Metzler, Thomas J., San Francisco Veterans Administration Medical
Center, San Francisco, CA, US
Yehuda, Rachel, Department of Psychiatry, Mount Sinai School of
Medicine, New York, NY, US
Marmar, Charles R., Department of Psychiatry, University of California,
San Francisco, CA, US
Address: Neylan, Thomas C., PTSD Program, Psychiatry Service, VA
Medical Center, 116P, 4150 Clement Street, San Francisco, CA, US,
neylan@itsa.ucsf.edu
Source: Psychoneuroendocrinology, Vol 30(4), May 2005. pp. 373-381.
Publisher: Netherlands: Elsevier Science
Abstract: This study examines whether pre- or post-dexamethasone
salivary cortisol is related to cumulative critical incident exposure,
peritraumatic responses, or post-traumatic stress disorder (PTSD)
symptom severity. Thirty active duty police officers completed the study
protocol, which included measures of peritraumatic emotional distress,
peritraumatic dissociation, duty-related trauma exposure, and PTSD
symptoms. Salivary cortisol was consolidated into three outcome
variables: (1) pre-dexamethasone free cortisol levels at 1, 30, 45, and
60 min after awakening, (2) post-dexamethasone cortisol levels at the
identical wake times, and (3) percentage of cortisol suppression.
Control variables included age, gender, average daily alcohol use, night
shift work, routine work environment stressors, and salivary
dexamethasone levels. Zero order correlations showed that greater levels
of PTSD symptoms, peritraumatic distress, and peritraumatic dissociation
were associated with lower levels of pre-dexamethasone cortisol levels
on awakening, but were not associated with the other two cortisol
variables. A trend was also noted for older subjects to have lower
pre-dexamethasone cortisol on awakening. When these four predictors were
entered simultaneously in a regression analysis, only age and PTSD
symptom severity significantly predicted pre-dexamethasone awakening
cortisol levels. These results replicate previous research indicating a
relationship between greater PTSD symptoms and lower levels of basal
cortisol on awakening, and extend this finding to a previously unstudied
non-treatment seeking population, urban police.
_____
Title: How Trauma, Recent Stressful Events, and PTSD Affect Functional
Health Status and Health Utilization in HIV-Infected Patients in the
South.
Author(s): Leserman, Jane, Department of Psychiatry, University of
North Carolina, Chapel Hill, NC, US, JLes@med.unc.edu
Whetten, Kathryn, Department of Public Policy and Community and Family
Medicine, Duke University, Durham, NC, US
Lowe, Kristin, Department of Public Policy and Community and Family
Medicine, Duke University, Durham, NC, US
Stangl, Dalene, Institute of Statistics and Decision Sciences, Duke
University, Durham, NC, US
Swartz, Marvin S., Department of Psychiatry, Duke University, Durham,
NC, US
Thielman, Nathan M., Division of Infectious Diseases, Department of
Medicine, Duke University, Durham, NC, US
Address: Leserman, Jane, Department of Psychiatry, University of
North Carolina at Chapel Hill, CB 7160, Medical School Wing C, Room 233,
Chapel Hill, NC, US, JLes@med.unc.edu
Source: Psychosomatic Medicine, Vol 67(3), May-Jun 2005. pp. 500-507.
Publisher: US: Lippincott Williams & Wilkins
Abstract: Objective: In addition to biological markers of human
immunodeficiency virus (HIV) disease progression, physical functioning
and utilization of health care may also be important indicators of
health status in HIV-infected patients. There is insufficient
understanding of the psychosocial predictors of health-related physical
functioning and use of health services among those with this chronic
disease. Therefore, the current study examines how trauma, severe
stressful events, posttraumatic stress disorder (PTSD), and depressive
symptoms are related to physical functioning and health utilization in
HIV-infected men and women living in rural areas of the South. Methods:
We consecutively sampled patients from 8 rural HIV clinics in 5 southern
states, obtaining 611 completed interviews. Results: We found that
patients with more lifetime trauma, stressful events, and PTSD symptoms
reported more bodily pain, and poorer physical, role, and cognitive
functioning. Trauma, recent stressful events, and PTSD explained from
12% to 27% of the variance in health-related functioning, over and above
that explained by demographic variables. In addition, patients with more
trauma, including sexual and physical abuse, and PTSD symptoms were at
greater risk for having bed disability, an overnight hospitalization, an
emergency room visit, and four or more HIV outpatient clinic visits in
the previous 9 months. Patients with a history of abuse had about twice
the risk of spending 5 or more days in bed, having an overnight hospital
stay, and visiting the emergency room, compared with those without
abuse. The effects of trauma and stress were not explained by CD4
lymphocyte count or HIV viral load; however, these effects appear to be
largely accounted for by increases in current PTSD symptoms. Conclusion:
These findings highlight the importance of addressing past trauma,
stress, and current PTSD within clinical HIV care.
_____
Title: Associations and Predictors of Posttraumatic Stress Levels
According to Person-Related, Disability-Related, and Trauma-Related
Variables Among Individuals With Spinal Cord Injuries.
Author(s): Martz, Erin, University of Missouri, Columbia, MO, US,
martze@missouri.edu
Address: Martz, Erin, Rehabilitation Counseling Program,
Educational, School, and Counseling Psychology Department, University of
Missouri, 4B Hill Hall, Columbia, MO, US, martze@missouri.edu
Source: Rehabilitation Psychology, Vol 50(2), May 2005. pp. 149-157.
Publisher: US: Educational Publishing Foundation
Abstract: Objective: To examine the associations and predictors of
posttraumatic stress among individuals with spinal cord injuries (SCI)
in the framework of a Person x Disability x Traumatic Event model.
Design: An exploratory study involving analyses of variance,
correlations, and a hierarchical multiple regression of a
cross-sectional sample. Participants: Three hundred twelve individuals
with SCI using a veteran or a civilian SCI clinic. Main Outcome
Measures: Purdue Posttraumatic Stress Disorder--Revised scale (PPTSD-R).
Results: Four out of all the examined variables had significant
regression coefficients: spiritual-religious coping, pain level,
severity of SCI, and number of traumatic events. Severity of SCI was a
significant predictor, but data suggested that severity of SCI had a
curvilinear association with both total posttraumatic stress levels and
hyperarousal scores. Conclusion: Treatment of an individual's pain may
reduce posttraumatic stress symptoms. Clinicians also can evaluate for
previous trauma unrelated to the onset of the SCI and can intervene with
the goal of reducing the impact of previous trauma on the individual's
present emotional state and reactions to SCI.
_____
Title: On Hardiness and Other Pathways to Resilience.
Author(s): Maddi, Salvatore R., University of California, Irvine,
CA, US, srmaddi@uci.edu
Address: Maddi, Salvatore R., Hardiness Institute, 4425 Jamboree,
Suite 100, Newport Beach, CA, US, srmaddi@uci.edu
Source: American Psychologist, Vol 60(3), Apr 2005. pp. 261-262.
Journal URL: http://www.apa.org/journals/amp.html
Publisher: US: American Psychological Assn
Publisher URL: http://www.apa.org
ISSN: 0003-066X (Print)
Digital Object Identifier: 10.1037/0003-066X.60.3.261
Language: English
Keywords: emotional experiences; traumatic events; aversive
events; loss; capacity to thrive; recovery; posttraumatic stress
disorder; resilience
Abstract: Comments on George Bonanno's article entitles Loss,
Trauma, and Human Resilience: Have We Underestimated the Human Capacity
to Thrive After Extremely Aversive Events?" (see record 2004-10043-003).
The author of this comment notes that Bonanno's article is a compelling
analysis of several different reactions to extremely aversive events.
With regard to major stressors, such as the death of a loved one or the
experience a life-threatening circumstance, there is, notably, not only
the psychopathological breakdown (e.g., posttraumatic stress disorder
[PTSD] or depressive disorder) that has been emphasized but also the
less recognized resilient response, in which there is little or no loss
of functioning. Whereas the emphasis in the breakdown response is
understandably on treatment that facilitates recovery, the resilient
response may require little but the person's own ongoing efforts in life
to continue effectively. Indeed, Bonanno suggested that the typical
treatment efforts following traumatic events might actually undermine
the resilient person's adjustment efforts. Bonanno's conceptualization
and supportive research evidence advance our understanding of
individuals' reactions to massive stressors. Further, Bonanno (2004)
argued that there are multiple pathways to resilience under stress, and
he identified personality hardiness as one of them. His presentation of
hardiness accurately emphasizes its interrelated attitudes of commitment
(rather than alienation), control (rather than powerlessness), and
challenge (rather than threat) but does not cover how this concept has
evolved over the last 25 years. Coordinating theory, research, and
practice over this period of time, the author has concluded (Maddi,
2002) that hardy attitudes amount to the courage and motivation to face
stressors accurately (rather than to deny or catastrophize them). This
courage and motivation lead to coping by problem solving rather than by
avoiding and to interacting with others by giving and getting assistance
and encouragement rather than by striking out or overprotecting. Thus,
personality hardiness is emerging as a pattern of attitudes and actions
that helps in transforming stressors from potential disasters into
growth opportunities. The author concludes that Bonanno's exciting
position has opened the way for such comparative analytic research
through which researchers can further their current knowledge concerning
how resilience under stress comes about.
_____
Title: Has Resilience to Severe Trauma Been Underestimated?
Author(s): Litz, Brett T., Department of Veterans Affairs Boston
Healthcare System, Boston, MA, US, brettlitz@comcast.com
Address: Litz, Brett T., Department of Veterans Affairs Boston
Healthcare System, 150 South Huntington Avenue, Boston, MA, US,
brettlitz@comcast.com
Source: American Psychologist, Vol 60(3), Apr 2005. pp. 262.
Publisher: US: American Psychological Assn
Abstract: Comments on George Bonanno's article entitles Loss,
trauma, and human resilience: Have we underestimated the human capacity
to thrive after extremely aversive events? (see record 2004-10043-003).
The author notes that Bonanno articulated a model of loss and
trauma-related resilience cogently and evocatively. In the trauma field,
there is a new focus on risk and resilience factors across the life span
(e.g., King, Vogt, & King, 2004), and the article by Bonanno will serve
as a herald for this new way of thinking about adjustment to trauma and
loss. Because the author believes that the most important function of
Bonanno's article should be to stimulate theory development and research
in this burgeoning area, he raises three issues in service of that goal.
_____
Title: The Human Capacity for Growth Through Adversity.
Author(s): Linley, P. Alex, University of Leicester, Leicester,
United Kingdom, PAL8@le.ac.uk
Joseph, Stephen, University of Warwick, Coventry, United Kingdom,
S.Joseph@warwick.ac.uk
Address: Linley, P. Alex, School of Psychology, University of
Leicester, Leicester, United Kingdom, LE1 7RH, PAL8@le.ac.uk
Source: American Psychologist, Vol 60(3), Apr 2005. pp. 262-264.
Publisher: US: American Psychological Assn
Abstract: Comments on George Bonanno's article entitled Loss,
trauma, and human resilience: Have we underestimated the human capacity
to thrive after extremely aversive events? (see record 2004-10043-003).
The authors are encouraged by Bonanno's recognition of the human
potential for resilience following adversity and his call for
psychologists to pay greater attention to this capacity rather than
simply focus on psychopathology. This approach parallels recent trends
within psychology toward a more "positive psychology," as championed by
former American Psychological Association President Martin Seligman.
However, it fails to recognize research trends within the traumatic
stress literature, which have increasingly pointed toward the capacity
not just for resilience but also for people to use aversive events as a
springboard for further growth and development. In this comment, the
authors argue that the real paradigm shift needed in dealing with loss
and trauma is not simply to include resilience (i.e., the absence of
psychopathology). Rather, psychologists should seek to develop an
understanding of reactions to adversity that explains the full range of
reactions, from psychopathology, through resilience, to adversarial
growth. Here they review the main points made by Bonanno (2004) within
the context of the adversarial growth literature before presenting a
brief overview of a new theory of adversarial growth that addresses
these salient considerations, explaining the three possible outcomes of
psychopathology, resilience, and adversarial growth following loss and
trauma.
_____
Title: Conceptual Clarifications in the Study of Resilience.
Author(s): Roisman, Glenn I., University of Illinois at
Urbana-Champaign, Champaign, IL, US, roisman@uiuc.edu
Address: Roisman, Glenn I., Department of Psychology, University
of Illinois at Urbana-Champaign, 603 East Daniel Street, Champaign, IL,
US, roisman@uiuc.edu
Source: American Psychologist, Vol 60(3), Apr 2005. pp. 264-265.
Publisher: US: American Psychological Assn
Abstract: Comments on George Bonanno's article entitled Loss,
trauma, and human resilience: Have we underestimated the human capacity
to thrive after extremely aversive events? (see record 2004-10043-003).
The authors note that Bonanno's article on loss, trauma, and human
resilience serves an important function for the field in drawing
attention to the pseudoscientific mythologies that have grown up around
brief normative (loss-related) and nonnormative (traumatic) stressors.
As the author rightly pointed out, traditional assumptions regarding the
absolute necessity of "grief work" in the case of loss and clinical
debriefing following exposure to traumatic events may indeed be
overdrawn (and overprescribed) in light of emerging evidence. Although
there is much to like about Bonanno's analysis, several limitations
inherent in the author's conceptualization of resilience are troubling
in light of the history of developmental research in this area, much of
which is cited in the target article. In essence, Bonanno defined adult
resilience as an individual's capacity to resist maladaptation in the
face of risky experiences (e.g., "stress resistance"). Although this is
one plausible way of conceptualizing resilience, it is by no means an
exclusive definition.
_____
Title: Clarifying and Extending the Construct of Adult Resilience.
Author(s): Bonanno, George A., Teachers College, Columbia
University, New York, NY, US, gab38@columbia.edu
Address: Bonanno, George A., Teachers College, Columbia
University, 525 West 120th Street, Box 218, New York, NY, US,
gab38@columbia.edu
Source: American Psychologist, Vol 60(3), Apr 2005. pp. 265-267.
Publisher: US: American Psychological Assn
Abstract: In this article the author responds to comments made in
this issue (see records 2005-03019-010; 2005-03019-011; 2005-03019-012;
2005-03019-013; and 2005-03019-014) responding to his original article
entitled Loss, trauma, and human resilience: Have we underestimated the
human capacity to thrive after extremely aversive events? (see record
2004-10043-003). The author notes that in his original article he
focused on three crucial points: Resilience among adults represents a
distinct and empirically separable outcome trajectory from that normally
associated with recovery from trauma; resilience is more prevalent than
generally accepted in either the lay or professional literature; and
there are multiple and sometimes unexpected factors that inform adult
resilience. Owing to the brevity of the article, the author could only
touch briefly on many of the more nuanced and complex issues suggested
by the resilience construct; this left plenty of room for critique.
Fortunately, the comments are generous and insightful and for the most
part compatible with the driving goal of the article. As might be
expected, of course, there were statements peppered throughout the
comments that the author deemed worthy of rebuttal or correction. He
considers four points that seemed to beg most urgently for response.
_____
Title: Natural Resilience and Innate Mental Health.
Author(s): Kelley, Thomas M., Wayne State University, Detroit, MI,
US, aa5216@wayne.edu
Address: Kelley, Thomas M., Department of Criminal Justice, Wayne
State University, Detroit, MI, US, aa5216@wayne.edu
Source: American Psychologist, Vol 60(3), Apr 2005. pp. 265.
Publisher: US: American Psychological Assn
Abstract: Comments on George Bonanno's article entitled Loss,
trauma, and human resilience: Have we underestimated the human capacity
to thrive after extremely aversive events? (see record 2004-10043-003).
The author notes that Bonanno's article on loss, trauma, and resilience
represents another important step toward pointing psychology in a more
positive and fruitful direction. Bonanno was right; psychologists have
dramatically underestimated the human capacity to thrive after extremely
aversive events. More important, psychologists have also failed to
realize that the human capacity for resilience, highlighted by Bonanno,
is natural and normal, part and parcel of the innate health built into
all human beings. Bonanno concluded from his review of the research on
grieving and posttraumatic stress disorder that resilience to
interpersonal loss and traumatic events is common and represents healthy
adjustment. This conclusion points to the existence of an innate human
psychological immune capacity.
_____
Title: Cognitive therapy for post-traumatic stress disorder:
Development and evaluation.
Author(s): Ehlers, Anke, Department of Psychology, Institute of
Psychiatry, King's College London, London, United Kingdom,
a.ehlers@iop.kcl.ac.uk
Clark, David M., Department of Psychology, Institute of Psychiatry,
King's College London, London, United Kingdom
Hackmann, Ann, Department of Psychiatry, Oxford University, Oxford,
United Kingdom
McManus, Freda, Department of Psychology, Institute of Psychiatry,
King's College London, London, United Kingdom
Fennell, Melanie, Department of Psychiatry, Oxford University, Oxford,
United Kingdom
Address: Ehlers, Anke, Department of Psychology, Institute of
Psychiatry, King's College London, PO77 De Crespigny Park, London,
United Kingdom, SE5 8AF, a.ehlers@iop.kcl.ac.uk
Source: Behaviour Research & Therapy, Vol 43(4), Apr 2005. pp. 413-431.
Publisher: Netherlands: Elsevier Science
Abstract: The paper describes the development of a cognitive
therapy (CT) program for post-traumatic stress disorder (PTSD) that is
based on a recent cognitive model (Behav. Res. Therapy 38 (2000) 319).
In a consecutive case series, 20 PTSD patients treated with CT showed
highly significant improvement in symptoms of PTSD, depression and
anxiety. A subsequent randomized controlled trial compared CT (N = 14)
and a 3-month waitlist condition (WL, N = 14). CT led to large
reductions in PTSD symptoms, disability, depression and anxiety, whereas
the waitlist group did not improve. In both studies, treatment gains
were well maintained at 6- month follow-up. CT was highly acceptable,
with an overall dropout rate of only 3%. The intent-to-treat effect
sizes for the degree of change in PTSD symptoms from pre to
post-treatment were 2.70-2.82 (self-report), and 2.07 (assessor-rated).
The controlled effect sizes for CT versus WL post-treatment scores were
2.25 (self-report) and 2.18 (assessor-rated). As predicted by the
cognitive model, good treatment outcome was related to greater changes
in dysfunctional post-traumatic cognitions. Patient characteristics such
as comorbidity, type of trauma, history of previous trauma, or time
since the traumatic event did not predict treatment response, however,
low educational attainment and low socioeconomic status were related to
better outcome.
_____
Title: Trauma-Related Intrusions and Psychosis: An Information
Processing Account.
Author(s): Steel, Craig, University College London, London, United
Kingdom, c.steel@iop.kcl.ac.uk
Fowler, David, University of East Anglia, Norwich, United Kingdom
Holmes, Emily A., MRC Cognition and Brain Sciences Unit, Cambridge,
United Kingdom
Address: Steel, Craig, Department of Mental Health Sciences,
Royal Free and University College London, Medical School, Holborn Union
Building, Archway Campus, London, United Kingdom, N19 5LW,
c.steel@iop.kcl.ac.uk
Source: Behavioural & Cognitive Psychotherapy, Vol 33(2), Apr 2005. pp.
139-152.
Publisher: US: Cambridge Univ Press
Abstract: There is active, current speculation about the
relationship between trauma and psychosis. However, little is known
about the information-processing mechanisms underlying the development
of trauma-related intrusions in this area. Our account highlights the
role of contextual integration, i.e. the need for experiential
information to be effectively integrated into a temporal and spatial
context in order to facilitate voluntary recall. Drawing on existing
models of both posttraumatic stress disorder (PTSD) and psychosis
(Brewin, 2001; Ehlers and Clark, 2000; Garety et al., 2001; Morrison,
2001), we propose a contextual integration account of trauma-related
intrusions. It is argued that the strength of contextual integration,
which occurs during encoding, influences the frequency and nature of
subsequent intrusive experiences. Consequently, individual differences
in schizotypal personality traits, which are known to be associated with
levels of contextual integration, are also related to the phenomenology
of trauma-related intrusions. Whilst intrusions can be seen to occur
within a range of disorders, it is argued that contextual integration
may be one key variable in understanding the relationship between an
experienced trauma and any consequent psychiatric symptomatology.
Implications for clinical interventions aimed at trauma-related
psychosis are discussed, along with research aimed at developing the
empirical basis for such interventions.
_____
Title: Corticolimbic Blood Flow in Posttraumatic Stress Disorder During
Script-Driven Imagery.
Author(s): Britton, Jennifer C., Neuroscience Program, University
of Michigan, Ann Arbor, MI, US
Phan, K. Luan, Department of Psychiatry, University of Chicago, Chicago,
IL, US
Taylor, Stephan F., Department of Psychiatry, University of Michigan,
Ann Arbor, MI, US
Fig, Lorraine M., Nuclear Medicine, Ann Arbor VAMC, Ann Arbor, MI, US
Liberzon, Israel, Department of Psychiatry, University of Michigan, Ann
Arbor, MI, US, liberzon@umich.edu
Address: Liberzon, Israel, University Hospital, Psychiatry
Department, 9D, 1500 E Medical Center Drive, Ann Arbor, MI, US,
liberzon@umich.edu
Source: Biological Psychiatry, Vol 57(8), Apr 2005. pp. 832-840.
Publisher: Netherlands: Elsevier Science
Abstract: Background: Functional neuroimaging experiments
targeting personal recall of emotional events may help elucidate neural
substrates underlying posttraumatic stress disorder (PTSD). Studies
suggest that limbic and paralimbic function might be altered in PTSD, as
compared with trauma-exposed control subjects; however, little is known
about functional changes resulting from traumatic experience itself. The
present study examined both PTSD-specific and trauma-specific regional
cerebral blood flow (rCBF) patterns during script-driven imagery.
Methods: Sixteen combat veterans with PTSD (PP); 15 combat veterans
without PTSD (CC); and 14 healthy, aged-matched noncombat control
subjects (NC) underwent [¹-sup-5O] H-sub-2O positron emission tomography
(PET) scanning during script-driven imagery of emotionally evocative and
neutral autobiographic events. Results: Differential patterns of
activation were detected in amygdala and medial frontal cortex. Past
trauma experience was associated with decreased amygdala activity (i.e.,
less activity than healthy control subjects); however, combat control
subjects deactivated this region (i.e., greater activity to neutral
scripts). All subjects deactivated medial frontal cortex; PTSD patients
had greater rostral anterior cingulate (rACC) deactivation compared with
control groups, who deactivated ventromedial prefrontal cortex (vmPFC).
Conclusions: Trauma-specific patterns may represent potential
compensatory changes to traumatic reminders, while patterns observed
only in the PTSD group may reflect neural substrates specific to PTSD
pathophysiology.
_____
Title: Efficacité d'une intervention de groupe auprès d'hommes agressés
sexuellement dans leur enfance.
Translated Title: Effectiveness of a group intervention for men
sexually molested during childhood.
Author(s): Tourigny, Marc, Département de psychoéducation,
Université de Sherbrooke, Sherbrooke, PQ, Canada
Guillor, Marie-Laure, Université de Montréal, Montréal, PQ, Canada
Morissette, Pauline, Université de Montréal, Montréal, PQ, Canada
Address: Tourigny, Marc, Departement de psychoeducation,
Universite de Sherbrooke, 2500, boulevard de l'Universite, Sherbrooke,
PQ, Canada, J1K 2R1
Source: Canadian Journal of Behavioural Science, Vol 37(2), Apr 2005.
pp. 97-109.
Publisher: Canada: Canadian Psychological Assn
Abstract: The purpose of this research was to evaluate the effects
of a group intervention intended for men victims of childhood sexual
abuse (CSA). A quasi-experimental design was used to compare 23 men who
took part in the group intervention against 13 men who suffered CSA but
who received no service relative to this victimization. Data was
collected through a self-administered questionnaire, which comprised
various sections, including: 1) one on the participants'
sociodemographic and CSA characteristics; 2) a posttraumatic stress
symptoms scale; 3) a psychological distress index; 4) a self-esteem
measure; and 5) a measure of the feeling of loneliness. The results
demonstrate that, compared with the men in the control group, the men
who completed the group intervention improved significantly in terms of
self-esteem and on the subscale measuring CSA-related traumatic
symptoms. No inter-group difference emerged concerning psychological
distress, posttraumatic stress, and feeling of loneliness. Despite
certain methodological limitations (including the non-random
distribution of subjects into groups and the small size of the samples),
the use of a quasi-experimental control-group design and of validated
standardized measures (including one for posttraumatic stress disorder)
lends strength and credence to the study.
_____
Title: Gender and PTSD.
Author(s): Fraser, George
Source: Canadian Journal of Psychiatry, Vol 50(5), Apr 2005. pp. 297.
Publisher: Canada: Canadian Psychiatric Assn
Reviewed Item: Rachel Kimerling; Paige Ouimette; Jessica Wolfe (Eds.)
(2002). Gender and PTSD; New York: The Guilford Press; 2002. 460 p.
Abstract: Reviews the book "Gender and PTSD" edited by Rachel
Kimerling, Paige Ouimette and Jessica Wolfe (see record 2003-04410-000).
This multiauthored book takes a comprehensive look at the many sex
issues that might explain the increased vulnerability of girls and women
to PTSD. Many readers will likely be surprised by how many issues need
to be considered in the management of male vs female PTSD patients or
clients. Knowledge of these issues will certainly assist PTSD therapists
in being more alert to therapy issues that previously might not have
even been considered. Another interesting area pointed out in this book
is that female sex may result in an underdiagnosis of PTSD. Girls and
women are more likely be diagnosed instead with various other disorders,
including depression and borderline personality disorder. There are many
other pertinent areas discussed, which help explain women's
vulnerability to PTSD. The various authors do point out that much of the
data analyzed and presented is early in its development; more research,
especially research addressing the sex differences in PTSD studies, is
necessary to better examine the sex variations that will guide the
theory and therapy of PTSD in women. This book may be the first to
address gender issues in PTSD and will be a guide to therapists.
_____
Title: Mother-Child Expression of Psychological Distress in War Trauma.
Author(s): Qouta, Samir, Gaza Community Mental Health Program, Gaza
City, Palestine
Punamäki, Raija-Leena, University of Tampere, Helsinki, Finland,
raija-leena.punamaki@uta.fi
Sarraj, Eyad El, Gaza Community Mental Health Program, Gaza City,
Palestine
Address: Punamäki, Raija-Leena, Department of Psychology, 330014
University of Tampere, Helsinki, Finland, raija-leena.punamaki@uta.fi
Source: Clinical Child Psychology & Psychiatry, Vol 10(2), Apr 2005. pp.
135-156.
Publisher: US: Sage Publications
Abstract: The aims of this study were, first, to examine how
exposure to war trauma, maternal neuroticism and psychological distress
are associated with child psychological distress, and, second, whether
good maternal mental health and low neuroticism can moderate the
negative impact of war trauma on child mental health. Third, we examined
whether mother-child dyads' psychological distress was dependent on who
was the main war trauma victim in the family: the mother, the child or
both. Fourth, we tested whether mother-child dyads express similar or
different symptoms. The sample consists of 121 Palestinian children
(aged 6-16 years; 45% girls and 55% boys), and their mothers (aged 21-55
years) living under conditions of military violence and war in Gaza.
Child psychological distress was measured using the CPTS-RI
(child-reported) and Rutter Parent Questionnaire (mother-reported), and
mothers' mental health was measured using the SCL-90- R. The results
failed to show any moderating effect of good maternal mental health or
low neuroticism in protecting child mental health from negative impact
of war trauma. The main effects showed that the child's young age, war
trauma and poor maternal mental health were associated with children's
internalizing symptoms, and male gender, maternal neuroticism and poor
mental health with children's externalizing symptoms. There were gender
differences in psychological distress depending on whether the mother,
the child or both were the main war trauma victim in the family: girls
showed particularly high psychological distress when their mothers were
exposed to war trauma (family systems model), whereas boys showed high
levels of distress when both they themselves and their mothers were
exposed to war trauma (accumulative impact model). Similarities were
confirmed in dyadic symptom expression: significant associations were
found between mothers' depressive and children's internalizing symptoms,
and between mothers' hostile and children's externalizing symptoms.
_____
Title: School-based Cognitive-Behavioural Therapy Group Intervention
for Refugee Children who have Experienced War-related Trauma.
Author(s): Ehntholt, Kimberly A., Maudsley Hospital, London, United
Kingdom, kim.ehntholt@slam.nhs.uk
Smith, Patrick A., Child Traumatic Stress Clinic, Maudsley Hospital,
London, United Kingdom
Yule, William, Maudsley Hospital (South London and Maudsley NHS Trust),
London, United Kingdom
Address: Ehntholt, Kimberly A., Michael Rutter Centre for
Children and Young People, Maudsley Hospital, De Crespigny Park, London,
United Kingdom, SE5 8AZ, kim.ehntholt@slam.nhs.uk
Source: Clinical Child Psychology & Psychiatry, Vol 10(2), Apr 2005. pp.
235-250.
Publisher: US: Sage Publications
Abstract: This study evaluated the effectiveness of a school-based
group intervention designed for children who have experienced trauma.
Twenty-six children (aged 11-15 years) who were refugees or
asylum-seekers from war-affected countries participated. The
manual-based intervention consisted of cognitive-behavioural therapy
(CBT) techniques and was implemented within secondary schools. The
treatment group (n = 15) received six sessions of group CBT over a
6-week period, while the control group (n = 11) were placed on a waiting
list for 6 weeks and then invited to enter treatment. Children in the
CBT group showed statistically significant, but clinically modest
improvements following the intervention, with decreases in overall
severity of post-traumatic stress symptoms. Significant improvements
were also found in overall behavioural difficulties and emotional
symptoms. Children in the waiting list control group did not show any
improvements over the same period. However, follow-up data, which were
only available for a small subset of eight children, suggest that gains
in the CBT group were not maintained at 2-month follow-up.
_____
Title: Posttraumatic stress disorder as a reaction to the experience of
psychosis and its sequelae.
Author(s): Centofanti, Antoni T., Department of Psychology and
Disability Studies, RMIT University, Bundoora, VIC, Australia,
Antoni.Centofanti@rmit.edu.au
Smith, David I., Department of Psychology and Disability Studies, RMIT
University, Bundoora, VIC, Australia
Altieri, Trish, Department of Psychology and Disability Studies, RMIT
University, Bundoora, VIC, Australia
Address: Centofanti, Antoni T., Department of Psychology and
Disability Studies, RMIT University, Po Box 71, Bundoora, VIC,
Australia, 3083, Antoni.Centofanti@rmit.edu.au
Source: Clinical Psychologist, Vol 9(1), Apr 2005. pp. 15-23.
Publisher: United Kingdom: Taylor & Francis
Abstract: The potentially distressing nature of both the symptoms
of psychosis and its treatment (i.e., hospitalisation) can have a
traumatic impact upon the individual. This pilot study investigates this
relationship in 20 outpatients hospitalised for psychosis within the
past year. All participated in a research interview. Five participants
(25%) met criteria for Post-Psychotic PTSD. Overall trauma levels were
related significantly to the total number of different types of previous
traumatic events experienced, the distress associated with police
conveyance to their most recent psychiatric hospitalisation, and the
total number of experiences related to harm to self/others during their
most recent hospitalisation. The implications of these findings are
discussed.
_____
Title: The Clenching-Grinding Spectrum and Fear Circuitry Disorders:
Clinical Insights from the Neuroscience/Paleoanthropology Interface.
Author(s): Bracha, H. Stefan, Veterans Affairs (VA) National Center
for Posttraumatic Stress Disorder, Honolulu, HI, US, H.Bracha@med.va.gov
Ralston, Tyler C., Clinical Bio-Markers of Early Stress Project, US
Williams, Andrew E., Clinical Bio-Markers of Early Stress Project, US
Yamashita, Jennifer M., Clinical Bio-Markers of Early Stress Project, US
Bracha, Adam S., Cornell University, Ithaca, NY, US
Address: Bracha, H. Stefan, National Center for PTSD, Department
of Veterans Affairs, Pacific Islands Health Care System, Spark M.
Matsunaga Medical Center, 1132 Bishop Street, Suite 307, Honolulu, HI,
US, H.Bracha@med.va.gov
Source: CNS Spectrums, Vol 10(4), Apr 2005. pp. 311-318.
Publisher: US: MBL Communications, Inc
Abstract: This review discusses the clenching-grinding spectrum
from the neuropsychiatric/neuroevolutionary perspective. In
neuropsychiatry, signs of jaw clenching may be a useful objective marker
for detecting or substantiating a self-report of current subjective
emotional distress. Similarly, accelerated tooth wear may be an
objective clinical sign for detecting, or substantiating, long-lasting
anxiety. Clenching-grinding behaviors affect at least 8 percent of the
population. We argue that during the early paleolithic environment of
evolutionary adaptedness, jaw clenching was an adaptive trait because it
rapidly strengthened the masseter and temporalis muscles, enabling a
stronger, deeper and therefore more lethal bite in expectation of
conflict (warfare) with conspecifics. Similarly, sharper incisors
produced by teeth grinding may have served as weaponry during early
human combat. We posit that alleles predisposing to fear-induced
clenching-grinding were evolutionarily conserved in the human clade
(lineage) since they remained adaptive for anatomically and
mitochondrially modern humans (Homo sapiens) well into the
mid-paleolithic. Clenching-grinding, sleep bruxism, myofacial pain,
craniomaxillofacial musculoskeletal pain, temporomandibular disorders,
oro-facial pain, and the fibromyalgia/chronic fatigue spectrum disorders
are linked. A 2003 Cochrane meta-analysis concluded that dental
procedures for the above spectrum disorders are not evidence based.
There is a need for early detection of clenching-grinding in anxiety
disorder clinics and for research into science-based interventions.
Finally, research needs to examine the possible utility of incorporating
physical signs into Diagnostic and Statistical Manual of Mental
Disorders, Fifth Edition posttraumatic stress disorder diagnostic
criteria. One of the diagnostic criterion that may need to undergo a
revision in Diagnostic and Statistical Manual of Mental Disorders, Fifth
Edition is Criterion D (persistent fear-circuitry activation not present
before the trauma). Grinding-induced incisor wear, and clenching-induced
palpable masseter tenderness may be examples of such objective physical
signs of persistent fear-circuitry activation (posttraumatic stress
disorder Criterion D).
_____
Title: Posttraumatische Belastungsstörungen bei somatischen
Erkrankungen.
Translated Title: PTSD in Somatic Disease.
Author(s): Krauseneck, Till, Psychiatrische Klinik und Poliklinik
der Ludwig-Maximilians, Universität München, München, Germany,
Till.Krauseneck@med.uni-muenchen.de
Rothenhäusler, H. -B., Universitätsklinik für Psychiatrie der
Karl-Franzens, Universität Graz, Graz, Germany
Schelling, G., Klinik für Anästhesiologie der Ludwig-Maximilians,
Universität München, München, Germany
Kapfhammer, H. -P., Universitätsklinik für Psychiatrie der
Karl-Franzens, Universität Graz, Graz, Germany
Address: Krauseneck, Till, Psychiatrische Klinik und Poliklinik,
LMU Munchen, Nussbaumstr. 7, 80336, Munchen, Germany,
Till.Krauseneck@med.uni-muenchen.de
Source: Fortschritte der Neurologie, Psychiatrie, Vol 73(4), Apr 2005.
pp. 206-217.
Publisher: Germany: Georg Thieme Verlag KG
Abstract: This review describes the incidence of posttraumatic
stress disorder (PTSD) in physically ill patients. At the beginning,
research in the field of PTSD was primarily focused on war veterans and
victims of bodily assault or rape. Starting in the early 90s, PTSD after
civilian traumas such as motor vehicle accidents was diagnosed
increasingly more often. Recent publications showed that PTSD can also
follow serious somatic diseases. Hence, awareness during anaesthesia,
prolonged ICU treatment (ARDS, septic shock), burns, successful
resuscitation after cardiac arrest, coronary artery bypass surgery,
organ transplantation and cancer were all linked to the development of
PTSD. Prevalence of PTSD in these medical conditions lies around 5-10%,
and it is therefore considered an important comorbidity. Unfortunately,
the diagnosis and treatment of PTSD are not well enough established yet
and thus do receive too little attention in the treatment regime of
somatic illness. Generally, PTSD can occur with every life-threatening
disease, but possibly also with less severe diseases if the patient
experiences intense fear. PTSD symptoms, especially intrusive
recollections, avoidance and hyperarousal can impair the patients'
quality of life more than the primary disease. This seems to be also
true for subsyndromal PTSD. To adequately diagnose and treat patients at
risk of developing PTSD, close collaboration between physicians of all
subspecialties and psychiatrists will be necessary.
_____
Title: Maintenance Therapy With Fluoxetine in Posttraumatic Stress
Disorder: A Placebo-Controlled Discontinuation Study.
Author(s): Davidson, Jonathan R. T., Department of Psychiatry and
Behavioral Sciences, Duke University Medical Center, Durham, NC, US,
Jonathan.Davidson@duke.edu
Connor, Kathryn M., Department of Psychiatry and Behavioral Sciences,
Duke University Medical Center, Durham, NC, US
Hertzberg, Michael A., Durham Veterans Administration Medical Center,
Durham, NC, US
Weisler, Richard H., Private Practice, Raleigh, NC, US
Wilson, William H., Department of Psychiatry and Behavioral Sciences,
Duke University Medical Center, Durham, NC, US
Payne, Victoria M., Department of Psychiatry and Behavioral Sciences,
Duke University Medical Center, Durham, NC, US
Address: Davidson, Jonathan R. T., Anxiety and Traumatic Stress
Program, Department of Psychiatry and Behavioral Sciences, Duke
University Medical Center, Box 3812, Durham, NC, US,
Jonathan.Davidson@duke.edu
Source: Journal of Clinical Psychopharmacology, Vol 25(2), Apr 2005. pp.
166-169.
Publisher: US: Lippincott Williams & Wilkins
Abstract: The effect of fluoxetine (FLU) in posttraumatic stress
disorder was studied in a one-year trial. Subjects received open-label
treatment for 6 months, followed by double-blind randomized treatment
with FLU or placebo (PBO) for 6 months. Rates of relapse were compared
using the Clinical Global Impressions of Improvement. One hundred
twenty-three subjects entered open-label treatment, of whom 114 returned
at least once. Sixty-two subjects were randomized to receive FLU or PBO,
of whom 57 returned at least once' and were analyzed. The dose of FLU
ranged from 10 to 60 mg/d; at randomization, mean doses were 48.6 and
42.1 mg for FLU and PBO groups. Rates of relapse were 22% for FLU versus
50% for PBO (P=0.02), and time to relapse on FLU was longer than for PBO
(P=0.02, log-rank statistic). The odds ratio for relapse on PBO relative
to FLU was 3.50. No significant differences were found on other
measures. Fluoxetine was well tolerated during double-blind treatment.
_____
Title: Hypomania With Topiramate.
Author(s): Kaplan, Marcia, Department of Psychiatry, University of
Cincinnati, Cincinnati, OH, US, mkaplan@3001.us
Address: Kaplan, Marcia, mkaplan@3001.us
Source: Journal of Clinical Psychopharmacology, Vol 25(2), Apr 2005. pp.
196-197.
Publisher: US: Lippincott Williams & Wilkins
Abstract: Presents a letter to the editor on the role of
topiramate in hypomania. Topiramate is a novel antiepileptic drug used
off-label by psychiatrists for treatment of mood disorders,
posttraumatic stress disorder, and weight loss. The author reports on 3
cases of hypomania that developed with the use of topiramate in clinical
outpatient practice. All 3 subjects had some degree of childhood trauma
and long-standing mood disorders. All developed hypomania within the
first few weeks of topiramate treatment in the absence of other changes
in medication, diet, or level of environmental stress. It was found that
emotional stress may cause neurotransmitter elevation or depletion that
leads to episodes of depression or mania. Furthermore, increased
dopamine because of cocaine or amphetamine abuse can induce maniclike
symptoms in those with or without an underlying mood disorder.
_____
Title: The Additive Benefit of Hypnosis and Cognitive-Behavioral
Therapy in Treating Acute Stress Disorder.
Author(s): Bryant, Richard A., School of Psychology, University of
New South Wales, Sydney, NSW, Australia, r.bryant@unsw.edu.au
Moulds, Michelle L., School of Psychology, University of New South
Wales, Sydney, NSW, Australia
Guthrie, Rachel M., School of Psychology, University of New South Wales,
Sydney, NSW, Australia
Nixon, Reginald D. V., School of Psychology, University of New South
Wales, Sydney, NSW, Australia
Address: Bryant, Richard A., School of Psychology, University of
New South Wales, 2052, Sydney, NSW, Australia, r.bryant@unsw.edu.au
Source: Journal of Consulting and Clinical Psychology, Vol 73(2), Apr
2005. pp. 334-340.
Publisher: US: American Psychological Assn
Abstract: This research represents the first controlled treatment
study of hypnosis and cognitive- behavioral therapy (CBT) of acute
stress disorder (ASD). Civilian trauma survivors (N = 87) who met
criteria for ASD were randomly allocated to 6 sessions of CBT, CBT
combined with hypnosis (CBT-hypnosis), or supportive counseling (SC).
CBT comprised exposure, cognitive restructuring, and anxiety management.
CBT-hypnosis comprised the CBT components with each imaginal exposure
preceded by a hypnotic induction and suggestions to engage fully in the
exposure. In terms of treatment completers (n = 69), fewer participants
in the CBT and CBT-hypnosis groups met criteria for posttraumatic stress
disorder at posttreatment and 6-month follow-up than those in the SC
group. CBT-hypnosis resulted in greater reduction in reexperiencing
symptoms at posttreatment than CBT. These findings suggest that hypnosis
may have use in facilitating the treatment effects of CBT for
posttraumatic stress.
_____
Title: Post- Traumatic Stress Disorder (PTSD): What We Have Learned and
What We Still Have Not Found Out.
Author(s): Flouri, Eirini, University of Oxford, Oxford, England
Source: Journal of Interpersonal Violence, Vol 20(4), Apr 2005. pp.
373-379.
Publisher: US: Sage Publications
Abstract: This article discusses the biomedical and the social
constructionist models applied to response to trauma, presents the
prevalence and the etiology of post-traumatic stress disorder (PTSD),
and describes its biological and psychological correlates in children
and adults. It concludes that future research might benefit from
investigating factors that may protect people who have been exposed to
an event likely to be traumatic from presenting with PTSD symptoms, and
factors that may affect the longitudinal course of PTSD and treatment
effectiveness.
_____
Title: Beyond PTSD: An Evolving Relationship Between Trauma Theory and
Family Violence Research.
Author(s): Becker-Blease, Kathryn A., Crimes Against Children
Research Center, University of New Hampshire, Durham, NH, US
Freyd, Jennifer J., University of Oregon, Eugene, OR, US
Source: Journal of Interpersonal Violence, Vol 20(4), Apr 2005. pp.
403-411.
Publisher: US: Sage Publications
Abstract: During the past 20 years, we have learned how similarly
harmful are experiences of terror, violence, and abuse, whether they
occur on the combat field or at home. The field of family violence has
gained much from the field of traumatic stress, and collaborations
between these two previously separate fields have yielded important new
answers, as well as new research questions. The field of traumatic
stress is poised to integrate, more fully than in the past, a variety of
aspects of trauma such as social betrayal, as well as outcomes of trauma
such as depression, criminality, and physiological harm that go beyond
posttraumatic stress. The field of family violence has much to offer in
this process. We look forward to improved research designs that will
further our knowledge of how trauma affects aspects of people's lives,
including productivity, relationships, cognition, and emotions, in
negative and positive ways.
_____
Title: Twenty Years of Progress in the Study of Trauma.
Author(s): MacIntosh, Heather B., University of Ottawa, Ottawa, ON,
Canada
Whiffen, Valerie E., University of Ottawa, Ottawa, ON, Canada
Source: Journal of Interpersonal Violence, Vol 20(4), Apr 2005. pp.
488-492.
Publisher: US: Sage Publications
Abstract: In this article, the authors argue that studies
investigating the nature of traumatic memory have made the greatest
contribution to trauma research in the past 20 years. Neuroimaging
studies provide empirical support for the diagnosis of posttraumatic
stress disorder and have important implications for the treatment of
trauma survivors. In the future, the authors hope to see an empirically
derived model of trauma that incorporates both mediating and moderating
factors to predict outcome.
_____
Title: Systemic Traumatic Stress: The Couple Adaptation to Traumatic
Stress Model.
Author(s): Goff, Briana S. Nelson, Marriage and Family Therapy
Program, School of Family Studies and Human Services, Kansas State
University, Manhattan, KS, US, bnelson@ksu.edu
Smith, Douglas B., Marriage and Family Therapy Program, School of Family
Studies and Human Services, Kansas State University, Manhattan, KS, US
Address: Goff, Briana S. Nelson, Marriage and Family Therapy
Program, School of Family Studies and Human Services, Kansas State
University, 322 Justin Hall, Manhattan, KS, US, bnelson@ksu.edu
Source: Journal of Marital & Family Therapy, Vol 31(2), Apr 2005. pp.
145-157.
Publisher: US: American Assn for Marriage & Family Therapy
Abstract: Research traditionally has focused on the development of
symptoms in those who experienced trauma directly but overlooked the
impact of trauma on the families of victims. In recent years,
researchers and clinicians have begun to examine how individual exposure
to traumatic stress affects the spouses/partners, children, and
professional helpers of trauma survivors. However, empirically
supported, theory-based literature that identifies the mechanisms by
which interpersonal or "secondary trauma" occurs in response to
traumatic events is limited. Here, we present the Couple Adaptation to
Traumatic Stress Model, a systemic model of the development of
interpersonal symptoms in the couple dyad based on empirical literature.
Potential mechanisms and clinical vignettes are included to describe the
systemic processes that occur with trauma couples. Areas for future
research and clinical implications also are identified.
_____
Title: Evaluation of a PTSD psychoeducational program for psychiatric
inpatients.
Author(s): Pratt, Sarah I., New Hampshire-Dartmouth Psychiatric
Research Center, Department of Psychiatry, Dartmouth Medical School,
Concord, NH, US, Sarah.I.Pratt@Dartmouth.edu
Rosenberg, Stanley, New Hampshire-Dartmouth Psychiatric Research Center,
Department of Psychiatry, Dartmouth Medical School, Concord, NH, US
Mueser, Kim T., New Hampshire-Dartmouth Psychiatric Research Center,
Department of Psychiatry, Dartmouth Medical School, Concord, NH, US
Brancato, Joseph, New Hampshire-Dartmouth Psychiatric Research Center,
Department of Psychiatry, Dartmouth Medical School, Concord, NH, US
Salyers, Michelle, New Hampshire-Dartmouth Psychiatric Research Center,
Department of Psychiatry, Dartmouth Medical School, Concord, NH, US
Jankowski, Mary Kay, New Hampshire-Dartmouth Psychiatric Research
Center, Department of Psychiatry, Dartmouth Medical School, Concord, NH,
US
Descamps, Monica, New Hampshire-Dartmouth Psychiatric Research Center,
Department of Psychiatry, Dartmouth Medical School, Concord, NH, US
Address: Pratt, Sarah I., New Hampshire-Dartmouth Psychiatric
Research Center, Main Building, 105 Pleasant Street, Concord, NH, US,
Sarah.I.Pratt@Dartmouth.edu
Source: Journal of Mental Health (UK), Vol 14(2), Apr 2005. pp. 121-127.
Publisher: United Kingdom: Taylor & Francis
Abstract: Background: Persons with severe mental illness are at
high risk for trauma and posttraumatic stress disorder (PTSD), but
trauma-focused interventions are rarely delivered. Aim: The purpose of
this study was to evaluate the feasibility of providing a
psychoeducational program for individuals with SMI and PTSD in a
psychiatric hospital, and to assess gains in knowledge and satisfaction
with the program. Method: Seventy inpatient participants who met
criteria for PTSD attended three sessions of a psychoeducational program
using a group format of video and discussion. The participants completed
a "knowledge of PTSD" questionnaire before and after the education
programme. Results: Participants demonstrated significant increases in
knowledge about trauma and PTSD, and reported high levels of
satisfaction with the program. Conclusion: Findings support the use of
this intervention as a first step in increasing knowledge about PTSD and
stimulating motivation to seek future treatment.
_____
Title: Differences in Posttraumatic Stress Disorder Symptoms between
Elderly Non-Hispanic Whites and African Americans.
Author(s): Mainous, Arch G. III, Medical University of South
Carolina, Department of Family Medicine, Charleston, SC, US,
mainouag@musc.edu
Smith, Daniel W., Medical University of South Carolina, Department of
Psychiatry, National Crime Victims Research and Treatment Center,
Charleston, SC, US
Acierno, Ron, Medical University of South Carolina, Department of
Psychiatry, National Crime Victims Research and Treatment Center,
Charleston, SC, US
Geesey, Mark E., Medical University of South Carolina, Department of
Family Medicine, Charleston, SC, US
Address: Mainous, Arch G. III, Medical University of South
Carolina, Department of Family Medicine, 295 Calhoun St., PO Box 20192,
Charleston, SC, US, mainouag@musc.edu
Source: Journal of the National Medical Association, Vol 97(4), Apr
2005. pp. 546-549.
Publisher: US: National Medical Assn
Abstract: This study was a secondary analysis of two similar data
sets to examine potential differences in PTSD symptoms between elderly
whites and African Americans (n=90). Without regard to trauma type,
there were no differences between the races in the distribution of PTSD
diagnosis or specific symptom constellations (e.g., re-experiencing,
avoidance, or arousal). No significant differences were yielded for
individuals who experienced a physical trauma. However, In cases of
nonphysical trauma, elderly whites were significantly more likely than
elderly African Americans to report hyperarousal symptoms, these results
suggest the need to better understand coping strategies used by whites
and African Americans in the face of trauma.
_____
Title: Embedded Journalists in the Iraq War: Are They at Greater
Psychological Risk?
Author(s): Feinstein, Anthony, Department of Psychiatry, Sunnybrook
and Women's College Health Sciences Centre, Toronto, ON, Canada,
antfeinstein@aol.com
Nicolson, Dawn, Department of Psychiatry, Sunnybrook and Women's College
Health Sciences Centre, Toronto, ON, Canada
Address: Feinstein, Anthony, Department of Psychiatry, Sunnybrook
and Women's College Health Sciences Centre, 2075 Bayview Avenue,
Toronto, ON, Canada, M4N 3M5, antfeinstein@aol.com
Source: Journal of Traumatic Stress, Vol 18(2), Apr 2005. pp. 129-132.
Publisher: US: John Wiley & Sons
Abstract: The current war in Iraq saw an alliance between the
media and the military, a process called embedded journalism. The aim of
this study was to explore whether this process affected the journalists'
vulnerability to psychological distress. Eighty-five of 100 journalists
approached agreed to participate; 38 (44.7%) were embedded. There were
no differences between embedded and unilateral (nonembedded) journalists
on demographic measures or in their exposure to traumatic events.
Similarly, the two groups did not differ on indices of posttraumatic
stress disorder, depression, psychological distress, and substance use.
Based on General Health Questionnaire scores, one third of all
journalists were psychologically distressed. There is no evidence from
the recent war in Iraq suggesting that embedded journalists are at
increased risk for psychological problems.
_____
Title: The Role of Loss of Meaning in the Pursuit of Treatment for
Posttraumatic Stress Disorder.
Author(s): Fontana, Alan, Northeast Program Evaluation Center, VA
National Center for PTSD, Connecticut Healthcare System, West Haven, CT,
US, Alan.Fontana@med.va.gov
Rosenheck, Robert, Northeast Program Evaluation Center, VA National
Center for PTSD, Connecticut Healthcare System, West Haven, CT, US
Address: Fontana, Alan, Northeast Program Evaluation Center, 182,
950 Campbell Avenue, West Haven, CT, US, Alan.Fontana@med.va.gov
Source: Journal of Traumatic Stress, Vol 18(2), Apr 2005. pp. 133-136.
Publisher: US: John Wiley & Sons
Abstract: Clinical observation and theory suggest that people who
have difficulty coping with their exposure to traumatic events often
experience a loss of meaning to their lives. This article examines the
contribution of loss of meaning to seeking help from clergy and/or
mental health providers. Results support the hypotheses that veterans
who have suffered a greater loss of meaning are more likely to seek help
from clergy and from VA mental health professionals. We suggest that
veterans who seek help from clergy are particularly desirous of
achieving a restoration of meaning that is specific to their loss, and
that this quest sustains a continued pursuit of mental health treatment,
especially among those who seek help from the VA.
_____
Title: Correlation Between Traumatic Events and Posttraumatic Stress
Disorder Among North Korean Defectors in South Korea.
Author(s): Jeon, WooTaek, Department of Psychiarry, College of
Medicine, Yonsei University, Seoul, Korea, wtjeon@yumc.yonsei.ac.kr
Hong, ChangHyung, Research Institute of Aging Science, Yonsei
University, Seoul, Korea
Lee, ChangHo, Department of Psychiarry, College of Medicine, Yonsei
University, Seoul, Korea
Kim, Dong Kee, Department of Biostatistics, College of Medicine, Yonsei
University, Seoul, Korea
Han, Mooyoung, Department of Biostatistics, College of Medicine, Yonsei
University, Seoul, Korea
Min, SungKil, Department of Psychiarry, College of Medicine, Yonsei
University, Seoul, Korea
Address: Jeon, WooTaek, Department of Psychiatry, College of
Medicine, Yonsei University, CPO Box 8044, Seoul, Korea,
wtjeon@yumc.yonsei.ac.kr
Source: Journal of Traumatic Stress, Vol 18(2), Apr 2005. pp. 147-154.
Publisher: US: John Wiley & Sons
Abstract: The number of North Korean defectors entering South
Korea has been increasing rapidly since 1994. Two hundred North Korean
defectors in South Korea were studied to identify their experiences of
traumatic events in North Korea and during defection, and the
correlation with Posttraumatic Stress Disorder (PTSD). Researchers
conducted face-to-face interviews and assisted defectors in performing a
self-report assessment of this survey. The study questionnaire consisted
of demographic characteristics, the Traumatic Experiences Scale for
North Korean Defectors, and the PTSD part of the Structured Clinical
Interview for DSM-III-R Korean version. Prevalence rate of PTSD in
defectors was 29.5%, with a higher rate for women. In factor analysis,
the 25 items of traumatic events experienced in North Korea were divided
into three factors: Physical Trauma, Political-Ideological Trauma, and
Family-Related Trauma. In addition, the 19 items of traumatic events
during defection were grouped into four factors: Physical Trauma,
Detection and Capture-Related Trauma, Family-Related Trauma, and
Betrayal-Related Trauma. In multifactorial logistic regression analysis,
Family-Related Trauma in North Korea had a significant odds ratio.
_____
Title: Treatment of Residual Insomnia After CBT for PTSD: Case Studies.
Author(s): DeViva, Jason C., Dartmouth Medical School, Lebanon, NH,
US, jason.deviva2@med.va.gov
Zayfert, Claudia, Dartmouth Medical School, Lebanon, NH, US
Pigeon, Wilfred R., Dartmouth Medical School, Lebanon, NH, US
Mellman, Thomas A., Dartmouth Medical School, Lebanon, NH, US
Address: DeViva, Jason C., Veterans Affairs Maryland Health Care
System Baltimore, 10 North Greene Street, Baltimore, MD, US,
jason.deviva2@med.va.gov
Source: Journal of Traumatic Stress, Vol 18(2), Apr 2005. pp. 155-159.
Publisher: US: John Wiley & Sons
Abstract: Insomnia is one of the most common symptoms of
posttraumatic stress disorder (PTSD). Evidence suggests that insomnia
may persist for many PTSD patients after other symptoms have responded
to cognitive-behavioral therapy (CBT). The present article reports the
effects of administering a five-session cognitive-behavioral insomnia
treatment to 5 patients who responded to CBT for PTSD yet continued to
report insomnia. Insomnia treatment was associated with improvements on
subjective sleep measures (Pittsburgh Sleep Quality Index, Insomnia
Severity Index, and Beliefs and Attitudes about Sleep Scale) and
self-monitored sleep efficiency and related measures in 4 of 5 cases.
Results highlight issues specific to treating insomnia in trauma
populations and future directions for examining treatment of insomnia
associated with PTSD.
_____
Title: Prediction of Numbing and Effortful Avoidance in Female Rape
Survivors With Chronic PTSD.
Author(s): Feuer, Catherine A., Center for Trauma Recovery,
University of Missouri, St. Louis, MO, US
Nishith, Pallavi, Center for Trauma Recovery, University of Missouri,
St. Louis, MO, US
Resick, Patricia, Center for Trauma Recovery, University of Missouri,
St. Louis, MO, US, Resick@med.va.gov
Address: Resick, Patricia, Center for Trauma Recovery, University
of Missouri, Weinman Building-LL, 8001 Natural Bridge Road, St. Louis,
MO, US, Resick@med.va.gov
Source: Journal of Traumatic Stress, Vol 18(2), Apr 2005. pp. 165-170.
Publisher: US: John Wiley & Sons
Abstract: The purpose of the present study was to investigate the
relationships among numbing, arousal, intrusion, and avoidance in a
sample of 272 female rape survivors. Multiple regression analyses were
conducted to test a theoretical model, which posits that hyperarousal
and numbing are functionally related mechanisms and intrusions and
avoidance are functionally related. Results supported the hypothesis
that arousal explained the majority of the variance in numbing beyond
that explained by avoidance and intrusion. In addition, intrusive
symptoms explained the majority of the variance in effortful avoidance
beyond that explained by numbing and arousal. The findings suggest that
numbing and effortful avoidance may be separate mechanisms associated
with symptoms of arousal and intrusion, respectively.
_____
Title: Role of Peer Support and Emotional Expression on Posttraumatic
Stress Disorder in Student Paramedics.
Author(s): Lowery, Kim, School of Psychology, Deakin University,
Burwood, VIC, Australia
Stokes, Mark A., School of Psychology, Deakin University, Burwood, VIC,
Australia, stokes@deakin.edu.au
Address: Stokes, Mark A., School of Psychology, Deakin
University, Burwood Highway, Burwood, VIC, Australia, 3125,
stokes@deakin.edu.au
Source: Journal of Traumatic Stress, Vol 18(2), Apr 2005. pp. 171-179.
Publisher: US: John Wiley & Sons
Abstract: This exploratory study contrasted and tested the
predictive value of the reverse buffering hypothesis of social support
and the information processing model of posttraumatic stress disorder
(PTSD) in an investigation of trauma-related symptomatology (TRS) in a
single sample of 42 student paramedics. Participants completed several
anonymous self-report measures of PTSD symptomatology, peer social
support, and attitude toward emotional expression. Regression-based path
analyses did not support either theory of PTSD in this population. A
path model of PTSD in student paramedics was subsequently developed,
indicating that a direct relationship exists between duty-related trauma
exposure, dysfunctional peer social support, and students' negative
attitudes toward emotional expression. This new model accounted for 30%
of the variance in student paramedics' TRS.
_____
Title: Neural basis of fear conditioning induced by video clip:
Positron emission tomography study.
Author(s): Doronbekov, Talant K., Division of Psychiatry and
Behavioral Proteomics, Department of Post-Genomics and Diseases, Course
of Advanced Medicine, Osaka, Japan
Tokunaga, Hiromasa, Division of Psychiatry and Behavioral Proteomics,
Department of Post-Genomics and Diseases, Course of Advanced Medicine,
Osaka, Japan, tokunaga@psy.med.osaka-u.ac.jp
Ikejiri, Yoshitaka, Division of Psychiatry and Behavioral Proteomics,
Department of Post-Genomics and Diseases, Course of Advanced Medicine,
Osaka, Japan
Kazui, Hiroaki, Division of Psychiatry and Behavioral Proteomics,
Department of Post-Genomics and Diseases, Course of Advanced Medicine,
Osaka, Japan
Hatta, Naoki, Division of Psychiatry and Behavioral Proteomics,
Department of Post-Genomics and Diseases, Course of Advanced Medicine,
Osaka, Japan
Masaki, Yoshihiro, Division of Psychiatry and Behavioral Proteomics,
Department of Post-Genomics and Diseases, Course of Advanced Medicine,
Osaka, Japan
Ogino, Atsushi, Division of Psychiatry and Behavioral Proteomics,
Department of Post-Genomics and Diseases, Course of Advanced Medicine,
Osaka, Japan
Miyoshi, Noriko, Division of Psychiatry and Behavioral Proteomics,
Department of Post-Genomics and Diseases, Course of Advanced Medicine,
Osaka, Japan
Oku, Naohiko, Division of Tracer Kinetics (Nuclear Medicine), Osaka
University Graduate School of Medicine, Osaka, Japan
Nishikawa, Takashi, Division of Psychiatry and Behavioral Proteomics,
Department of Post-Genomics and Diseases, Course of Advanced Medicine,
Osaka, Japan
Takeda, Masatoshi, Division of Psychiatry and Behavioral Proteomics,
Department of Post-Genomics and Diseases, Course of Advanced Medicine,
Osaka, Japan
Address: Tokunaga, Hiromasa, Division of Psychiatry and
Behavioral Proteomics, Department of Post-Genomics and Diseases, Course
of Advanced Medicine, Osaka University Graduate School of Medicine,
2-2-D3, Yamadaoka, Suita, Osaka, Japan, 565-0871,
tokunaga@psy.med.osaka-u.ac.jp
Source: Psychiatry & Clinical Neurosciences, Vol 59(2), Apr 2005. pp.
155-162.
Publisher: United Kingdom: Blackwell Publishing
Abstract: In patients with post-traumatic stress disorder (PTSD),
re-experiencing the trauma is often induced by external cues in the
environment. The cues, which were emotionally neutral for the patients
before the traumatic event, become fearful ones after the event. This
phenomenon is considered to be associated with fear conditioning. The
paradigm was set up so that the emotionality changes in the patients
with PTSD would be reproduced, and the regional cerebral blood flow
(rCBF) measured with positron emission tomography (PET) was compared
during exposure to the same stimuli before and after acquisition of fear
conditioning. Ten healthy male subjects were asked to look at some
emotionally neutral photos, then to watch a video with fearful content
that also contained images similar to that presented in the photos, and
afterwards to look at the photos again. Five of the 10 subjects felt
that the object in the photos was more fearful after watching the video
than before, and they were considered to have acquired fear
conditioning. In those five subjects, the rCBF in the right amygdala and
the left posterior cingulate gyrus after acquisition of fear
conditioning significantly increased relative to the rCBF before
conditioning. Thus, these regions seem to have a critical role in fear
conditioning.
_____
Title: Stress, Trauma, and Substance Use: An Overview.
Author(s): Bride, Brian E., University of Georgia, Athens, GA, US
MacMaster, Samuel A., University of Tennessee, Knoxville, TN, US
Source: Stress, Trauma and Crisis: An International Journal, Vol 8(2-3),
Apr-Sep 2005. pp. 75-78.
Publisher: United Kingdom: Taylor & Francis
Abstract: This special issue of Stress, Trauma, and Crisis: An
International Journal (Vol 8[2-3]) focuses on the interaction between
stress, trauma, and substance use. In soliciting manuscripts for this
special issue, we cast a deliberately wide net. It would have been
relatively easy to compile eight manuscripts that addressed the topic
through a myopic lens, such as by focusing only on the assessment and
treatment of comorbid posttraumatic stress disorder and substance use
disorders. But we left it up to the authors to determine how to address
the issue of the interaction between stress, trauma, and substance use
and where to place the emphasis. This special issue is an addition to
the literature that depicts both the breadth of the relationship between
stress, trauma, and substance use, as well as how closely these
phenomena are linked. These eight articles provide innovative conceptual
models, research findings, and recommendations to the practice field
that are applied to a diverse body of individuals affected by substance
abuse.
_____
Title: Factors Associated with Trauma Symptoms Among Runaway/Homeless
Adolescents.
Author(s): Thompson, Sanna J., University of Texas, Austin School
of Social Work, Austin, TX, US, SannaThompson@mail.utexas.edu
Address: Thompson, Sanna J., University of Texas Austin,
Substance Abuse Research Center, 1717 W., 6th St., Suite 335, Campus Box
R5000, Austin, TX, US, SannaThompson@mail.utexas.edu
Source: Stress, Trauma and Crisis: An International Journal, Vol 8(2-3),
Apr-Sep 2005. pp. 143-156.
Publisher: United Kingdom: Taylor & Francis
Abstract: Runaway/homeless youth often suffer from exposure to
chronic family distress and confront numerous traumatic events that may
produce symptoms of PTSD. This study evaluated runaway/homeless youth's
PTSD symptoms and associated factors. Data were collected at youth
emergency shelters. Ninety-eight percent of participants had elevated
PTSD symptom scores. Although use of inhalants and LSD was associated
with PTSD symptoms, only depression, anxiety, and dissociation, mother's
ecstasy or LSD use, youth's worry about family relationships, and poor
family communication predicted higher PTSD scores. Runaway/homeless
youth entering emergency shelters services must be evaluated concerning
trauma and associated comorbid symptoms.
_____
Title: Subthreshold PTSD: A Comparison of Alcohol, Depression, and
Health Problems in Canadian Peacekeepers with Different Levels of
Traumatic Stress.
Author(s): Yarvis, Jeffrey S., University of Georgia, Athens, GA,
US
Bordnick, Patrick S., University of Georgia, Athens, GA, US
Spivey, Christina A., University of Georgia, Athens, GA, US
Pedlar, David, Veterans Affairs Canada, Charlottetown, Canada
Address: Yarvis, Jeffrey S., CMR 442, Box 726, APO AE, US
Source: Stress, Trauma and Crisis: An International Journal, Vol 8(2-3),
Apr-Sep 2005. pp. 195-213.
Publisher: United Kingdom: Taylor & Francis
Abstract: Posttraumatic stress disorder (PTSD) is associated with
depression, alcohol use disorders and physical health problems.
Subthreshold posttraumatic syndromes may contribute to these problems.
Participants were previously deployed male peacekeepers who completed a
battery of questionnaires, including measures of PTSD symptoms,
depression, alcohol use, and physical health. Statistically significant
differences were found 1) between groups with full and no PTSD on
depressive symptoms, alcohol use disorders, and physical health
problems, and 2) between Subthreshold and no PTSD groups on depression
and physical health problems. Results suggest Subthreshold PTSD
represents a distinct construct warranting further investigation.
_____
Title: Connectedness Through Time and Space, Mind and Heart.
Author(s): Lewis, Sheldon, (Ed), Advances in Mind-Body Medicine,
InnerDoorway, LLC, New York, NY, US, editor@advancesjournal.com
Address: Lewis, Sheldon, Advances in Mind-Body Medicine,
InnerDoorway, LLC, 1560 Broadway, Suite 813, New York, NY, US,
editor@advancesjournal.com
Source: Advances in Mind-Body Medicine, Vol 21(1), Spr 2005. pp. 3.
Publisher: US: InnoVision Communications
Abstract: People around the world identified with those who
suffered loss of life, family, and property in the recent tsunami in the
Indian Ocean. Through the wonders of technology and media, and the
efforts of philanthropic and relief organizations, we experience our
connectedness with others around the globe. This sense of connectedness,
intrinsic to human life, is an important factor in healing, argues an
author in this issue. He advocates a systems approach to understanding
what has been termed "spontaneous or miraculous remission or healing."
He presents an alternative hypothesis that the progression and
resolution of human disease and illness are context- or
system-dependent. Another author engages the issues involved in studying
the use of an ancient spiritual practice as a mind-body therapy. The
variability of meditation practice and the subjectivity of the
meditation experience make it difficult to standardize and quantify the
effects of meditation on health, according to the authors. In the
interview that appears in this issue of Advances, Naparstek sums up the
need for connectivity, not only for those in need of healing from
traumatic events, but also the need for healing in us all.
_____
Title: Is Posttraumatic Stress in Youth a Culture-Bound Phenomenon? A
Comparison of Symptom Trends in Selected US, and Russian Communities.
Author(s): Ruchkin, Vladislav, Yale Child Study Center, New Haven,
CT, US, vladislav.ruchkin@yale.edu
Schwab-Stone, Mary
Jones, Stephanie
Cicchetti, Domenic V.
Koposov, Roman
Vermeiren, Robert
Address: Ruchkin, Vladislav, Yale Child Study Center, 230 South
Frontage Rd., New Haven, CT, US, vladislav.ruchkin@yale.edu
Source: American Journal of Psychiatry, Vol 162(3), Mar 2005. pp.
538-544.
Publisher: US: American Psychiatric Assn
Abstract: Objective: The cross-cultural applicability of the
concept of posttraumatic stress was investigated by assessing symptom
frequency and levels of comorbid psychopathology in adolescents from the
United States and Russia. Method: A self-report survey was conducted in
representative samples of 2,157 adolescents 14 to 17 years old from
urban communities of the United States (N = 1,212) and Russia (N=945).
Results: In both countries, the levels of all three major clusters of
posttraumatic symptoms (reexperiencing, avoidance, and arousal), as well
as of internalizing psychopathology, increased along with the level of
posttraumatic stress. Expectations about the future had a tendency to
decrease with increasing posttraumatic stress. No differences between
countries in significant interaction effects for symptom levels were
found. Conclusions: The current findings suggest that posttraumatic
symptoms and their associations with other adolescent mental health
problems are not culture bound and that the psychological consequences
of trauma follow similar dynamics cross-culturally.
_____
Title: The Role of Peritraumatic Dissociation and Gender in the
Association Between Trauma and Mental Health in a Palestinian Community
Sample.
Author(s): Punamäki, Raija-Leena, Department of Psychology,
University of Tampere, Tampere, Finland, raija-leena.punamaki@uta.fi
Komproe, Ivan H.
Qouta, Samir
Elmasri, Mustafa
de Jong, JoopT. V. M.
Address: Punamäki, Raija-Leena, Department of Psychology,
University of Tampere, 33014, Tampere, Finland,
raija-leena.punamaki@uta.fi
Source: American Journal of Psychiatry, Vol 162(3), Mar 2005. pp.
545-551.
Publisher: US: American Psychiatric Assn
Abstract: Objective: This research focused on gender- specific
trauma exposure and mental health symptoms among Palestinians living in
conditions of military violence. It also examined the gender-specific
role of peritraumatic dissociation in moderating the association between
lifetime trauma and mental health. Method: A random sample of 311
Palestinian women and 274 men ages 16-60 years from the Gaza Strip
participated. The subjects were asked about lifetime trauma and
peritraumatic dissociation during their most severe traumatic
experience. Mental health was indicated by total scores and diagnostic
variables of posttraumatic stress disorder (PTSD), anxiety, mood
(depression), and somatization disorders. Symptoms of hostility were
assessed as a total score. Results: The women reported a lower level of
lifetime trauma than the men, but exposure to trauma was associated with
PTSD among both genders. Exposure to lifetime trauma was further
associated with anxiety, mood, and somatoform disorders only among women
but not among men. No gender differences were found in the level of
peritraumatic dissociation. Analyses on moderating effects showed that
peritraumatic dissociation made both men and women more vulnerable to
symptoms of hostility and men to depressive symptoms when they were
exposed to lifetime trauma. Conclusions: The results are consistent with
previous studies in more peaceful conditions: men experience more
traumatic events, whereas exposure is associated with more severe
psychiatric disorders among women. Peritraumatic dissociation as an
acute response to trauma constituted a risk for mental health symptoms
in both genders.
_____
Title: Specialized Inpatient Trauma Treatment for Adults Abused as
Children: A Follow-Up Study.
Author(s): Stalker, Carol A., Homewood Health Centre, Guelph, ON,
Canada
Palmer, Sally E., Homewood Health Centre, Guelph, ON, Canada
Wright, David C., Homewood Health Centre, Guelph, ON, Canada
Gebotys, Robert, Homewood Health Centre, Guelph, ON, Canada
Address: Stalker, Carol A., Faculty of Social Work, Wilfrid
Laurier University, Waterloo, ON, Canada, N2L3C5
Source: American Journal of Psychiatry, Vol 162(3), Mar 2005. pp.
552-559.
Publisher: US: American Psychiatric Assn
Abstract: Objective: The authors investigated outcome at discharge
and at follow-up assessments for adults abused as children who completed
a 6-week inpatient program for traumatic stress recovery. Method:
Participants were assessed at admission, discharge, and 3, 6, and 12
months postdischarge on measures of global symptom severity,
posttraumatic stress disorder (PTSD), and disrupted beliefs. Two
wait-list comparison groups were also assessed at two points in time for
comparison with the discharge and 3- month postdischarge assessments of
the treatment group. Results: Relative to admission, the mean scores on
all outcome measures for the treatment group were improved at discharge
and at 6 and 12 months. Relative to a wait list group, the treatment
group was significantly improved at discharge. After 3 months, the
scores for the treatment group were not different from those of a wait
list group because of deterioration in the treatment group. Age, source
of income, and number of axis II disorders were associated with
differing patterns of PTSD symptom change over time. Between 32% and
45%, depending on outcome measure, met stringent criteria for clinically
significant change at 12 months postdischarge. Conclusions: At discharge
from a specialized inpatient treatment program, adults with a history of
abuse during childhood showed improvement relative to a wait list group.
Scores tended to deteriorate in the 3 months following discharge but
rebounded to discharge levels by 12 months postdischarge. Although many
abused adults benefited from specialized inpatient treatment, a
substantial proportion did not show clinically significant change 1 year
later.
_____
Title: The Science and Controversy of Traumatic Memory.
Author(s): McNally, Richard J., Department of Psychology, Harvard
University, Cambridge, MA, US, rjm@wjh.harvard.edu
Address: McNally, Richard J., Department of Psychology, Harvard
University, 1230 William James Hall, 33 Kirkland Street, Cambridgece,
MA, US, rjm@wjh.harvard.edu
Source: American Journal of Psychology, Vol 118(1), Spr 2005. pp.
152-158.
Publisher: US: Univ of Illinois Press
Reviewed Item: Chris R. Brewin (2003). Posttraumatic Stress Disorder:
Malady or Myth?; New Haven, CT: Yale University Press, 2003. xii + 271
pp.
Abstract: Reviews book Posttraumatic Stress Disorder: Malady or
Myth? by Chris R. Brewin. (see record 2003-07155-000). Posttraumatic
Stress Disorder: Malady or Myth? reflects an attempt to make sense of
the chaos of "traumatology." Brewin is a professor at the University of
London's University College, an internationally renowned experimental
psychopathologist, and a clinical psychologist whose prolific output
includes important contributions to the fields of mood disorders,
cognitive behavior therapy, and PTSD. He is clearly qualified to tackle
the topic of trauma. Brewin's book has many virtues. It is marvelously
written and never dull. He takes pains to present both sides of the
debates he discusses, and he mentions important works on trauma that are
seldom cited by most other mainstream trauma specialists (e.g., Burkett
& Whitley, 1998; Young, 1995). Most importantly, Brewin is firmly
committed to a scientific, data-based approach to resolving
controversies in our field. Brewin provides an updated review of studies
inspired by his dual representation theory of PTSD. According to his
theory, we need to postulate two memory systems to account for the
symptoms of PTSD: a verbally accessible memory (VAM) system and a
situationally accessible memory (SAM) system. Brewin also covers
important work on how trauma can affect self-concept and identity, and
he reviews recent neuroscience work on stress and the brain. He also
includes a solid overview of treatments for PTSD, pointing out the
interventions that either do not work or are harmful and suggesting new
avenues for treating the illness.
_____
Title: A Functional Magnetic Resonance Imaging Study of Amygdala and
Medial Prefrontal Cortex Responses to Overtly Presented Fearful Faces in
Posttraumatic Stress Disorder.
Author(s): Shin, Lisa M., Department of Psychology, Tufts
University, Medford, MA, US, lisa.shin@tufts.edu
Wright, Christopher I., Department of Psychiatry, Massachusetts General
Hospital, US
Cannistraro, Paul A., Department of Psychiatry, Massachusetts General
Hospital, US
Wedig, Michelle M., Department of Psychiatry, Massachusetts General
Hospital, US
McMullin, Katherine, Department of Psychiatry, Massachusetts General
Hospital, US
Martis, Brian, Department of Psychiatry, University of Michigan, Ann
Arbor, MI, US
Macklin, Michael L., Veterans Affairs Research Service, Manchester, NH,
US
Lasko, Natasha B., Department of Psychiatry, Massachusetts General
Hospital, US
Cavanagh, Sarah R., Department of Psychology, Tufts University, Medford,
MA, US
Krangel, Terri S., Department of Psychology, Tufts University, Medford,
MA, US
Orr, Scott P., Department of Psychiatry, Massachusetts General Hospital,
US
Pitman, Roger K., Department of Psychiatry, Massachusetts General
Hospital, US
Whalen, Paul J., Department of Psychiatry, University of Wisconsin,
Madison, WI, US
Rauch, Scott L., Department of Psychiatry, Massachusetts General
Hospital, US
Address: Shin, Lisa M., Department of Psychology, Tufts
University, 490 Boston Ave, Medford, MA, US, isa.shin@tufts.edu
Source: Archives of General Psychiatry, Vol 62(3), Mar 2005. pp.
273-281.
Publisher: US: American Medical Assn
Abstract: Background: Previous functional neuroimaging studies
have demonstrated exaggerated amygdala responses and diminished medial
prefrontal cortex responses during the symptomatic state in
posttraumatic stress disorder (PTSD). Objectives: To determine whether
these abnormalities also occur in response to overtly presented
affective stimuli unrelated to trauma; to examine the functional
relationship between the amygdala and medial prefrontal cortex and their
relationship to PTSD symptom severity in response to these stimuli; and
to determine whether responsivity of these regions habituates normally
across repeated stimulus presentations in PTSD. Design: Case-control
study. Setting: Academic medical center. X Participants: Volunteer
sample of 13 men with PTSD (PTSD group) and 13 trauma-exposed men
without PTSD (control group). Main Outcome Measures: We used functional
magnetic resonance imaging (fMRI) to study blood oxygenation
level-dependent signal during the presentation of emotional facial
expressions. Results: The PTSD group exhibited exaggerated amygdala
responses and diminished medial prefrontal cortex responses to fearful
vs happy facial expressions. In addition, in the PTSD group, blood
oxygenation level-dependent signal changes in the amygdala were
negatively correlated with signal changes in the medial prefrontal
cortex, and symptom severity was negatively related to blood oxygenation
level-dependent signal changes in the medial prefrontal cortex. Finally,
relative to the control group, the PTSD group tended to exhibit
diminished habituation of fearful vs happy responses in the right
amygdala across functional runs, although this effect did not exceed our
a priori statistical threshold. Conclusions: These results provide
evidence for exaggerated amygdala responsivity, diminished medial
prefrontal cortex responsivity, and a reciprocal relationship between
these 2 regions during passive viewing of overtly presented affective
stimuli unrelated to trauma in PTSD.
_____
Title: Heart Rate and Posttraumatic Stress in Injured Children.
Author(s): Kassam-Adams, Nancy, TraumaLink: The Pediatric
Interdisciplinary Injury Control Research Center, Children's Hospital of
Philadelphia, Philadelphia, PA, US, nlkaphd@mail.med.upenn.edu
Garcia-España, J. Felipe, TraumaLink: The Pediatric Interdisciplinary
Injury Control Research Center, Children's Hospital of Philadelphia,
Philadelphia, PA, US
Fein, Joel A., TraumaLink: The Pediatric Interdisciplinary Injury
Control Research Center, Children's Hospital of Philadelphia,
Philadelphia, PA, US
Winston, Flaura Koplin, TraumaLink: The Pediatric Interdisciplinary
Injury Control Research Center, Children's Hospital of Philadelphia,
Philadelphia, PA, US
Address: Kassam-Adams, Nancy, Children's Hospital of
Philadelphia, Trauma-Link 3535, 10th floor, 34th Street and Civic Center
Boulevard, Philadelphia, PA, US, nlkaphd@mail.med.upenn.edu
Source: Archives of General Psychiatry, Vol 62(3), Mar 2005. pp.
335-340.
Publisher: US: American Medical Assn
Abstract: Background: Elevated, acute heart rate has been related
to later posttraumatic stress disorder (PTSD) development in injured
adults, but this has not been examined in children and adolescents.
Better understanding of the relationship between acute physiological
arousal and later child PTSD could help elucidate the etiology of
posttrauma responses in children and might identify useful markers for
PTSD risk. Objective: To evaluate the relationship between heart rate
assessed in the emergency department (ED) during normal clinical care
and later PTSD outcome in traumatically injured children. Design:
Prospective cohort study assessed heart rate at ED triage and PTSD an
average of 6 months' postinjury. Setting: Large, urban pediatric
academic medical center in the northeastern United States. Participants:
One hundred ninety children and adolescents (aged 8-17 years)
hospitalized for traffic-related injury. Main Outcome Measure:
Clinician-Administered PTSD Scale for Children and Adolescents. Results:
The group of children who developed partial or full PTSD had a higher
mean ± SD heart rate at ED triage than those who did not go on to have
PTSD (109.6±22.3 vs 99.7± 18.0 beats per minute). Children with an
elevated heart rate (defined as ≥2 SDs higher than the normal resting
heart rate for their age and sex) at ED triage were more likely to meet
criteria for partial or full PTSD at follow-up, even after adjusting for
age, sex, and injury (adjusted odds ratio, 2.4 [95% confidence interval,
1.1-5.4]). Conclusion: These results suggest an association between
early physiological arousal and the development or persistence of PTSD
symptoms in injured children and point to the importance of better
understanding the interplay between physiological and psychological
functioning after a traumatic stressor.
_____
Title: Psychological Aspects of Terror and Witnessing.
Author(s): Ihanus, Juhani, Department of Psychology, University of
Helsinki, Helsinki, Finland
Address: Ihanus, Juhani, Department of Psychology, University of
Helsinki, P.O. Box 9, FI-00014, Helsinki, Finland
Source: Journal of Psychohistory, Vol 32(3), Win 2005. pp. 268-277.
Publisher: US: Assn for Psychohistory
Abstract: Terror, war, nuclear and environmental catastrophes and
other disasters overwhelm the human mind with burdens that are basically
very hard or even impossible to carry. The human mind and its psychic
processing cannot understand or accept the state of total non-existence,
the loss of the self, of others and of the whole world. Against such
threats of annihilation and feelings of utter helplessness we build up
competence: survival fantasies and images of wealth, abundance,
omniscience and omnipotence. The possibility of limitless destruction is
replaced by apparently more manageable technocalculations, heroic
survival strategies, ideological refuge, messianistic cults, millenary
dreams, and insistence on limited numbers of casualties. The
psychological effects of terror, concentration camps, war and nuclear
disasters tear off our normal psychological protection, resulting in
psychic numbing, the denial of reality, identification with the
aggressor, shame, guilt, aimlessness, apathy and antisocial behavior.
Posttraumatic disruptions also include--at both conscious and
unconscious levels--the sense of not being really alive, the phobic
anticipation of another traumatic disaster, repeated agonies,
self-doubts and aversions.
_____
Title: Health Service Use Predictors Among Trauma Survivors: A Critical
Review.
Author(s): Elhai, Jon D., Disaster Mental Health Institute,
University of South Dakota, Vermillion, SD, US, jonelhai@hotmail.com
North, Terry C., Mental Health Service, Omaha Veterans Affairs Medical
Center, Omaha, NE, US
Frueh, B. Christopher, Mental Health Service, Charleston Veterans
Affairs Medical Center, Charleston, SC, US
Address: Elhai, Jon D., Disaster Mental Health Institute,
University of South Dakota, 414 East Clark Street-SDU 114, Vermillion,
SD, US, jonelhai@hotmail.com
Source: Psychological Services, Vol 2(1), Win-Spr 2005. pp. 3-19.
Publisher: US: Educational Publishing Foundation
Abstract: This article had 2 aims: (a) to comprehensively review
and synthesize the literature on predictors of health service
utilization in survivors of traumatic events and posttraumatic stress
disorder (PTSD) patients and (b) to discuss methodological issues in
examining service utilization in this population. PsycINFO was searched
for relevant articles published through April 2004. Included studies had
to primarily sample trauma survivors or PTSD patients and statistically
explore health service use determinants. Although some findings
conflicted across studies, increased mental health service use was
generally related to being female, having a previous trauma history, and
having a PTSD diagnosis. Increased medical service use was found among
those with a PTSD diagnosis. Methodological recommendations are made for
future health service use studies.
_____
Title: Personality Assessment Inventory (PAI) Profiles of Male Veterans
With Combat-Related Posttraumatic Stress Disorder.
Author(s): Mozley, Susannah L., Boston VA Healthcare System, Boston
University School of Medicine, Boston, MA, US,
susannah.mozley2@med.va.gov
Miller, Mark W., Boston VA Healthcare System, Boston University School
of Medicine, Boston, MA, US
Weathers, Frank W., Auburn University, Auburn, AL, US
Beckham, Jean C., Durham, NC VA Medical Center, Duke University Medical
Center, Durham, NC, US
Feldman, Michelle E., Durham, NC VA Medical Center, Durham, NC, US
Address: Mozley, Susannah L., Boston VA Healthcare System, Boston
University School of Medicine, Boston, MA, US,
susannah.mozley2@med.va.gov
Source: Journal of Psychopathology & Behavioral Assessment, Vol 27(3),
Sep 2005. pp. 179-189.
Publisher: Germany: Springer
Abstract: The Personality Assessment Inventory (PAI; L. C. Morey,
1991) is a promising tool for the assessment of Posttraumatic Stress
Disorder (PTSD), but few studies have examined the PAI profiles of
individuals with the diagnosis. In this study, the PAI was administered
to 176 combat veterans with PTSD. Results showed significant elevations
on scales measuring depression, somatic complaints, anxiety,
anxiety-related disorders, schizophrenia, and negative impression
management. The Traumatic Stress subscale was the highest point in the
mean score profile and was moderately correlated with several
established measures of PTSD. Veterans with and without comorbid major
depression differed on PAI scales assessing depression, anxiety, and
warmth. Analysis of two-point codetypes for the PAI and the MMPI-2
revealed substantial heterogeneity in symptom endorsement on both
instruments, suggesting that there may be no clear PTSD profile on
either instrument. Results provide a reference point for future work
with the PAI in PTSD samples.
_____
Title: Group crisis intervention for children during ongoing war
conflict.
Author(s): Thabet, Abdel Aziz, Al Quds University, School of Public
Health, Gaza, Palestine
Vostanis, Panos, Greenwood Institute of Child Health, Leicester, United
Kingdom, pv11@le.ac.uk
Karim, Khalid, Greenwood Institute of Child Health, Leicester, United
Kingdom
Address: Vostanis, Panos, Greenwood Institute of Child Health,
Westcotes House, Westcotes Drive, Leicester, United Kingdom, LE3 OQU,
pv11@le.ac.uk
Source: European Child & Adolescent Psychiatry, Vol 14(5), Aug 2005. pp.
262-269.
Publisher: Germany: Springer
Abstract: The aim of this study was to evaluate the short-term
impact of a group crisis intervention for children aged 9-15 years from
five refugee camps in the Gaza Strip during ongoing war conflict.
Children were selected if they reported moderate to severe posttraumatic
stress reactions, and were allocated to group intervention (N = 47)
encouraging expression of experiences and emotions through storytelling,
drawing, free play and role-play; education about symptoms (N = 22); or
no intervention (N = 42). Children completed the CPTSD-RI and the CDI
pre-and post-intervention. No significant impact of the group
intervention was established on children's posttraumatic or depressive
symptoms. Possible explanations of the findings are discussed, including
the continuing exposure to trauma and the non-active nature of the
intervention.
_____
Title: Post-traumatic stress disorder among recently diagnosed patients
with HIV/AIDS in South Africa.
Author(s): Olley, B. O., MRC Unit on Anxiety Disorders, Department
of Psychiatry, University of Stellenbosch, Cape Town, South Africa
Zeier, M. D., Infectious Disease Clinic, Department of Internal
Medicine, Tygerberg Hospital, Cape Town, South Africa
Seedat, S., MRC Unit on Anxiety Disorders, Department of Psychiatry,
University of Stellenbosch, Cape Town, South Africa, sseedat@sun.ac.za
Stein, D. J., MRC Unit on Anxiety Disorders, Department of Psychiatry,
University of Stellenbosch, Cape Town, South Africa
Address: Seedat, S., MRC Unit on Anxiety Disorders, Department of
Psychiatry, University of Stellenbosch, PO Box 19063, Tygerberg, 7505,
Cape Town, South Africa, sseedat@sun.ac.za
Source: AIDS Care, Vol 17(5), Jul 2005. pp. 550-557.
Publisher: United Kingdom: Taylor & Francis
Abstract: This study examined the prevalence of and factors
associated with post-traumatic stress disorder in recently diagnosed
HIV/AIDS patients in South Africa. One hundred and forty-nine (44 male,
105 female) recently diagnosed HIV/AIDS patients (mean duration since
diagnosis = 5.8 months, SD = 4.1) were evaluated. Subjects were assessed
using the MINI International Neuropsychiatric Interview (MINI), the
Carver Brief COPE coping scale and the Sheehan Disability Scale. In
addition, previous exposures to trauma and past risk behaviours were
assessed. Twenty-two patients (14.8%) met criteria for PTSD. Current
psychiatric conditions more likely to be associated with PTSD included
major depressive disorder (29% in PTSD patients versus 7% in non-PTSD
patients, p = 0.004), suicidality (54% versus 11%, p = 0.001) and social
anxiety disorder (40% versus 13%, p = 0.04). Further patients with PTSD
reported significantly more work impairment and demonstrated a trend
towards higher usage of alcohol as a means of coping. Discriminant
function analysis indicated that female gender and a history of sexual
violation in the past year were significantly associated with a
diagnosis of PTSD. Patients whose PTSD was a direct result of an
HIV/AIDS diagnosis (8/22) did not differ from other patients with PTSD
on demographic or clinical features. In the South African context, PTSD
is not an uncommon disorder in patients with HIV/AIDS. In some cases,
PTSD is secondary to the diagnosis of HIV/AIDS but in most cases it is
seen after other traumas, with sexual violation and intimate partner
violence in women being particularly important.
_____
Title: Acceptance and Commitment Therapy in the Treatment of Comorbid
Substance Abuse and Post-Traumatic Stress Disorder: A Case Study.
Author(s): Batten, Sonja V., Trauma Recovery Program, VA Maryland
Health Care System, Baltimore, MD, US, svbatten@earthlink.net
Hayes, Steven C., Department of Psychology, University of Nevada, NV, US
Address: Batten, Sonja V., Trauma Recovery Programs (116B), VA
Maryland Health Care System, 10 N. Greene St., Baltimore, MD, US,
svbatten@earthlink.net
Source: Clinical Case Studies, Vol 4(3), Jul 2005. pp. 246-262.
Publisher: US: Sage Publications
Abstract: Although post-traumatic stress disorder (PTSD) and
substance abuse are commonly co-occuring conditions, it is generally
recommended that an individual must first receive successful substance
abuse treatment before posttraumatic symptoms can be addressed. Given
the high comorbidity of these conditions, however, it would be helpful
if more broadly focused therapies were available that simultaneously
targeted common functional processes underlying the multiple problems of
the dually diagnosed. Both PTSD and substance abuse can be
conceptualized as disorders with significant experiential avoidance
components. One treatment that has been specifically developed for the
treatment of experiential avoidance is Acceptance and Commitment Therapy
(ACT). In this case study, application of ACT for an individual with
comorbid PTSD and substance abuse is described, and its effects are
examined.
_____
Title: Is Post-Traumatic Stress Disorder a helpful concept for adults
with intellectual disability?
Author(s): Mitchell, A., Sheffield Care Trust, Sheffield, United
Kingdom
Clegg, Jennifer, University of Nottingham, Nottingham, United Kingdom,
Jennifer.Clegg@Nottingham.ac.uk
Address: Clegg, Jennifer, Clinical Psychology, ADRU, University
Hospital, B Floor, Nottingham, United Kingdom, NG7 2UH,
Jennifer.Clegg@Nottingham.ac.uk
Source: Journal of Intellectual Disability Research, Vol 49(7), Jul
2005. pp. 552-559.
Publisher: United Kingdom: Blackwell Publishing
Abstract: Background: Research using the concept of Post-Traumatic
Stress Disorder (PTSD) with adults with intellectual disability (ID)
assumes they perceive and react to traumatic events in a similar way to
nondisabled adults. Reactions to trauma displayed by children may be
relevant to adults with ID as well. Methods: Two focus groups were held
with professionals and practitioners to explore the relevance of
criteria from child as well as adult literature to adults with ID who
experience trauma. Descriptive thematic analysis was carried out.
Results: Abuse, parental bereavement, and having children removed were
considered common sources of trauma. Similarities identified between
disabled and non-disabled adults were flashbacks and nightmares;
distressed by reminders; avoidance; hypervigilance and increased
arousal. Differences were the frequent occurrence of multiple rather
than single events, which were considered significant in generating
chronic problems similar to those described as PTSD; also the occurrence
of physical health problems and behavioural re-enactments. Discussion
and Conclusions: Experienced professionals and practitioners considered
most of the ideas from PTSD research with non-disabled adults to be
relevant to adults with ID who experience trauma, but that some
behaviour reported in research with children was also relevant. Topics
and questions for use in clinical and research practice with individuals
who have experienced trauma were proposed.
_____
Title: Trauma, PTSD, and Resilience: A Review of the Literature.
Author(s): Agaibi, Christine E., University of Akron, Akron, OH, US
Wilson, John P., Cleveland State University, Cleveland, OH, US
Source: Trauma, Violence, & Abuse, Vol 6(3), Jul 2005. pp. 195-216.
Publisher: US: Sage Publications
Abstract: Based on the available literature, this review article
investigates the issue of resilience in relation to trauma and
posttraumatic stress disorder. Resilient coping to extreme stress and
trauma is a multifaceted phenomena characterized as a complex repertoire
of behavioral tendencies. An integrative Person × Situation model is
developed based on the literature that specifies the nature of
interactions among five classes of variables: (a) personality, (b)
affect regulation, (c) coping, (d) ego defenses, and (e) the utilization
and mobilization of protective factors and resources to aid coping.
_____
Title: Enhanced Cortisol Suppression Following Dexamethasone
Administration in Domestic Violence Survivors.
Author(s): Griffin, Michael G., Department of Psychology, Center
for Trauma Recovery, University of Missouri-St. Louis, St. Louis, MO,
US, michael_griffin@umsl.edu
Resick, Patricia A.
Yehuda, Rachel
Address: Griffin, Michael G., University of Missouri-St. Louis,
Center for Trauma Recovery, Kathy J. Weinman Bldg., 8001 Natural Bridge
Rd., St. Louis, MO, US, michael_griffin@umsl.edu
Source: American Journal of Psychiatry, Vol 162(6), Jun 2005. pp.
1192-1199.
Publisher: US: American Psychiatric Assn
Abstract: Objective: The authors compared responses of female
domestic violence survivors and a matched group of nontraumatized
participants to a low-dose (0.5 mg) dexamethasone suppression test
(DST). Method: Seventy female domestic violence survivors and 14
nontraumatized women matched for age and race were recruited.
Participants were assessed for trauma severity, severity of PTSD and
depressive symptoms, and DST cortisol response. Of the domestic violence
survivors who were DST-compliant, comparisons were made among those with
PTSD (N=15), those with PTSD plus depression (N=27), and those with no
PTSD or depression diagnosis (N=8) along with the nontraumatized
comparison subjects (N=14). Results: Domestic violence survivors with
PTSD, regardless of whether or not they had comorbid depression, had
significantly lower baseline cortisol levels at 9:00 a.m. than the
healthy subjects and trauma survivors with no diagnosis. Survivors with
a sole diagnosis of PTSD showed significantly greater cortisol
suppression to dexamethasone than did healthy subjects or the group
diagnosed with PTSD plus depression. Conclusions: These findings agree
with previous studies showing hypothalamicpituitary-adrenal (HPA) axis
abnormalities in PTSD. The findings suggest that the chronic nature of
domestic violence leads to a severe dysregulation of the HPA axis.
_____
Title: Utility of the Trauma Symptom Inventory's Atypical Response
Scale in Detecting Malingered Post-Traumatic Stress Disorder.
Author(s): Elhai, Jon D., Disaster Mental Health Institute,
University of South Dakota, Vermillion, SD, US, jonelhai@hotmail.com
Gray, Matthew J., University of Wyoming, Laramie, WY, US
Naifeh, James A., Disaster Mental Health Institute, University of South
Dakota, Vermillion, SD, US
Butcher, Jimmie J., Clinical Psychology Training Program, Disaster
Mental Health Institute, University of South Dakota, Vermillion, SD, US
Davis, Joanne L., University of Tulsa, Tulsa, OK, US
Falsetti, Sherry A., Department of Family and Community Medicine,
University of Illinois College of Medicine, Rockford, IL, US
Best, Connie L., National Crime Victims Research and Treatment Center,
Medical University of South Carolina, Charleston, SC, US
Address: Elhai, Jon D., Disaster Mental Health Institute,
University of South Dakota, 414 East Clark Street-SDU 114, Vermillion,
SD, US, jelhai@usd.edu
Source: Assessment, Vol 12(2), Jun 2005. pp. 210-219.
Publisher: US: Sage Publications
Abstract: The authors examined the Trauma Symptom Inventory's
(TSI) ability to discriminate 88 student post-traumatic stress disorder
(PTSD) simulators screened for genuine PTSD from 48 clinical
PTSD-diagnosed outpatients. Results demonstrated between-group
differences on several TSI clinical scales and the Atypical Response
(ATR) validity scale. Discriminant function analysis using ATR revealed
75% correct patient classification but only 48% correct simulator
classification, with an overall correct classification rate of 59%
(positive predictive power [PPP] = .71; negative predictive power [NPP]
= .51). Individual ATR cutoff scores did not yield impressive
classification results, with the optimal cutoff (T score = 61) correctly
classifying only 61% of simulators and patients (PPP = .66, NPP = .54).
Although ATR was not developed as a malingered PTSD screen, instead
serving as a general validity screen, caution is recommended in its
current clinical use for detecting malingered PTSD.
Conference: Annual meeting of the International Society for
Traumatic Stress Studies, 20th, Nov, 2004, New Orleans, LA, US
Conference Notes: Portions of this article were presented at the
aforementioned conference.
_____
Title: A Longitudinal Study of Retirement in Older Male Veterans.
Author(s): Schnurr, Paula P., Veterans Affairs Medical Center,
National Center for Posttraumatic Stress Disorder, White River Junction,
VT, US, paula.schnurr@dartmouth.edu
Lunney, Carole A., Veterans Affairs Medical Center, National Center for
Posttraumatic Stress, White River Junction, VT, US
Sengupta, Anjana, Veterans Affairs Medical Center, National Center for
Posttraumatic Stress, White River Junction, VT, US
Spiro, Avron III, Boston Veterans Affairs Health Care System, Boston,
MA, US
Address: Schnurr, Paula P., National Center for Posttraumatic
Stress Disorder, Veterans Affairs Medical Center, (116D), White River
Junction, VT, US, paula.schnurr@dartmouth.edu
Source: Journal of Consulting and Clinical Psychology, Vol 73(3), Jun
2005. pp. 561-566.
Publisher: US: American Psychological Assn
Abstract: In this study, the authors examined the effect of
retirement on psychological and physical symptoms in 404 older male
veterans who were taking part in an ongoing longitudinal study.
Hierarchical linear modeling was used to analyze symptom trajectories
from preretirement, peri-retirement, and postretirement periods in
veterans with either lifetime full or partial posttraumatic stress
disorder (PTSD), trauma exposure only, or no traumatic exposure. As
expected, the PTSD group experienced greater increases in psychological
and physical symptoms during retirement, relative to the other groups.
Retirement due to poor health in the PTSD group did not account for the
findings regarding physical symptoms. Results indicate that clinicians
should recognize and address the potential for older individuals with
PTSD to experience difficulties during retirement.
Conference: Annual Meeting of the International Society for
Traumatic Stress Studies, Nov, 2004, New Orleans, LA, US
Conference Notes: This article was presented at the aforementioned
meeting.
_____
Title: Secondary Traumatization in Partners and Parents of Dutch
Peacekeeping Soldiers.
Author(s): Dirkzwager, Anja J. E., Department of Medical
Psychology, VU University Medical Center, Amsterdam, Netherlands,
anja_dirkzwager@hotmail.com
Bramsen, Inge, Department of Medical Psychology, VU University Medical
Center, Amsterdam, Netherlands
Adèr, Herman, Department of Clinical Epidemiology and Biostatistics, VU
University Medical Center, Amsterdam, Netherlands
van der Ploeg, Henk M., Department of Medical Psychology, VU University
Medical Center, Amsterdam, Netherlands
Address: Dirkzwager, Anja J. E., Department of Medical
Psychology, VU University Medical Center, Van Der Boechorststraat 7,
1081 BT, Amsterdam, Netherlands, anja_dirkzwager@hotmail.com
Source: Journal of Family Psychology, Vol 19(2), Jun 2005. pp. 217-226.
Publisher: US: American Psychological Assn
Abstract: This study examines secondary traumatization among 708
partners and 332 parents of Dutch peacekeepers (i.e., personnel who
participated in military actions implemented by international
organizations such as the United Nations). Partners or parents of
peacekeepers with 4 levels of posttraumatic stress symptoms were
compared on posttraumatic stress, health problems, the quality of the
marital relationship, and social support. In comparison with partners of
peacekeepers without posttraumatic stress disorder (PTSD) symptoms,
partners of peacekeepers with PTSD symptoms reported more sleeping and
somatic problems, reported more negative social support, and judged the
marital relationship as less favorable. No significant differences were
found for parents. Thus, peacekeepers' stress reactions were related to
various problems of their partners. A systemic approach to the treatment
of persons with PTSD appears appropriate.
_____
Title: Strangers at Home: Comment on Dirkzwager, Bramsen, Adèr, and van
der Ploeg (2005).
Author(s): Figley, Charles R., Traumatology Institute, Florida
State University, Tallahassee, FL, US, cfigley@fsu.edu
Address: Figley, Charles R., Traumatology Institute, Florida
State University, 1564 Keily Run, Tallahassee, FL, US, cfigley@fsu.edu
Source: Journal of Family Psychology, Vol 19(2), Jun 2005. pp. 227-229.
Publisher: US: American Psychological Assn
Abstract: This comment summarizes the findings of the article by
A. J. E. Dirkzwager, I. Bramsen, H. Adèr, and H. M. van der Ploeg (2005;
see record 2005-06518-006) and notes that it can serve as a reawakening
about the immediate and long-term psychosocial consequences of war, not
only for those troops who are deployed but also for the loved ones who
await their return. The lessons learned once again--that the mental
health of the returning peacekeeper parallels that of his or her
partner, that partners of traumatized soldiers report more posttraumatic
stress disorder symptoms, somatic and sleep problems, negative social
support, and low marital morale than partners of nontraumatized
soldiers--are consistent with systemic traumatology theory. This comment
traces the historical and theoretical foundations that underlie the
concept of secondary trauma (i.e., compassion fatigue) and discusses the
implications for family psychology practice in helping veterans and
their families recover from their ordeals.
_____
Title: Families at Risk: Comment on Dirkzwager, Bramsen, Adèr, and van
der Ploeg (2005).
Author(s): Fairbank, John A., University of California, Los
Angeles-Duke University National Center for Child Traumatic Stress,
Department of Psychiatry and Behavioral Sciences, Duke University
Medical Center, Durham, NC, US, jaf@psych.duhs.duke.edu
Fairbank, Doreen W., Department of Psychology, Meredith College,
Raleigh, NC, US
Address: Fairbank, John A., UCLA-Duke University National Center
for Child Traumatic Stress, Department of Psychiatry and Behavioral
Sciences, Duke University Medical Center, DUMC Box 3438, Durham, NC, US,
jaf@psych.duhs.duke.edu
Source: Journal of Family Psychology, Vol 19(2), Jun 2005. pp. 230-232.
Publisher: US: American Psychological Assn
Abstract: New findings from a study by A. J. E. Dirkzwager, I.
Bramsen, H. Adèr, and H. M. van der Ploeg (2005; see record
2005-06518-006) provide important empirical information on the adverse
psychological and functional adjustment of families of former Dutch
peacekeepers suffering from posttraumatic stress disorder (PTSD). In
this comment the authors consider a few methodological limitations and
issues for future study, including the need for intergenerational
studies of the legacy of peacekeeping-related PTSD. Attention to
considering the treatment needs of families of traumatized former
peacekeepers is encouraged.
_____
Title: When Family Members Go To War--A Systemic Perspective on Harm
and Healing: Comment on Dirkzwager, Bramsen, Adèr, and van der Ploeg
(2005).
Author(s): Fals-Stewart, William, RTI International, Research
Triangle Park, NC, US, wstewart@rti.org
Kelley, Michelle, Department of Psychology, Old Dominion University,
Norfolk, VA, US
Address: Fals-Stewart, William, 3040 Cornwallis Road, Research
Triangle Park, NC, US, wstewart@rti.org
Source: Journal of Family Psychology, Vol 19(2), Jun 2005. pp. 233-236.
Publisher: US: American Psychological Assn
Abstract: The article by A. J. E. Dirkzwager, I. Bramsen, H. Adèr,
and H. M. van der Ploeg (2005; see record 2005-06518-006) provides
compelling evidence of trauma transmission of posttraumatic stress
symptoms (PTSS) from male peacekeepers to their female partners. Given
the rise in troop deployment throughout the globe and increased exposure
of soldiers to combat violence, the investigation is highly relevant,
important and timely, illustrating the broad systemic emotional toll on
couples when partners go to war. The purpose of this comment is to
recommend future research directions (a) to reveal the characteristics
of those individuals, couples, and family members that may be predictive
of vulnerability and resiliency to PTSS and its sequelae; (b) to
understand the interrelationship of PTSS and secondary trauma,
relationship adjustment, and social support; and (c) to develop and test
intervention methods that may be effective in reducing PTSS and other
psychosocial problems among peacekeepers, their partners, and other
family members.
_____
Title: A Comparison of Adolescent Inpatients With and Without a History
of Violence Perpetration: Impulsivity, PTSD, and Violence Risk.
Author(s): Fehon, Dwain C., Department of Psychiatry, Yale
University School of Medicine, New Haven, CT, US
Grilo, Carlos M., Department of Psychiatry, Yale University School of
Medicine, New Haven, CT, US
Lipschitz, Deborah S., Department of Psychiatry, Yale University School
of Medicine, New Haven, CT, US
Address: Fehon, Dwain C., Yale-New Haven Psychiatric Hospital,
184 Liberty Street, New Haven, CT, US
Source: Journal of Nervous & Mental Disease, Vol 193(6), Jun 2005. pp.
405-411.
Publisher: US: Lippincott Williams & Wilkins
Abstract: How childhood maltreatment and violence victimization
contributes to subsequent violent behavior remains an understudied area.
We examined 130 psychiatrically hospitalized adolescents and compared
those with a history of perpetrating violence to those without a history
of violence perpetration. Perpetrators of physical violence were
significantly more likely to have been a victim and/or witness to family
and community violence and also reported significantly higher levels of
a broad range of psychopathology than nonperpetrators. Correlational
analyses with the study group of violence perpetrators revealed that
higher levels of impulsivity, dissociation, and PTSD were significantly
associated with higher levels of violence. Furthermore, multiple
regression analysis showed that symptoms of impulsivity and PTSD
contributed significantly to the prediction of violence risk. Our
findings demonstrate that violence exposure and childhood maltreatment
are indeed common negative life events among adolescent inpatients, and
that symptoms of PTSD may predispose traumatized youth toward impulsive
violent behavior.
_____
Title: A survey of PTSD screening and referral practices in VA
addiction treatment programs.
Author(s): Young, Helena E., National Center for PTSD, VA Palo Alto
Health Care System, Menlo Park, CA, US, helena.young@med.va.gov
Rosen, Craig S., National Center for PTSD, VA Palo Alto Health Care
System, Menlo Park, CA, US
Finney, John W., VA Sierra-Pacific Mental Illness Research Education and
Clinical Center, Palo Alto, CA, US
Address: Young, Helena E., National Center for PTSD, VA Palo Alto
Health Care System, Menlo Park, CA, US, helena.young@med.va.gov
Source: Journal of Substance Abuse Treatment, Vol 28(4), Jun 2005. pp.
313-319.
Publisher: Netherlands: Elsevier Science
Abstract: Veterans with posttraumatic stress disorder (PTSD) and
substance use disorders (SUDs) demonstrate worse outcomes following
treatment for SUDs than do veterans with SUDs only, and so PTSD
treatment may enhance SUD outcomes for patients. A survey of current
practice patterns in VA SUD treatment programs was undertaken to
determine their concurrence with emerging practice guidelines for the
assessment and treatment of SUD-PTSD comorbidity. Clinicians in
outpatient SUD clinics and/or inpatient SUD programs were surveyed in
six VA medical centers in 1999 and 2001 (respondents n = 57 and n = 39,
respectively). Although one half to two thirds of clinicians working
with SUD patients routinely screen for trauma exposure and PTSD, few
assessments are systematically conducted using validated measures.
Routine referrals to PTSD specialty and dual-diagnosis programs and to
veterans' centers are made by between 35% and 60% of providers across
inpatient and outpatient settings. Implications for improvement of
clinical outcomes are discussed.
_____
Title: Americans as Survivors.
Author(s): Lifton, Robert Jay, Department of Psychiatry, Harvard
Medical School, Boston, MA, US
Source: New England Journal of Medicine, Vol 352(22), Jun 2005. pp.
2263-2265.
Publisher: US: Massachusetts Medical Society
Abstract: Physicians have always been concerned with how people
survive trauma. Less noted has been the experience of Americans as
survivors of violent collective trauma. We owe this lack of attention to
the relative rarity of large-scale killing and dying on American soil
and to the fact that in wars fought abroad, suffering has usually been
countered by a sense of victorious achievement. All this changed as a
result of the Vietnam War, in which heavy American casualties were
followed by defeat; then the terrorist attacks of September 11, 2001,
which brought large-scale trauma home to Americans; and, now, the war in
Iraq and the anguish and uncertainty associated with it. The collective
psychological responses to these events reverberate throughout our
society--as they would in any society undergoing similar trauma. The
author examines some consistent patterns of psychological trauma in
Americans--a sense of individual and collective fear and vulnerability
and feelings of injured national pride and humiliation.
_____
Title: Posttraumatic obsessive-compulsive disorder: A case series.
Author(s): Sasson, Yehuda, Division of Psychiatry, Chaim Sheba
Medical Center, Tel-Hashomer, Israel
Dekel, Sharon, Division of Psychiatry, Chaim Sheba Medical Center,
Tel-Hashomer, Israel
Nacasch, Nitza, Division of Psychiatry, Chaim Sheba Medical Center,
Tel-Hashomer, Israel
Chopra, Miriam, Division of Psychiatry, Chaim Sheba Medical Center,
Tel-Hashomer, Israel
Zinger, Yaffa, Division of Psychiatry, Chaim Sheba Medical Center,
Tel-Hashomer, Israel
Amital, Daniella, Division of Psychiatry, Chaim Sheba Medical Center,
Tel-Hashomer, Israel
Zohar, Joseph, Division of Psychiatry, Chaim Sheba Medical Center,
Tel-Hashomer, Israel, jzohar@post.tau.ac.il
Address: Zohar, Joseph, Division of Psychiatry, Chaim Sheba
Medical Center, Tel-Hashomer, Israel, 52621, jzohar@post.tau.ac.il
Source: Psychiatry Research, Vol 135(2), Jun 2005. pp. 145-152.
Publisher: Netherlands: Elsevier Science
Abstract: This report documents emerging posttraumatic
obsessive-compulsive disorder in 13 Israeli military veterans diagnosed
with both obsessive-compulsive disorder (OCD) and posttraumatic stress
disorder (PTSD), for whom the onset of OCD was clearly associated with
the trauma. Data presented include four detailed case reports that
delineate relations between symptomatology in the two disorders.
Clinical and theoretical implications of these data are discussed.
_____
Title: Alternatives to Debriefing and Modifications to Cognitive
Behavior Therapy for Posttraumatic Stress Disorder.
Author(s): Belaise, Carlotta, Laboratory of Experimental
Psychotherapy, Department of Psychology, University of Bologna, Bologna,
Italy
Fava, Giovanni A., Laboratory of Experimental Psychotherapy, Department
of Psychology, University of Bologna, Bologna, Italy,
giovanniandrea.fava@unibo.it
Marks, Isaac M., Department of Psychiatry, Imperial College School of
Medicine, United Kingdom
Address: Fava, Giovanni A., Dipartimento di Psicologia,
Universita di Bologna, Viale Berti Pichat, 5, IT-40127, Bologna, Italy,
giovanniandrea.fava@unibo.it
Source: Psychotherapy & Psychosomatics, Vol 74(4), Jun 2005. pp.
212-217.
Publisher: Switzerland: Karger
Abstract: Background: Psychological debriefing uses brief
unsystematic exposure, and is ineffective for posttraumatic stress
symptoms and disorder. Systematic exposure alone and cognitive
restructuring alone are each effective. Other approaches too may be
useful. Methods: The treatment of 3 posttraumatic stress disorder (PTSD)
patients is detailed in which there was no exposure to the main
traumatic event. There was exposure to related cues in case 1, exposure
to related and other cues followed by well-being therapy (WBT) in case 2
and WBT in case 3. Results: The 3 patients improved enduringly,
confirming earlier findings that exposure to the main trauma is not
essential for PTSD to improve. Conclusions: A study is needed of
therapeutic mechanisms in PTSD and of the value of WBT in a randomized
controlled trial.
_____
Title: Delayed Onset of Posttraumatic Stress Disorder Among Male Combat
Veterans: A Case Series.
Author(s): Ruzich, Michelle J., Medical School, Australian National
University, Canberra, ACT, Australia, michelle.ruzich@act.gov.au
Looi, Jeffrey Chee Leong, Medical School, Australian National
University, Canberra, ACT, Australia
Robertson, Michael David, Mayo Healthcare Group, Taree, Australia
Address: Ruzich, Michelle J., Research Centre for the
Neurosciences of Ageing (RESCENA), Older Persons Mental Health (ACT
Health), Calvary Hospital, Level 1, Lewisham Bldg., Bruce, ACT,
Australia, 2617, michelle.ruzich@act.gov.au
Source: American Journal of Geriatric Psychiatry, Vol 13(5), May 2005.
pp. 424-427.
Publisher: US: American Psychiatric Assn
Abstract: Objective: Authors investigated the nature of
delayed-onset posttraumatic stress disorder (PTSD) among combat
veterans. Methods: PTSD, along with cognitive and emotional functioning,
was assessed in a case series of elderly Australian war veterans.
Results: Fifteen elderly male subjects consecutively referred to an
outpatient psychiatric clinic were identified as having PTSD with
significantly delayed onset. In most cases, the onset of PTSD symptoms
was associated with unrelated medical complaints, psychosocial stress,
and/or mild cognitive impairment. Conclusion: Environmental stressors,
coupled with age-related neurodegeneration, may potentially contribute
to the late-life recrudescence or emergence of PTSD symptoms in veterans
exposed to combat-related trauma.
_____
Title: Does Memory of a Traumatic Event Increase the Risk for
Posttraumatic Stress Disorder in Patients With Traumatic Brain Injury? A
Prospective Study.
Author(s): Gil, Sharon
Caspi, Yael
Ben-Ari, Irit Zilberman
Koren, Danny
Klein, Ehud, e_klein@rambam.health.gov.il
Address: Klein, Ehud, Department of Psychiatry, Rambam Medical
Center, P.O. Box 9602, Haifa, Israel, 31096,
e_klein@rambam.health.gov.il
Source: American Journal of Psychiatry, Vol 162(5), May 2005. pp.
963-969.
Publisher: US: American Psychiatric Assn
Publisher URL: http://www.appi.org
ISSN: 0002-953X (Print)
Digital Object Identifier: 10.1176/appi.ajp.162.5.963
Language: English
Keywords: traumatic event memory; prediction; development of
posttraumatic stress disorder; patients with mild traumatic brain injury
Abstract: Objective: The present study examined prospectively the
relationship between memory of the traumatic event and subsequent
development of posttraumatic stress disorder (PTSD). More specifically,
the aims of this study were to 1) investigate the possibility that lack
of memory of the traumatic event might be a protective factor; 2 assess
whether memory of the traumatic event equally affects the three symptom
clusters of PTSD: reexperiencing, avoidance, and hyperarousal; and 3)
explore the predictive value of memory of the traumatic event for the
development of subsequent PTSD in the immediate aftermath of the event.
Method: One hundred twenty subjects with mild traumatic brain injury who
were hospitalized for observation were assessed immediately after the
trauma and followed up 1 week, 3 months, and 6 months later. All
participants underwent psychiatric evaluation and self-assessment of
their memory of the traumatic event. Results: Overall, 17 (14%) of the
participants met full criteria for PTSD at 6 months. Subjects with
memory of the traumatic event were significantly more likely to develop
PTSD than those without memory of the traumatic event; the difference
between the groups resulted primarily from the reexperiencing cluster.
Logistic regression analysis revealed that memory of the traumatic event
within the first 24 hours is a strong predictor of PTSD 6 months after
the event. Conclusions: Our study indicated that memory of a traumatic
event is a strong predictor and a potential risk factor for subsequent
development of PTSD. Future studies are needed to show whether these
findings can be generalized to other traumatic conditions.
_____
Record: 23
Title: Circadian Rhythm of Salivary Cortisol in Holocaust Survivors
With and Without PTSD.
Author(s): Yehuda, Rachel, rachel.yehuda@med.va.gov
Golier, Julia A.
Kaufman, Shira
Address: Yehuda, Rachel, Psychiatry OOMH, Bronx VA Medical
Center, 130 W. Kingsbridge Rd., Bronx, NY, US, rachel.yehuda@med.va.gov
Source: American Journal of Psychiatry, Vol 162(5), May 2005. pp.
998-1000.
Journal URL: http://ajp.psychiatryonline.org/
Publisher: US: American Psychiatric Assn
Publisher URL: http://www.appi.org
ISSN: 0002-953X (Print)
Digital Object Identifier: 10.1176/appi.ajp.162.5.998
Language: English
Keywords: salivary cortisol; circadian rhythms; posttraumatic
stress disorder; geriatric trauma survivors; Holocaust
Abstract: Objective: The authors' goal was to determine whether
cortisol circadian rhythm alterations observed in younger subjects with
posttraumatic stress disorder (PTSD) are also present in geriatric
trauma survivors with PTSD. Method: Salivary cortisol levels were
measured at six intervals from awakening until bedtime in 23 Holocaust
survivors with PTSD, 19 Holocaust survivors without PTSD, and 25
subjects who had not been exposed to the Holocaust. Thirty-three of the
subjects were men, and 34 were women. Results: Cortisol levels were
significantly lower at awakening, at 8:00 a.m., and at 8:00 p.m. in
Holocaust survivors with PTSD than in nonexposed subjects, resulting in
a flatter circadian rhythm, similar to what has been observed in aging
but different from what has been reported in younger subjects with PTSD.
Conclusions: These data provide evidence of differential neuroendocrine
alterations in geriatric PTSD.
_____
Record: 24
Title: Posttraumatic Stress Disorders in Children and Adolescents
Handbook.
Author(s): Ordoña, Truce TG.
Source: American Journal of Psychiatry, Vol 162(5), May 2005. pp.
1035-1036.
Journal URL: http://ajp.psychiatryonline.org/
Publisher: US: American Psychiatric Assn
Publisher URL: http://www.appi.org
Reviewed Item: Raul R. Silva (Ed.) (No Year Given). Posttraumatic
Stress Disorders in Children and Adolescents Handbook; New York, W.W.
Norton & Co., 371 pp., $22.95 (paper)
ISSN: 0002-953X (Print)
Language: English
Keywords: posttraumatic stress disorders; children; adolescents
Abstract: Reviews the book, Posttraumatic Stress Disorders in
Children and Adolescents Handbook. With 28 contributors from New York
City and six from Lebanon, this book's 15 chapters cover every
conceivable nook and cranny of PTSD, a much ignored psychiatric
condition. Topics covered include 1) epidemiology, 2) resiliency and
vulnerability factors, 3) risk factors, 4) legal aspects, 5)
neurobiology, 6 etiology and pathogenesis, 7) clinical findings, 8)
gender differences, 9) intergenerational links between mothers and
children with PTSD spectrum illness, 10) assessment, 11) differential
diagnosis, 12) childhood versus adult PTSD, 13) treatment of children
exposed to trauma, 14) clinical case examples, and 15) PTSD in children
and adolescents following war. The editor shows an uncanny sense of
reverence and irreverence for traditional views of PTSD and, in the
process, gives coherent meaning to the often conflicting and muddled
views of this disorder, which all mental health professionals deal with.
The aggregate impact of this handbook is in shedding light not only on
what makes humans break down but also on what makes humans bounce back.
_____
Record: 25
Title: Early Intervention for Trauma and Traumatic Loss.
Author(s): Herman, Judith L.
Source: American Journal of Psychiatry, Vol 162(5), May 2005. pp.
1036-1037.
Journal URL: http://ajp.psychiatryonline.org/
Publisher: US: American Psychiatric Assn
Publisher URL: http://www.appi.org
Reviewed Item: Brett T. Litz (Ed.) (2004). Early Intervention for
Trauma and Traumatic Loss; New York, Guilford Publications, 2004, 338
pp., $40.00
ISSN: 0002-953X (Print)
Language: English
Keywords: trauma; traumatic loss; early intervention; critical
incident stress debriefing; psychological first aid
Abstract: Reviews the book, Early Intervention for Trauma and
Traumatic Loss (see record 2004-95079-000). The authors offer a critique
of critical incident stress debriefing in the aftermath of traumatic
events. Although this type of group intervention has become an
established practice, even mandatory in many first-responder
organizations, rigorous clinical trials suggest that critical incident
stress debriefing is ineffective for preventing the development of
posttraumatic stress disorder. One problem with interventions such as
critical incident stress debriefing is that most people may neither want
nor need this sort of professional "help." Although extreme distress is
common in the immediate aftermath of a traumatic event, most survivors
will recover spontaneously, with support from the people they know and
trust. Litz recommends a minimally intrusive crisis response called
"psychological first aid": providing information and practical
problem-solving assistance and comforting survivors without pressuring
them to explore the details of the traumatic event. This sensible
approach respects the privacy and resiliency of survivors. The reviewer
notes that individual treatments are the only alternative proposed in
place of the discredited large-group interventions. Participatory models
of intervention that engage members of a traumatized community in
designing their own crisis responses are simply ignored. Despite these
limitations, she feels that this book will be of interest to researchers
and policy makers seeking to develop an evidence-based approach to early
intervention and disaster planning.
_____
Record: 26
Title: Posttraumatic Stress Disorder: Malady or Myth?
Author(s): Denton, Donald D. Jr.
Source: American Journal of Psychiatry, Vol 162(5), May 2005. pp. 1036.
Journal URL: http://ajp.psychiatryonline.org/
Publisher: US: American Psychiatric Assn
Publisher URL: http://www.appi.org
Reviewed Item: Chris R. Brewin (2003). Posttraumatic Stress Disorder:
Malady or Myth?; New Haven, Conn., Yale University Press, 2003, 271 pp.,
$40.00
ISSN: 0002-953X (Print)
Language: English
Keywords: posttraumatic stress disorder; trauma's impact on memory
Abstract: Reviews the book, Posttraumatic Stress Disorder: Malady
or Myth? (see record 2003-07155-000). The reviewer feels that this
volume is well organized, is clearly written, and uses the current
research about trauma's impact on memory. Beginning with an overview of
the clinical and cultural aspects of the disorder, Brewin moves to
detailed discussions of trauma's impact on identity, the puzzling ways
in which trauma is remembered, and the debates around the false memory
syndrome. He outlines the dual task for both survivor and therapist:
addressing the posttrauma intrusive memories and reformulating the
posttrauma identity. The author's distinction between declarative and
nondeclarative forms of memory provides us with a helpful way to
understand how trauma continues to affect a patient's life. Finally,
Brewin presents a three-step schema around which responses to survivors
of large-scale trauma may be implemented. Brewin asks clinicians and
researchers to show "the same flexibility and resourcefulness shown by
survivors" as they provide comfort and counsel to people "suddenly
confronted with the unexpected, the unwanted and the unimaginable."
_____
Record: 27
Title: Pathways to Recurrent Trauma Among Young Black Men: Traumatic
Stress, Substance Use, and the "Code of the Street".
Author(s): Rich, John A., Department of Medicine, Boston University
School of Medicine, Boston, MA, US, jrich@bu.edu
Grey, Courtney M., Department of Medicine, Boston University School of
Medicine, Boston, MA, US
Address: Rich, John A., 1010 Massachusetts Ave, 6th Floor,
Boston, MA, US, jrich@bu.edu
Source: American Journal of Public Health, Vol 95(5), May 2005. pp.
816-824.
Journal URL: http://www.ajph.org
Publisher: US: American Public Health Assn
Publisher URL: http://www.ajph.org
ISSN: 0090-0036 (Print)
1541-0048 (Electronic)
Language: English
Keywords: black men; traumatic stress; recurrent interpersonal
violence; substance use; reinjury; prevention
Abstract: Recurrent interpersonal violence is a major cause of
death and disability among young Black men. Quantitative studies have
uncovered factors associated with reinjury, but little is known about
how these factors work together. We interviewed young Black male victims
to understand their experience of violence. Qualitative analysis of
their narratives revealed how their struggle to reestablish safety
shaped their response to injury. Aspects of the "code of the street"
(including the need for respect) and lack of faith in the police
combined with traumatic stress and substance use to accentuate their
sense of vulnerability. Victims then reacted to protect themselves in
ways that could increase their risk of reinjury. We describe a model
with implications for reducing rates of recurrent violent injuries.
_____
Record: 28
Title: Psychopathology Among New York City Public School Children 6
Months After September 11.
Author(s): Hoven, Christina W., Department of Epidemiology, Mailman
School of Public Health, Columbia University-New York State Psychiatric
Institute, New York, NY, US, ch42@columbia.edu
Duarte, Cristiane S., Department of Epidemiology, Mailman School of
Public Health, Columbia University-New York State Psychiatric Institute,
New York, NY, US
Lucas, Christopher P., Department of Psychiatry, College of Physicians
and Surgeons, Columbia University-New York State Psychiatric Institute,
New York, NY, US
Wu, Ping, Department of Epidemiology, Mailman School of Public Health,
Columbia University-New York State Psychiatric Institute, New York, NY,
US
Mandell, Donald J., Department of Epidemiology, Mailman School of Public
Health, Columbia University-New York State Psychiatric Institute, New
York, NY, US
Goodwin, Renee D., Department of Epidemiology, Mailman School of Public
Health, Columbia University-New York State Psychiatric Institute, New
York, NY, US
Cohen, Michael, The Michael Cohen Group, LLC, US
Balaban, Victor, National Center for Chronic Disease Prevention and
Health Promotion, Centers for Disease Control and Prevention, Atlanta,
GA, US
Woodruff, Bradley A., National Center for Chronic Disease Prevention and
Health Promotion, Centers for Disease Control and Prevention, Atlanta,
GA, US
Bin, Fan, Columbia University-New York State Psychiatric Institute, New
York, NY, US
Musa, George J., Columbia University-New York State Psychiatric
Institute, New York, NY, US
Mei, Lori, New York City Department of Education, New York, NY, US
Cantor, Pamela A., Children's Mental Health Alliance, US
Aber, J. Lawrence, Department of Psychology, New York University, New
York, NY, US
Cohen, Patricia, Department of Epidemiology, Mailman School of Public
Health, Columbia University-New York State Psychiatric Institute, New
York, NY, US
Susser, Ezra, Department of Epidemiology, Mailman School of Public
Health, Columbia University-New York State Psychiatric Institute, New
York, NY, US
Address: Hoven, Christina W., Child Psychiatric Epidemiology
Group, Columbia University- New York State Psychiatric Institute, 1051
Riverside Dr, Unit 43, New York, NY, US, ch42@columbia.edu
Source: Archives of General Psychiatry, Vol 62(5), May 2005. pp.
545-552.
Journal URL: http://archpsyc.ama-assn.org/
Publisher: US: American Medical Assn
Publisher URL: http://www.amapublications.com
ISSN: 0003-990X (Print)
Digital Object Identifier: 10.1001/archpsyc.62.5.545
Language: English
Keywords: psychopathology; public school children; September 11;
mental disorders; traumatic event
Abstract: Children exposed to a traumatic event may be at higher
risk for developing mental disorders. The prevalence of child
psychopathology, however, has not been assessed in a population-based
sample exposed to different levels of mass trauma or across a range of
disorders. The objective of this study is to determine prevalence and
correlates of probable mental disorders among New York City, NY, public
school students 6 months following the September 11, 2001, World Trade
Center attack. A survey was used as the study design using participants
from a citywide, random, representative sample of 8236 students from New
York City public schools in grades 4 through 12, including over-sampling
in closest proximity to the World Trade Center site (ground zero) and
other high-risk areas. Children were screened for probable mental
disorders with the Diagnostic Interview Schedule for Children Predictive
Scales. One or more of 6 probable anxiety/depressive disorders were
identified in 28.6% of all children. The most prevalent were probable
agoraphobia (14.8%), probable separation anxiety (12.3%), and probable
posttraumatic stress disorder (10.6%). Higher levels of exposure
correspond to higher prevalence for all probable anxiety/depressive
disorders. Girls and children in grades 4 and 5 were the most affected.
In logistic regression analyses, child's exposure (adjusted odds ratio,
1.62), exposure of a child's family member (adjusted odds ratio, 1.80),
and the child's prior trauma (adjusted odds ratio, 2.01) were related to
increased likelihood of probable anxiety/ depressive disorders. Results
were adjusted for different types of exposure, sociodemographic
characteristics, and child mental health service use. A high proportion
of New York City public school children had a probable mental disorder 6
months after September 11, 2001. The data suggest that there is a
relationship between level of exposure to trauma and likelihood of child
anxiety/depressive disorders in the community. The results support the
need to apply wide-area epidemiological approaches to mental health
assessment after any large-scale disaster.
_____
Record: 29
Title: Post-traumatic Stress Disorder, Crime, and Trance.
Author(s): Perkins, Meg
Address: Perkins, Meg, Maranatha Counselling Centre, 19 Whitton
Road, Indooroopilly, QLD, Australia, 4068
Source: Australian Journal of Clinical & Experimental Hypnosis, Vol
33(1), May 2005. pp. 93-97.
Publisher: Australia: Australian Society of Hypnosis
Publisher URL: http://www.ozhypnosis.com.au
ISSN: 0156-0417 (Print)
Language: English
Keywords: posttraumatic stress disorder; crime; trance;
correctional center; dissociation; offender rehabilitation; trauma
therapy
Abstract: In late 1991, I was employed as the psychologist at a
correctional centre in Queensland which housed a relatively large number
of "lifers"--prisoners who had been given a mandatory life sentence
after pleading guilty to, or being found guilty of, murder. Many of the
lifers were approaching the date at which they would be eligible to
apply for parole. The task was assigned to me to interview each of the
lifers and to make an assessment as to whether they were suitable for
parole. This assessment was to be based on such factors as their
addressing the issues that led to the offending behaviour, the presence
or absence of remorse in their presentation, and their ability to
demonstrate empathy with the victim. It was interesting to note that
many of the lifers did not remember committing the crime. There appears
to be a definite link between PTSD and dissociative states and crime.
There is a role for hypnosis researchers to determine at what point the
trance states commence and how they are activated in terms of offender
rehabilitation programs. Perhaps also trauma therapy for first offenders
may prevent further acts of crime for these victims.
_____
Record: 30
Title: Peritraumatic dissociation and experiential avoidance as
predictors of posttraumatic stress symptomatology.
Author(s): Marx, Brian P., Department of Psychology, Temple
University, Philadelphia, PA, US, bmarx@temple.edu
Sloan, Denise M., Department of Psychology, Temple University,
Philadelphia, PA, US
Address: Marx, Brian P., Department of Psychology, Temple
University, Weiss Hall, Philadelphia, PA, US, bmarx@temple.edu
Source: Behaviour Research & Therapy, Vol 43(5), May 2005. pp. 569-583.
Journal URL: http://www.elsevier.com/inca/publications/store/2/6/5/
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0005-7967 (Print)
Digital Object Identifier: 10.1016/j.brat.2004.04.004
Language: English
Keywords: peritraumatic dissociation; risk factors; posttraumatic
stress disorder; experiential avoidance
Abstract: This study examined whether peritraumatic dissociation
serves as a proxy risk factor for experiential avoidance in its
relationship with posttraumatic stress disorder (PTSD) symptomatology.
One hundred eighty-five trauma survivors completed measures that
assessed for peritraumatic dissociation, experiential avoidance, and
PTSD symptom severity. The results indicated that peritraumatic
dissociation and experiential avoidance were significantly related to
PTSD symptomatology at baseline. However, after initial levels of PTSD
symptomatology were taken into account, only experiential avoidance was
related to PTSD symptoms both 4- and 8-weeks later. These results
indicate that peritraumatic dissociation is not a proxy risk factor for
experiential avoidance and contributes to the growing body of literature
indicating that experiential avoidance is an important factor related to
the psychological symptoms experienced by trauma survivors.
_____
Record: 31
Title: Unwanted memories of assault: What intrusion characteristics are
associated with PTSD?
Author(s): Michael, T., Department of Psychology, Institute of
Psychiatry, London, United Kingdom
Ehlers, A., Department of Psychology, Institute of Psychiatry, London,
United Kingdom, a.ehlers@iop.kcl.ac.uk
Halligan, S. L., Department of Psychology, Institute of Psychiatry,
London, United Kingdom
Clark, D. M., Department of Psychology, Institute of Psychiatry, London,
United Kingdom
Address: Ehlers, A., Department of Psychology, Institute of
Psychiatry, PO77, De Crespigny Park, London, United Kingdom, SE5 8AF,
a.ehlers@iop.kcl.ac.uk
Source: Behaviour Research & Therapy, Vol 43(5), May 2005. pp. 613-628.
Journal URL: http://www.elsevier.com/inca/publications/store/2/6/5/
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0005-7967 (Print)
Digital Object Identifier: 10.1016/j.brat.2004.04.006
Language: English
Keywords: trauma memories; posttraumatic stress disorder;
intrusive memories; symptom severity; assault; physical abuse; sexual
abuse
Abstract: Intrusive memories are common in the immediate aftermath
of traumatic events, but neither their presence or frequency are good
predictors of the persistence of posttraumatic stress disorder (PTSD).
Two studies of assault survivors, a cross-sectional study (N = 81) and a
6-month prospective longitudinal study (N = 73), explored whether
characteristics of the intrusive memories improve the prediction.
Intrusion characteristics were assessed with an Intrusion Interview and
an Intrusion Provocation Task. The distress caused by the intrusions,
their "here and now" quality, and their lack of a context predicted PTSD
severity. The presence of intrusive memories only explained 9% of the
variance of PTSD severity at 6 months after assault. Among survivors
with intrusions, intrusion frequency only explained 8% of the variance
of PTSD symptom severity at 6 months. Newness, distress and lack of
context explained an additional 43% of the variance. These intrusion
characteristics also predicted PTSD severity at 6 months over and above
what could be predicted from PTSD diagnostic status at initial
assessment. Further predictors of PTSD severity were rumination about
the intrusive memories, and the ease and persistence with which
intrusive memories could be triggered by photographs depicting assaults.
The results have implications for the early identification of trauma
survivors at risk of chronic PTSD.
_____
Record: 32
Title: Thyroid Hormone Alterations Among Women with Posttraumatic
Stress Disorder Due to Childhood Sexual Abuse.
Author(s): Friedman, Matthew J., Department of Psychiatry,
Dartmouth Medical School, Hanover, Germany,
Matthew.Friedman@Dartmouth.Edu
Wang, Sheila, Emotions and Quantitative Psychophysiology Section,
Laboratory of Personality and Cognition, National Institute on Aging,
Baltimore, MD, US
Jalowiec, John E., Department of Psychiatry, Dartmouth Medical School,
Hanover, Germany
McHugo, Gregory J., Department of Psychiatry, Dartmouth Medical School,
Hanover, Germany
McDonagh-Coyle, Annmarie, Department of Psychiatry, Dartmouth Medical
School, Hanover, Germany
Address: Friedman, Matthew J., National Center for PTSD, VA
Medical Center, 215 North Main Street, White River Junction, VT, US,
Matthew.Friedman@Dartmouth.Edu
Source: Biological Psychiatry, Vol 57(10), May 2005. pp. 1186-1192.
Journal URL:
http://www.elsevier.com/inca/publications/store/5/0/5/7/5/0/
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0006-3223 (Print)
Digital Object Identifier: 10.1016/j.biopsych.2005.01.019
Language: English
Keywords: thyroid hormone alterations; posttraumatic stress
disorder; childhood sexual abuse; triiodothyronine
Abstract: Background: Research on thyroid activity among male
combat veterans with posttraumatic stress disorder (PTSD) has
consistently shown elevations in total triiodothyronine (TT-sub-3) and
inconsistent elevations of other thyroid variables. This study is the
first large scale investigation of thyroid function in women with PTSD.
Methods: Thyroid function was measured in 63 women with PTSD due to
childhood sexual abuse (PTSD-CSA) in comparison with a community sample
of 42 women without current PTSD-CSA. Clinical measures included the
Clinician Administered PTSD Scale (CAPS), the Evaluation of Lifetime
Stressors, the Trauma Assessment for Adults and the Beck Depression
Inventory. Results: Women with PTSD-CSA showed significant elevations in
Total T-sub-3 and the TT-sub-3/free thyroxine (TT-sub-3/FT-sub-4) ratio,
the FT-sub-3TT-sub-3 ratio, and modest reductions in thyroid stimulating
hormone relative to our community sample. These findings could not be
explained by the influence of prior trauma, lifetime PTSD or depressive
symptoms. Conclusions: Altered thyroid activity, especially elevated
Total T-sub-3 levels, was found in women with PTSD associated with
childhood sexual abuse.
_____
Record: 33
Title: Preliminary evidence for lymphocyte distribution differences at
rest and after acute psychological stress in PTSD-symptomatic women.
Author(s): Glover, Dorie A., Division of Child and Adolescent
Psychiatry, Department of Psychiatry and Biobehavioral Sciences, UCLA
Neuropsychiatric Institute, Los Angeles, CA, US, dglover@mednet.ucla.edu
Steele, Amber C., Division of Child and Adolescent Psychiatry,
Department of Psychiatry and Biobehavioral Sciences, UCLA
Neuropsychiatric Institute, Los Angeles, CA, US
Stuber, Margaret L., Division of Child and Adolescent Psychiatry,
Department of Psychiatry and Biobehavioral Sciences, UCLA
Neuropsychiatric Institute, Los Angeles, CA, US
Fahey, John L., Microbiology, Immunology and Molecular
Genetics-CIRID/Med-CIA, UCLA Geffen School of Medicine, Los Angeles, CA,
US
Address: Glover, Dorie A., Division of Child and Adolescent
Psychiatry, Department of Psychiatry and Biobehavioral Sciences, UCLA
Neuropsychiatric Institute, Los Angeles, CA, US, dglover@mednet.ucla.edu
Source: Brain, Behavior & Immunity, Vol 19(3), May 2005. pp. 243-251.
Journal URL: http://www.academicpress.com/bbi
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0889-1591 (Print)
Digital Object Identifier: 10.1016/j.bbi.2004.08.002
Language: English
Keywords: lymphocyte distribution differences; psychological
stress; posttraumatic stress disorder; natural killer cells; cancer
survivors
Abstract: This study investigated circulating natural killer (NK),
CD4+ and CD8+ cells in response to acute psychological challenge among
mothers of child cancer survivors with and without posttraumatic stress
symptoms (PTSS). Control mothers of healthy children (n = 9) were
compared to 17 cancer mothers with (PTSS: n = 9) and without PTSS (No
PTSS: n = 7) under conditions of rest, after a generic stressor (MAT:
mental arithmetic task) and a personalized stressor (script-driven
trauma imagery), and after recovery from each stressor. Results indicate
the PTSS group had higher percentage CD4+ and lower CD8+ levels than
non-symptomatic women and blunted NK reactivity to generic challenge.
Multiple regression analyses indicated PTSS effects were independent of
self-reported distress. Contrary to expectations, cancer mothers without
PTSS were not significantly different from controls on tonic or phasic
immune outcomes. Also unlike predictions, reactivity to challenge was
greatest to the non-social MAT stressor compared to the personalized
challenge for all groups. Conclusions are constrained by study
limitations (e.g., small sample size and potential phase order effects).
Nonetheless, results are consistent with an emerging literature on
PTSS-associated immune differences and further suggest these effects may
be distinct from that associated with subjective distress more
generally.
_____
Record: 34
Title: Symptoms of Distress and Posttraumatic Stress among South
African Former Political Detainees.
Author(s): Kagee, Ashraf, Department of Psychology, University of
Stellenbosch, Matieland, South Africa, skagee@sun.ac.za
Address: Kagee, Ashraf, Department of Psychology, University of
Stellenbosch, Private Bag X1, Matieland, South Africa, 7602,
skagee@sun.ac.za
Source: Ethnicity & Health, Vol 10(2), May 2005. pp. 169-179.
Journal URL: http://www.tandf.co.uk/journals/carfax/13557858.html
Publisher: United Kingdom: Taylor & Francis
Publisher URL: http://www.taylorandfrancis.com/
ISSN: 1355-7858 (Print)
1465-3419 (Electronic)
Language: English
Keywords: distress symptoms; posttraumatic stress; South Africa;
political detainees; long term traumatization; torture; abuse
Abstract: Considerable debate has centred on the question of
traumatisation among individuals who have survived human rights
violations in societies that have undergone political conflict. In order
to gain an estimate of the extent of long-term traumatisation among
political activists who experienced torture and abuse in detention
during the apartheid era in South Africa, a sample of 148 survivors of
such experiences were recruited in a cross-sectional study and asked to
complete the Hopkins Symptom Checklist (HSCL), the Impact of Event Scale
(IES), and the Trauma Symptoms section of the Harvard Trauma
Questionnaire (HTQ). The proportions of the sample that scored above the
clinical cut-points on these measures were calculated. On the HSCL,
14.19% of the sample scored above the cut-point for clinical
significance of 44; on the IES, 17.57% scored above the clinical
cut-point of 44; and on the HTQ, 37.83% scored above the cut-point of
75. Moreover, the sample's mean scores were significantly higher than
the cut-point for clinically significant distress on the HSCL (p
<0.001); significantly lower than the cut-point for severe
traumatisation on the IES (p < 0.001); and non-significantly lower than
the cut-point for clinically significant traumatisation on the HTQ (p =
0.074). These results are considered in terms of current theoretical
debates on the relevance and applicability of posttraumatic stress
disorder as a circumscribed nosological entity in developing countries
that are in the process of coming to terms with a history of political
conflict.
_____
Record: 35
Title: Improving primary care for military personnel and veterans with
posttraumatic stress disorder--the road ahead.
Author(s): Engel, Charles C., F. Edward Hébert School of Medicine,
Bethesda, MD, US, cengel@usuhs.mil
Address: Engel, Charles C., F. Edward Hebert School of Medicine,
Bethesda, MD, US, cengel@usuhs.mil
Source: General Hospital Psychiatry, Vol 27(3), May-Jun 2005. pp.
158-160.
Journal URL:
http://www.elsevier.com/inca/publications/store/5/0/5/7/6/1/
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0163-8343 (Print)
Digital Object Identifier: 10.1016/j.genhosppsych.2005.01.001
Language: English
Keywords: military personnel; posttraumatic stress disorder;
specialty care settings; health policy; veteran primary care settings;
mental health services
Abstract: In this editorial, the author attempts to formulate a
clinical and health policy response to psychological trauma care,
particularly with respect to military personnel experiencing
posttraumatic stress disorder (PTSD). In his analysis, the author points
to an excellent study appearing in this issue of the General Hospital
Psychiatry. Magruder et al report on a systematic regional VA primary
care sample of military veterans and find that 11.5% of the subjects
meet research interview criteria for PTSD. This is the largest study of
PTSD in primary care to date and reveals substantial room for
improvement in services. While almost all clinical PTSD research have
been done in specialty care settings, Magruder et al. find that only 48%
of VA primary care patients with PTSD received specialty mental health
care. The challenges associated with improving PTSD care in primary care
settings are arguably even more formidable in the defense health system.
Magruder et al's research represents one more important step toward a
population health approach to PTSD prevention and management for
military personnel and veterans.
_____
Record: 36
Title: Prevalence of posttraumatic stress disorder in Veterans Affairs
primary care clinics.
Author(s): Magruder, Kathryn M., Mental Health Service, Ralph H.
Johnson Veterans Affairs Medical Center, Charleston, SC, US,
magrudkm@musc.edu
Frueh, B. Christopher, Mental Health Service, Ralph H. Johnson Veterans
Affairs Medical Center, Charleston, SC, US
Knapp, Rebecca G., Department of Biostatistics, Bioinformatics and
Epidemiology, Medical University of South Carolina, Charleston, SC, US
Davis, Lori, Veterans Affairs Medical Center, Tuscaloosa, AL, US
Hamner, Mark B., Mental Health Service, Ralph H. Johnson Veterans
Affairs Medical Center, Charleston, SC, US
Martin, Renée Hebert, Department of Biostatistics, Bioinformatics and
Epidemiology, Medical University of South Carolina, Charleston, SC, US
Gold, Paul B., Department of Psychiatry and Behavioral Sciences, Medical
University of South Carolina, Charleston, SC, US
Arana, George W., Mental Health Service, Ralph H. Johnson Veterans
Affairs Medical Center, Charleston, SC, US
Address: Magruder, Kathryn M., Mental Health Service (116), Ralph
H. Johnson Veterans Affairs Medical Center, 109 Bee Street, Charleston,
SC, US, magrudkm@musc.edu
Source: General Hospital Psychiatry, Vol 27(3), May-Jun 2005. pp.
167-179.
Journal URL:
http://www.elsevier.com/inca/publications/store/5/0/5/7/6/1/
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0163-8343 (Print)
Language: English
Keywords: posttraumatic stress disorder; primary care settings;
Veterans Affairs; comorbidity
Abstract: Although posttraumatic stress disorder (PTSD) is
relatively common in community epidemiologic surveys (5-6% for men,
10-12% for women), and psychiatric patients with PTSD are known to have
poor functioning and high levels of psychiatric comorbidity, there are
no studies that address PTSD prevalence, functioning, and burden in
primary care settings. This article reports on (1) the prevalence of
PTSD using Diagnostic and Statistical Manual of Mental Disorders-Fourth
Edition diagnostic criteria in Veterans Affairs (VA) primary care
settings, (2) associated sociodemographic characteristics and
comorbidities, (3) functional status related to PTSD, (4) the extent to
which PTSD was recognized by providers and (5) health services use
patterns (including specialty mental health) of PTSD patients. Patients
were randomly selected from those who had an outpatient visit in FY 1999
at one of four VA hospitals; 888 patients consented (74.1% of 1198
contacted); 746 patients (84.0% of consenting patients; 62.3% of
contacted patients) were reached for telephone diagnostic interviews.
Diagnostic interviews with the Clinician Administered PTSD Scale yielded
estimates of current PTSD prevalence of 11.5%. At statistically
significant levels, PTSD was positively associated with a variety of
comorbid psychiatric disorders, war zone service, age <65 years, not
working, less formal education and decreased functioning. Of patients
diagnosed with PTSD by study procedures, 12-month medical record review
indicated that providers identified only 46.5% and only 47.7% had used
mental health specialty services. PTSD-positive [PTSD(+)] patients who
used mental health care in the past 12 months were more apt to be
identified as having PTSD than nonmental health service users (78.0% vs.
17.8%). Although PTSD(+) patients had more medical record diagnoses than
PTSD-negative [PTSD(-)] patients (6.28 vs. 4.95), their use of primary
care, urgent care and inpatient care was not different from PTSD(-)
patients.
_____
Record: 37
Title: Learning and Memory in Aging Combat Veterans with PTSD.
Author(s): Yehuda, Rachel, Traumatic Stress Studies Program,
Psychiatry Department, Mount Sinai School of Medicine, Bronx Veterans
Affairs, New York, NY, US, Rachel.Yehuda@med.va.gov
Golier, Julia A., Traumatic Stress Studies Program, Psychiatry
Department, Mount Sinai School of Medicine, Bronx Veterans Affairs, New
York, NY, US
Tischler, Lisa, Traumatic Stress Studies Program, Psychiatry Department,
Mount Sinai School of Medicine, Bronx Veterans Affairs, New York, NY, US
Stavitsky, Karina, Traumatic Stress Studies Program, Psychiatry
Department, Mount Sinai School of Medicine, Bronx Veterans Affairs, New
York, NY, US
Harvey, Philip D., Traumatic Stress Studies Program, Psychiatry
Department, Mount Sinai School of Medicine, Bronx Veterans Affairs, New
York, NY, US
Address: Yehuda, Rachel, Bronx VA OOMH, 130 West Kingsbridge
Road, Bronx, NY, US, Rachel.Yehuda@med.va.gov
Source: Journal of Clinical & Experimental Neuropsychology, Vol 27(4),
May 2005. pp. 504-515.
Journal URL: http://www.swets.nl/sps/journals/jcen.html
Publisher: United Kingdom: Taylor & Francis
Publisher URL: http://www.taylorandfrancis.com/
ISSN: 1380-3395 (Print)
Language: English
Keywords: learning; memory; aging; combat veterans; posttraumatic
stress disorder
Abstract: The California Verbal Learning Test (CVLT) was
administered to examine learning and memory performance in aging combat
veterans with (n=30) and without PTSD (n=20), and veterans unexposed to
combat (n=15). Combat veterans with PTSD (PTSD+) showed many impairments
compared to non-exposed veterans, but only long-delay free recall
consistently discriminated the PTSD+ group from combat-exposed subjects
without PTSD (PTSD-), when data were corrected for subscale scores on
the WAIS (Vocabulary, Block Design). Alterations in total learning were
associated with PTSD when controlling for substance abuse and
depression. Two contrast measures, proactive interference and
recognition hits, distinguished combat from noncombat veterans, and may
be related to trauma exposure. Impairments in total learning are similar
to what has been observed in Holocaust survivors. However, increased
severity of rapid forgetting may be a specific alteration in older
combat veterans, likely reflecting aspects of both combat exposure and
aging.
_____
Record: 38
Title: Editorial: Peripheral is Central to the question.
Author(s): Wong, M. -L., Center for Pharmacogenomics, University of
California, Los Angeles, CA, US, mali@ucla.edu
Licinio, J., Center for Pharmacogenomics, University of California, Los
Angeles, CA, US
Address: Wong, M. -L., mali@ucla.edu
Source: Molecular Psychiatry, Vol 10(5), May 2005. pp. 421-422.
Journal URL: http://www.nature.com/mp
Publisher: United Kingdom: Nature Publishing
Publisher URL: http://www.nature.com/
ISSN: 1359-4184 (Print)
Digital Object Identifier: 10.1038/sj.mp.4001674
Language: English
Keywords: peripheral blood mononuclear cell gene expression;
posttraumatic stress disorder; trauma survivors
Abstract: This editorial comments on an article by Segman et al
(see record 2005-04778-014) that examined gene expression profiles of
peripheral blood mononuclear cells (PBMCs) collected from trauma
survivors, and identified a gene expression 'signature' for
post-traumatic stress disorder (PTSD). Patients were studied immediately
following a traumatic event, 1 month, and 4 months later. Upon reading
their work it seems clear why PTSD would be the ideal condition to
attempt such a conceptually bold study: The traumatic event is clearly
identifiable; therefore, sequential time course samples can be obtained
and studied in a systematic way. It is particularly amazing that
exemplar research design can emerge from and be directly related to an
unstable sociopolitical milieu. This work by Segman et al carries the
promise to bring a Renaissance to the field. They have revisited the
question of finding psychiatric correlates in peripheral blood and their
rigorous experimental design and data analysis have propelled research
in PTSD to the 21st century.
_____
Record: 39
Title: Peripheral blood mononuclear cell gene expression profiles
identify emergent post-traumatic stress disorder among trauma survivors.
Author(s): Segman, R. H., Department of Psychiatry, Hadassah
University Hospital, Jerusalem, Israel, sronen@md2.huji.ac.il
Shefi, N., School of Computer Science and Engineering, Hebrew
University, Jerusalem, Israel
Goltser-Dubner, T., Department of Psychiatry, Hadassah University
Hospital, Jerusalem, Israel
Friedman, N., School of Computer Science and Engineering, Hebrew
University, Jerusalem, Israel, nir@cs.huji.ac.il
Kaminski, N., Functional Genomics Unit, Chaim Sheba Medical Center,
Israel
Shalev, A. Y., Department of Psychiatry, Hadassah University Hospital,
Jerusalem, Israel, ashalev@cc.huji.ac.il
Address: Segman, R. H., Department of Psychiatry, Hadassah-Hebrew
University Medical Center, Hadassah University Hospital, PO Box 12000,
Ein Karem, Jerusalem, Israel, 91120, sronen@md2.huji.ac.il
Source: Molecular Psychiatry, Vol 10(5), May 2005. pp. 500-513.
Journal URL: http://www.nature.com/mp
Publisher: United Kingdom: Nature Publishing
Publisher URL: http://www.nature.com/
ISSN: 1359-4184 (Print)
Digital Object Identifier: 10.1038/sj.mp.4001636
Language: English
Keywords: peripheral blood mononuclear cell gene expression;
posttraumatic stress disorder; trauma survivors
Abstract: Trauma survivors show marked differences in the severity
and persistence of post-traumatic stress disorder (PTSD) symptoms. Early
symptoms subside in most, but persist as acute and chronic PTSD in a
significant minority. The underlying molecular mechanisms or outcome
predictors determining these differences are not known. Molecular
markers for identifying any mental disorder are currently lacking. Gene
expression profiling during the triggering and development of PTSD may
be informative of its onset and course. We used oligonucleotide
microarrays to measure peripheral blood mononuclear cell (PBMC) gene
expression of trauma survivors at the emergency room and 4 months later.
Gene expression signatures at both time points distinguished survivors
who met DSM-IV diagnostic criteria for PTSD at 1 and 4 months, from
those who met no PTSD criterion. Expression signatures at both time
points correlated with the severity of each of the three PTSD symptom
clusters assessed 4 months following exposure among all survivors.
Results demonstrate a general reduction in PBMCs' expression of
transcription activators among psychologically affected trauma
survivors. Several differentiating genes were previously described as
having a role in stress response. These findings provide initial
evidence that peripheral gene expression signatures following trauma
identify an evolving neuropsychiatric disorder and are informative of
its key clinical features and outcome. Replications in larger samples,
as well as studies focusing on specific markers within the signatures
discovered, are warranted to confirm and extend the diagnostic utility
and pathogenetic implications of our results.
_____
Record: 40
Title: Corrigendum: Peripheral blood mononuclear cell gene expression
profiles identify emergent post-traumatic stress disorder among trauma
survivors.
Author(s): Segman, R. H., Department of Psychiatry, Hadassah
University Hospital, Jerusalem, Israel, sronen@md2.huji.ac.il
Shefi, N., School of Computer Science and Engineering, Hebrew
University, Jerusalem, Israel
Goltser-Dubner, T., Department of Psychiatry, Hadassah University
Hospital, Jerusalem, Israel
Friedman, N., School of Computer Science and Engineering, Hebrew
University, Jerusalem, Israel, nir@cs.huji.ac.il
Kaminski, N., Functional Genomics Unit, Chaim Sheba Medical Center,
Israel
Shalev, A. Y., Department of Psychiatry, Hadassah University Hospital,
Jerusalem, Israel, ashalev@cc.huji.ac.il
Address: Segman, R. H., Department of Psychiatry, Hadassah-Hebrew
University Medical Center, Hadassah University Hospital, PO Box 12000,
Ein Karem, Jerusalem, Israel, 91120, sronen@md2.huji.ac.il
Source: Molecular Psychiatry, Vol 10(5), May 2005. pp. 514.
Journal URL: http://www.nature.com/mp
Publisher: United Kingdom: Nature Publishing
Publisher URL: http://www.nature.com/
ISSN: 1359-4184 (Print)
Digital Object Identifier: 10.1038/sj.mp.4001654
Language: English
Keywords: peripheral blood mononuclear cell gene expression;
posttraumatic stress disorder; trauma survivors
Abstract: Reports an error in the original article by R.H. Segman
et al (Molecular Psychiatry, 2005[May], Vol 10[5], 500-513). In the
Supplementary Notes of this article, the password and username of the
GEO deposit were included by mistake. The only information required to
access the data are the GEO serial numbers provided. The username and
password are not required. (The following abstract of this article
originally appeared in record 2005-04778-014.) Trauma survivors show
marked differences in the severity and persistence of post-traumatic
stress disorder (PTSD) symptoms. Early symptoms subside in most, but
persist as acute and chronic PTSD in a significant minority. The
underlying molecular mechanisms or outcome predictors determining these
differences are not known. Molecular markers for identifying any mental
disorder are currently lacking. Gene expression profiling during the
triggering and development of PTSD may be informative of its onset and
course. We used oligonucleotide microarrays to measure peripheral blood
mononuclear cell (PBMC) gene expression of trauma survivors at the
emergency room and 4 months later. Gene expression signatures at both
time points distinguished survivors who met DSM-IV diagnostic criteria
for PTSD at 1 and 4 months, from those who met no PTSD criterion.
Expression signatures at both time points correlated with the severity
of each of the three PTSD symptom clusters assessed 4 months following
exposure among all survivors. Results demonstrate a general reduction in
PBMCs' expression of transcription activators among psychologically
affected trauma survivors. Several differentiating genes were previously
described as having a role in stress response. These findings provide
initial evidence that peripheral gene expression signatures following
trauma identify an evolving neuropsychiatric disorder and are
informative of its key clinical features and outcome. Replications in
larger samples, as well as studies focusing on specific markers within
the signatures discovered, are warranted to confirm and extend the
diagnostic utility and pathogenetic implications of our results.
_____
Record: 41
Title: Symptoms of post-traumatic stress disorder after non-traumatic
events: Evidence from an open population study.
Author(s): Mol, Saskia S. L., Department of General Practice,
Maastricht University, Utrecht, Netherlands, s.s.l.mol@umcutrecht.nl
Arntz, Arnoud, Department of Medical, Clinical and Experimental
Psychology, Maastricht University, Utrecht, Netherlands
Metsemakers, Job F. M., Department of General Practice, Maastricht
University, Utrecht, Netherlands
Dinant, Geert-Jan, Department of General Practice, Maastricht
University, Utrecht, Netherlands
Vilters-Van Montfort, Pauline A. P., Department of General Practice,
Maastricht University, Utrecht, Netherlands
Knottnerus, J. André, Department of General Practice, Maastricht
University, Utrecht, Netherlands
Address: Mol, Saskia S. L., Department of General Practice, UMC
Utrecht, Julius Centre, Stratenum 6.108, Postbox 85060, 3508 AB,
Utrecht, Netherlands, s.s.l.mol@umcutrecht.nl
Source: British Journal of Psychiatry, Vol 186(6), Jun 2005. pp.
494-499.
Journal URL: http://bjp.rcpsych.org/
Publisher: United Kingdom: Royal College of Psychiatrists
Publisher URL: http://www.rcpsych.ac.uk/
ISSN: 0007-1250 (Print)
1472-1465 (Electronic)
Digital Object Identifier: 10.1192/bjp.186.6.494
Language: English
Keywords: symptoms; posttraumatic stress disorder; non-traumatic
events; life-events; demographic characteristics; history of stressful
events
Abstract: Background: Post-traumatic stress disorder (PTSD) is the
only psychiatric condition that requires a specific event to have
occurred for its diagnosis. Aims: To gather evidence from the adult
general population on whether life events (e.g. divorce, unemployment)
generate as many symptoms of post-traumatic stress as traumatic events
(e.g. accidents, abuse). Method: Data on demographic characteristics and
history of stressful events were collected through a written
questionnaire sent to a random sample of 2997 adults. Respondents also
filled out a PTSD symptom checklist, keeping in mind their worst event.
Mean PTSD scores were compared, controlling for differences between the
two groups. Differences in item scores and in the distribution of the
total PTSD scores were analysed. Results: Of the 1498 respondents, 832
were eligible for inclusion in our analysis. For events from the past 30
years the PTSD scores were higher after life events than after traumatic
events; for earlier events the scores were the same for both types of
events. These findings could not be explained by differences in
demographics, history of stressful events, individual item scores, or
the distribution of the total PTSD scores. Conclusions: Life events can
generate at least as many PTSD symptoms as traumatic events. Our
findings call for further studies on the specificity of traumatic events
as a cause of PTSD.
_____
Record: 42
Title: Hopelessness as a Risk Factor for Post-traumatic Stress Disorder
Symptoms Among Interpersonal Violence Survivors.
Author(s): Scher, Christine D., California State University, San
Bernardino, CA, US, cscher@csusb.edu
Resick, Patricia A., University of Missouri, St Louis, MO, US
Address: Scher, Christine D., Department of Psychology,
California State University, 5500 University Parkway, San Bernardino,
CA, US, cscher@csusb.edu
Source: Cognitive Behaviour Therapy, Vol 34(2), Jun 2005. pp. 99-107.
Journal URL: http://www.tandf.co.uk/journals/tfs/02845717.html
Publisher: United Kingdom: Taylor & Francis
Publisher URL: http://www.taylorandfrancis.com/
ISSN: 1650-6073 (Print)
Language: English
Keywords: posttraumatic stress disorder; risk factors;
hopelessness; interpersonal violence; female survivors
Abstract: Post-traumatic stress disorder often co-occurs with
depression, and they may share common risk factors. One possible common
cognitive risk factor is hopelessness. Thus, we examined whether
hopelessness was related to symptoms of post-traumatic stress disorder.
Participants were 202 female survivors of interpersonal violence.
Relationships between self-reported and interviewer-rated measures of
hopelessness gathered at 2 weeks post-trauma and self-reported and
interviewer-rated symptoms of post-traumatic stress disorder gathered at
2 weeks and 3 months post-trauma were examined. Hierarchical,
simultaneous regression analyses that co-varied trauma type revealed
that hopelessness was related to self-reported symptoms of
post-traumatic stress disorder, both concurrently and prospectively.
Follow-up analyses revealed that relationships between hopelessness and
symptoms of post-traumatic stress disorder were due almost entirely to
shared variance with depression. No relationships were found between
hopelessness and interviewer-rated symptoms of post-traumatic stress
disorder.
_____
Record: 43
Title: Trauma Groups: An Overview.
Author(s): Weinberg, Haim, Beit Berl College, Israel,
haimw@netvision.net.il
Nuttman-Shwartz, Orit, Social Work Department, Sapir Academic College,
Israel, Orits@makash.ac.il
Gilmore, Martha, Private Practice, Davis, CA, US, m1gilmore@ucdavis.edu
Address: Weinberg, Haim, 6 Hardoof Street, Tel Aviv, Israel,
69930, haimw@netvision.net.il
Source: Group Analysis, Vol 38(2), Jun 2005. pp. 187-202.
Publisher: US: Sage Publications
Publisher URL: http://www.sagepublications.com/
ISSN: 0533-3164 (Print)
1461-717X (Electronic)
Digital Object Identifier: 10.1177/0533316405052378
Language: English
Keywords: trauma; post-traumatic stress disorder; group treatment
Abstract: Beginning with a brief review of trauma and
post-traumatic stress disorder, the authors consider the role of group
treatment of trauma. Several models of groups are discussed along with
available research regarding efficacy. A discussion of the special
dynamics of trauma groups and important considerations for group
conducting follows and the issue of vicarious traumatization for the
group conductor is addressed. A short discussion regarding the need to
integrate traumatized individuals back into society concludes the paper.
_____
Record: 44
Title: On the Job after 9/11: Looking at Worker's Block Through a Group
Lens.
Author(s): Kleinberg, Jeffrey, Private Practice, New York, NY, US,
JKleinberg@aol.com
Address: Kleinberg, Jeffrey, 35 East 35th Street, New York, NY,
US, JKleinberg@aol.com
Source: Group Analysis, Vol 38(2), Jun 2005. pp. 203-218.
Publisher: US: Sage Publications
Publisher URL: http://www.sagepublications.com/
ISSN: 0533-3164 (Print)
1461-717X (Electronic)
Digital Object Identifier: 10.1177/0533316405052379
Language: English
Keywords: terrorism; September 11; posttraumatic effect; Worker's
Block; organizations
Abstract: The terror attacks of 11 September 2001 have produced a
posttraumatic effect in many workers. They have developed what the
author defines as 'Worker's Block', an emotional disengagement from
their job. The author suggests that factors contributing to this
vocational crisis include the nature of the stressor, deficits in the
individual's resiliency and the hardiness of one's employer. From his
group-centered perspective, the author discusses ways to strengthen
individuals and their organizations in order to minimize the damaging
effects of future attacks on the workforce.
_____
Record: 45
Title: Book Review: Group Psychotherapy for Psychological Trauma.
Author(s): Brom, Danny
Source: Group Analysis, Vol 38(2), Jun 2005. pp. 324-325.
Publisher: US: Sage Publications
Publisher URL: http://www.sagepublications.com/
Reviewed Item: R. H. Klein and V. L. Schermer (eds) (2000). Group
Psychotherapy for Psychological Trauma; The Guilford Press, New York.
2000. pp. 364 Hb. US$50
ISSN: 0533-3164 (Print)
1461-717X (Electronic)
Digital Object Identifier: 10.1177/0533316405056893
Language: English
Keywords: group psychotherapy; psychological trauma; posttraumatic
stress disorder
Abstract: Group Psychotherapy for Psychological Trauma (see record
2000-03901-000), edited by R. H. Klein and V. L. Schermer, is a complete
and comprehensive book on group treatment, reviewing the concepts of
trauma and post-traumatic psychopathology and giving a wide range of
options of group interventions within the spectrum of post traumatic
disorders. The book starts with a thorough description of the
consequences of trauma for the individual, describing not only the
phenomenology of post traumatic disorders, including the Post Traumatic
Stress Disorder (PTSD) clusters, but also cognitive changes and changes
in object relations and different influences on the self. Group therapy
for trauma victims is introduced in an equally thorough and
comprehensive manner, and presents a range of ways to use the group
setting for engendering healing of the various injuries caused by
traumatic experiences. The second part of the book focuses on different
traumatized populations, from severe illness through disaster to
torture. Each chapter is well laid out, giving a thorough description of
the problem and then focusing on the technical aspects of the treatment
and ending with clinical examples. The only missing topic in this book
is the evidence base for the effectiveness of group therapy for trauma.
But even without this, this book is an excellent guide and resource for
all interested in the field of group therapy for the traumatized.
_____
Record: 46
Title: Psychopathology following trauma: The role of subjective
experience.
Author(s): Creamer, Mark, Australian Centre for Posttraumatic
Mental Health, University of Melbourne, West Heidelberg, VIC, Australia,
markcc@unimelb.edu.au
McFarlane, Alexander C., University of Adelaide, Australia
Burgess, Philip, Centre for Mental Health Research, University of
Queensland, Brisbane, QLD, Australia
Address: Creamer, Mark, Australian Centre for Posttraumatic
Mental Health, University of Melbourne, A&RMC Repat Campus, P.O. Box
5444, West Heidelberg, VIC, Australia, 3081, markcc@unimelb.edu.au
Source: Journal of Affective Disorders, Vol 86(2-3), Jun 2005. pp.
175-182.
Journal URL:
http://www.elsevier.com/inca/publications/store/5/0/6/0/7/7/
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0165-0327 (Print)
Digital Object Identifier: 10.1016/j.jad.2005.01.015
Language: English
Keywords: psychopathology; trauma; posttraumatic stress disorder
Abstract: Background: The DSM-IV definition of posttraumatic
stress disorder (PTSD) widened the stressor criterion to include
objective (A1) and subjective (A2) components. The prevalence of
Criterion A2, and its association with traumatic memory and
psychopathology, was examined in a large community sample. Method: The
presence of Criterion A2 and traumatic memories, as well as DSM-IV
anxiety, affective and substance use disorders, were examined in a
community sample of 6104 adults with a history of traumatic exposure.
Results: Most individuals met Criterion A2 (76%), with higher prevalence
in females (81%) than males (69%). A2 was more common following certain
traumas (such as assaultive violence). Excluding those people with PTSD,
prevalence of most psychiatric disorders was higher in those who met
Criterion A2 than in those who only met Criterion A1. Only 3% of those
who did not meet A2 went on to suffer persistent traumatic memories. The
prevalence of psychiatric disorders was higher in those with A2 and
traumatic memories than in those with A2 and no traumatic memories.
Limitations: The retrospective nature of the data raises the potential
for reporting biases. The data set allowed only one of several possible
predictors of posttraumatic adjustment to be examined and only 12-month,
and not lifetime, prevalence of psychiatric conditions was available.
Conclusions: The experience of powerful emotions at the time of
traumatic exposure is common and is associated with increased prevalence
not only of PTSD, but also of a range of other psychiatric conditions.
Traumatic memories may mediate this association.
_____
Record: 47
Title: Resolution of trauma-related guilt following treatment of PTSD
in female rape victims: A result of cognitive processing therapy
targeting comorbid depression?
Author(s): Nishith, Pallavi, Center for Trauma Recovery, University
of Missouri, St. Louis, MO, US
Nixon, Reginald D. V., School of Psychology, Flinders University,
Adelaide, SA, Australia, reg.nixon@flinders.edu.au
Resick, Patricia A., Center for Trauma Recovery, University of Missouri,
St. Louis, MO, US
Address: Nixon, Reginald D. V., School of Psychology, Flinders
University, GPO Box 2100, Adelaide, SA, Australia, 5001,
reg.nixon@flinders.edu.au
Source: Journal of Affective Disorders, Vol 86(2-3), Jun 2005. pp.
259-265.
Journal URL:
http://www.elsevier.com/inca/publications/store/5/0/6/0/7/7/
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0165-0327 (Print)
Digital Object Identifier: 10.1016/j.jad.2005.02.013
Language: English
Keywords: trauma related guilt; posttraumatic stress disorder;
female rape victims; cognitive processing therapy; comorbidity; major
depressive disorder; treatment
Abstract: Background and methods: Although Resick et al. (2002)
[Resick, P.A., Nishith, P., Weaver, T.L., Astin, M.C., Feuer, C.A.,
2002. A comparison of cognitive-processing therapy with prolonged
exposure and a waiting condition for the treatment of chronic
posttraumatic stress disorder in female rape victims. J. Consult. Clin.
Psychol. 70, 867-879.] reported comparable results for treating
rape-related posttraumatic stress disorder (PTSD) using either
cognitive-processing therapy (CPT) or prolonged exposure (PE), there was
some suggestion that CPT resulted in better outcomes than PE for certain
aspects of trauma-related guilt. The present study revisited these
findings to examine whether this effect was a function of improvement in
a subset of participants with both PTSD and major depressive disorder
(MDD). Results: Results indicated that CPT was just as effective in
treating 'pure' PTSD and PTSD with comorbid MDD in terms of guilt.
Clinical significance testing underscored that CPT was more effective in
reducing certain trauma-related guilt cognitions than PE. Limitations:
Findings cannot be generalized to men, and only one measure of guilt was
used. Conclusions: The observed superiority of CPT over PE for treating
certain guilt cognitions was not due to participant comorbidity. Further
research is recommended to untangle the relationship between guilt,
depression and differential response to treatment in PTSD following
sexual assault trauma.
_____
Record: 48
Title: Childhood Traumatic Grief: An Exploration of the Construct in
Children Bereaved on September 11.
Author(s): Brown, Elissa J., St. John's University, Queens, NY, US,
browne@stjohns.edu
Goodman, Robin F., National Child Traumatic Stress Network, US
Address: Brown, Elissa J., Department of Psychology, St. John's
University, 8000 Utopia Parkway, Queens, NY, US, browne@stjohns.edu
Source: Journal of Clinical Child & Adolescent Psychology, Vol 34(2),
Jun 2005. pp. 248-259.
Journal URL:
https://www.erlbaum.com/shop/tek9.asp?pg=products&specific=1537-4416
Publisher: US: Lawrence Erlbaum
Publisher URL: http://www.erlbaum.com/
ISSN: 1537-4416 (Print)
1532-7639 (Electronic)
Digital Object Identifier: 10.1207/s15374424jccp3402_4
Language: English
Keywords: childhood traumatic grief; demographic characteristics;
trauma exposure; coping strategies; psychiatric symptoms; self esteem;
September 11 attacks
Abstract: This study is an exploration of the measurement and
correlates of childhood traumatic grief (CTG). Eighty-three children of
uniformed service personnel who died during the World Trade Center
attack on September 11, 2001, were assessed using measures of
demographic characteristics, trauma exposure (physical proximity,
emotional proximity, and secondary adversities), use of coping
strategies, psychiatric symptoms (posttraumatic stress disorder [PTSD],
general anxiety, depression), self-esteem, and traumatic grief. An
exploratory factor analysis of the Extended Grief Inventory (EGI; Layne,
Savjak, Saltzman, & Pynoos, 2001) indicated distinct constructs of
normal versus traumatic grief. CTG factor scores were correlated with
secondary adversities from the traumatic event, symptoms of PTSD,
anxiety, depression, and coping responses, underscoring the theoretical
and clinical utility of the content of the measure. Study limitations
and future research recommendations are discussed.
_____
Record: 49
Title: Cognitive-Behavioral Therapy for PTSD in the Real World: Do
Interpersonal Relationships Make a Real Difference?
Author(s): Monson, Candice M., VA National Center for PTSD, Boston,
MA, US, candice.monson@med.va.gov
Rodriguez, Benjamin F., Southern Illinois University at Carbondale,
Carbondale, IL, US
Warner, Reid, Dartmouth College, Hanover, NH, US
Address: Monson, Candice M., VA National Center for PTSD, Women's
Health Sciences Division, VA Boston Healthcare System, 150 South
Huntington Avenue (1168), Boston, MA, US, candice.monson@med.va.gov
Source: Journal of Clinical Psychology, Vol 61(6), Jun 2005. pp.
751-761.
Journal URL: http://www.interscience.wiley.com/jpages/0021-9762/
Publisher: US: John Wiley & Sons
Publisher URL: http://www.wiley.com/WileyCDA/
ISSN: 0021-9762 (Print)
1097-4679 (Electronic)
Digital Object Identifier: 10.1002/jclp.20096
Language: English
Keywords: veterans; posttraumatic stress disorder; interpersonal
relationships; relationship functioning; cognitive behavioral therapy;
trauma-focused; skills-focused; treatment effectiveness
Abstract: The goal of this effectiveness study was to investigate
the role of pre-treatment interpersonal relationship functioning in two
forms of group cognitive-behavioral treatment (CBT) for veterans with
PTSD. Analysis of data from 45 veterans who completed either trauma- or
skills-focused CBT indicated no overall differences between the two
treatments in PTSD symptomatology, alcohol abuse, or violence
perpetration at four months post-treatment. However, there was a
stronger inverse relationship between intimate relationship functioning
and violence outcomes in the trauma-focused group versus the
skills-focused group. While no differences in violence outcomes were
found between the treatments at poorer levels of pre-treatment intimate
relationship functioning, those receiving trauma-focused treatment with
better pre-treatment intimate relationships reported less violence.
Extended relationship functioning and violence outcomes were less
strongly associated in the trauma-focused group versus the
skills-focused group. The theoretical implications of these results, as
well as the clinical opportunities to improve CBT for PTSD by
capitalizing on patients' relationships, are discussed.
Conference: Annual Meeting of the International Society for
Traumatic Stress Studies, 2002
Conference Notes: Portions of this research were presented at the
aforementioned conference.
_____
Record: 50
Title: Further Examination of the Exposure Model Underlying the
Efficacy of Written Emotional Disclosure.
Author(s): Sloan, Denise M., Department of Psychology, Temple
University, Philadelphia, PA, US, dsloan@temple.edu
Marx, Brian P., Department of Psychology, Temple University,
Philadelphia, PA, US
Epstein, Eva M., Department of Psychology, Temple University,
Philadelphia, PA, US
Address: Sloan, Denise M., Department of Psychology, Temple
University, Weiss Hall, Philadelphia, PA, US, dsloan@temple.edu
Source: Journal of Consulting and Clinical Psychology, Vol 73(3), Jun
2005. pp. 549-554.
Journal URL: http://www.apa.org/journals/ccp.html
Publisher: US: American Psychological Assn
Publisher URL: http://www.apa.org
ISSN: 0022-006X (Print)
Digital Object Identifier: 10.1037/0022-006X.73.3.549
Language: English
Keywords: emotion; written disclosure; salivary cortisol; trauma;
posttraumatic stress symptoms; exposure hypothesis
Abstract: In the current study, the authors examined the effects
of systematically varying the writing instructions for the written
emotional disclosure procedure. College undergraduates with a trauma
history and at least moderate posttraumatic stress symptoms were asked
to write about (a) the same traumatic experience, (b) different
traumatic experiences, or (c) nontraumatic everyday events across 3
written disclosure sessions. Results show that participants who wrote
about the same traumatic experience reported significant reductions in
psychological and physical symptoms at follow-up assessments compared
with other participants. These findings suggest that written emotional
disclosure may be most effective when individuals are instructed to
write about the same traumatic or stressful event at each writing
session, a finding consistent with exposure-based treatments.
Record: 1
Title: Psychological Aspects of Terror and Witnessing.
Author(s): Ihanus, Juhani, Department of Psychology, University of
Helsinki, Helsinki, Finland
Address: Ihanus, Juhani, Department of Psychology, University of
Helsinki, P.O. Box 9, FI-00014, Helsinki, Finland
Source: Journal of Psychohistory, Vol 32(3), Win 2005. pp. 268-277.
Publisher: US: Assn for Psychohistory
Publisher URL: http://www.psychohistory.com
ISSN: 0145-3378 (Print)
Language: English
Keywords: terror; witnessing; war; nuclear catastrophes;
environmental catastrophes; psychological effects; posttraumatic
disruptions; mind
Abstract: Terror, war, nuclear and environmental catastrophes and
other disasters overwhelm the human mind with burdens that are basically
very hard or even impossible to carry. The human mind and its psychic
processing cannot understand or accept the state of total non-existence,
the loss of the self, of others and of the whole world. Against such
threats of annihilation and feelings of utter helplessness we build up
competence: survival fantasies and images of wealth, abundance,
omniscience and omnipotence. The possibility of limitless destruction is
replaced by apparently more manageable technocalculations, heroic
survival strategies, ideological refuge, messianistic cults, millenary
dreams, and insistence on limited numbers of casualties. The
psychological effects of terror, concentration camps, war and nuclear
disasters tear off our normal psychological protection, resulting in
psychic numbing, the denial of reality, identification with the
aggressor, shame, guilt, aimlessness, apathy and antisocial behavior.
Posttraumatic disruptions also include--at both conscious and
unconscious levels--the sense of not being really alive, the phobic
anticipation of another traumatic disaster, repeated agonies,
self-doubts and aversions.
_____
Record: 2
Title: Health Service Use Predictors Among Trauma Survivors: A Critical
Review.
Author(s): Elhai, Jon D., Disaster Mental Health Institute,
University of South Dakota, Vermillion, SD, US, jonelhai@hotmail.com
North, Terry C., Mental Health Service, Omaha Veterans Affairs Medical
Center, Omaha, NE, US
Frueh, B. Christopher, Mental Health Service, Charleston Veterans
Affairs Medical Center, Charleston, SC, US
Address: Elhai, Jon D., Disaster Mental Health Institute,
University of South Dakota, 414 East Clark Street-SDU 114, Vermillion,
SD, US, jonelhai@hotmail.com
Source: Psychological Services, Vol 2(1), Win-Spr 2005. pp. 3-19.
Journal URL: http://www.apa.org/journals/ser.html
Publisher: US: Educational Publishing Foundation
Publisher URL: http://www.apa.org
ISSN: 1541-1559 (Print)
Digital Object Identifier: 10.1037/1541-1559.2.1.3
Language: English
Keywords: health service utilization; trauma survivors;
posttraumatic stress disorder; emotional trauma; health services
research; methodological issues
Abstract: This article had 2 aims: (a) to comprehensively review
and synthesize the literature on predictors of health service
utilization in survivors of traumatic events and posttraumatic stress
disorder (PTSD) patients and (b) to discuss methodological issues in
examining service utilization in this population. PsycINFO was searched
for relevant articles published through April 2004. Included studies had
to primarily sample trauma survivors or PTSD patients and statistically
explore health service use determinants. Although some findings
conflicted across studies, increased mental health service use was
generally related to being female, having a previous trauma history, and
having a PTSD diagnosis. Increased medical service use was found among
those with a PTSD diagnosis. Methodological recommendations are made for
future health service use studies.
_____
Record: 3
Title: Personality Assessment Inventory (PAI) Profiles of Male Veterans
With Combat-Related Posttraumatic Stress Disorder.
Author(s): Mozley, Susannah L., Boston VA Healthcare System, Boston
University School of Medicine, Boston, MA, US,
susannah.mozley2@med.va.gov
Miller, Mark W., Boston VA Healthcare System, Boston University School
of Medicine, Boston, MA, US
Weathers, Frank W., Auburn University, Auburn, AL, US
Beckham, Jean C., Durham, NC VA Medical Center, Duke University Medical
Center, Durham, NC, US
Feldman, Michelle E., Durham, NC VA Medical Center, Durham, NC, US
Address: Mozley, Susannah L., Boston VA Healthcare System, Boston
University School of Medicine, Boston, MA, US,
susannah.mozley2@med.va.gov
Source: Journal of Psychopathology & Behavioral Assessment, Vol 27(3),
Sep 2005. pp. 179-189.
Journal URL: http://www.wkap.nl/journalhome.htm/0882-2689
Publisher: Germany: Springer
Publisher URL: http://www.springeronline.com
ISSN: 0882-2689 (Print)
Digital Object Identifier: 10.1007/s10862-005-0634-6
Language: English
Keywords: personality assessment inventory profiles; combat
veterans; posttraumatic stress disorder; diagnosis; comorbidity
Abstract: The Personality Assessment Inventory (PAI; L. C. Morey,
1991) is a promising tool for the assessment of Posttraumatic Stress
Disorder (PTSD), but few studies have examined the PAI profiles of
individuals with the diagnosis. In this study, the PAI was administered
to 176 combat veterans with PTSD. Results showed significant elevations
on scales measuring depression, somatic complaints, anxiety,
anxiety-related disorders, schizophrenia, and negative impression
management. The Traumatic Stress subscale was the highest point in the
mean score profile and was moderately correlated with several
established measures of PTSD. Veterans with and without comorbid major
depression differed on PAI scales assessing depression, anxiety, and
warmth. Analysis of two-point codetypes for the PAI and the MMPI-2
revealed substantial heterogeneity in symptom endorsement on both
instruments, suggesting that there may be no clear PTSD profile on
either instrument. Results provide a reference point for future work
with the PAI in PTSD samples.
_____
Record: 4
Title: Group crisis intervention for children during ongoing war
conflict.
Author(s): Thabet, Abdel Aziz, Al Quds University, School of Public
Health, Gaza, Palestine
Vostanis, Panos, Greenwood Institute of Child Health, Leicester, United
Kingdom, pv11@le.ac.uk
Karim, Khalid, Greenwood Institute of Child Health, Leicester, United
Kingdom
Address: Vostanis, Panos, Greenwood Institute of Child Health,
Westcotes House, Westcotes Drive, Leicester, United Kingdom, LE3 OQU,
pv11@le.ac.uk
Source: European Child & Adolescent Psychiatry, Vol 14(5), Aug 2005. pp.
262-269.
Journal URL:
http://www.springeronline.com/sgw/cda/frontpage/0,11855,4-40109-70-11176
08-0,00.html
Publisher: Germany: Springer
Publisher URL: http://www.springeronline.com
ISSN: 1018-8827 (Print)
1435-135X (Electronic)
Digital Object Identifier: 10.1007/s00787-005-0466-7
Language: English
Keywords: group crisis intervention; war conflict; posttraumatic
stress; depressive symptoms; Gaza Strip
Abstract: The aim of this study was to evaluate the short-term
impact of a group crisis intervention for children aged 9-15 years from
five refugee camps in the Gaza Strip during ongoing war conflict.
Children were selected if they reported moderate to severe posttraumatic
stress reactions, and were allocated to group intervention (N = 47)
encouraging expression of experiences and emotions through storytelling,
drawing, free play and role-play; education about symptoms (N = 22); or
no intervention (N = 42). Children completed the CPTSD-RI and the CDI
pre-and post-intervention. No significant impact of the group
intervention was established on children's posttraumatic or depressive
symptoms. Possible explanations of the findings are discussed, including
the continuing exposure to trauma and the non-active nature of the
intervention.
_____
Record: 5
Title: Post-traumatic stress disorder among recently diagnosed patients
with HIV/AIDS in South Africa.
Author(s): Olley, B. O., MRC Unit on Anxiety Disorders, Department
of Psychiatry, University of Stellenbosch, Cape Town, South Africa
Zeier, M. D., Infectious Disease Clinic, Department of Internal
Medicine, Tygerberg Hospital, Cape Town, South Africa
Seedat, S., MRC Unit on Anxiety Disorders, Department of Psychiatry,
University of Stellenbosch, Cape Town, South Africa, sseedat@sun.ac.za
Stein, D. J., MRC Unit on Anxiety Disorders, Department of Psychiatry,
University of Stellenbosch, Cape Town, South Africa
Address: Seedat, S., MRC Unit on Anxiety Disorders, Department of
Psychiatry, University of Stellenbosch, PO Box 19063, Tygerberg, 7505,
Cape Town, South Africa, sseedat@sun.ac.za
Source: AIDS Care, Vol 17(5), Jul 2005. pp. 550-557.
Journal URL: http://www.tandf.co.uk/journals/carfax/09540121.html
Publisher: United Kingdom: Taylor & Francis
Publisher URL: http://www.taylorandfrancis.com/
ISSN: 0954-0121 (Print)
1360-0451 (Electronic)
Language: English
Keywords: post traumatic stress disorder; HIV patients; AIDS
patients; epidemiology; client characteristics
Abstract: This study examined the prevalence of and factors
associated with post-traumatic stress disorder in recently diagnosed
HIV/AIDS patients in South Africa. One hundred and forty-nine (44 male,
105 female) recently diagnosed HIV/AIDS patients (mean duration since
diagnosis = 5.8 months, SD = 4.1) were evaluated. Subjects were assessed
using the MINI International Neuropsychiatric Interview (MINI), the
Carver Brief COPE coping scale and the Sheehan Disability Scale. In
addition, previous exposures to trauma and past risk behaviours were
assessed. Twenty-two patients (14.8%) met criteria for PTSD. Current
psychiatric conditions more likely to be associated with PTSD included
major depressive disorder (29% in PTSD patients versus 7% in non-PTSD
patients, p = 0.004), suicidality (54% versus 11%, p = 0.001) and social
anxiety disorder (40% versus 13%, p = 0.04). Further patients with PTSD
reported significantly more work impairment and demonstrated a trend
towards higher usage of alcohol as a means of coping. Discriminant
function analysis indicated that female gender and a history of sexual
violation in the past year were significantly associated with a
diagnosis of PTSD. Patients whose PTSD was a direct result of an
HIV/AIDS diagnosis (8/22) did not differ from other patients with PTSD
on demographic or clinical features. In the South African context, PTSD
is not an uncommon disorder in patients with HIV/AIDS. In some cases,
PTSD is secondary to the diagnosis of HIV/AIDS but in most cases it is
seen after other traumas, with sexual violation and intimate partner
violence in women being particularly important.
_____
Record: 6
Title: Acceptance and Commitment Therapy in the Treatment of Comorbid
Substance Abuse and Post-Traumatic Stress Disorder: A Case Study.
Author(s): Batten, Sonja V., Trauma Recovery Program, VA Maryland
Health Care System, Baltimore, MD, US, svbatten@earthlink.net
Hayes, Steven C., Department of Psychology, University of Nevada, NV, US
Address: Batten, Sonja V., Trauma Recovery Programs (116B), VA
Maryland Health Care System, 10 N. Greene St., Baltimore, MD, US,
svbatten@earthlink.net
Source: Clinical Case Studies, Vol 4(3), Jul 2005. pp. 246-262.
Journal URL: http://www.sagepub.com/journal.aspx?pid=274
Publisher: US: Sage Publications
Publisher URL: http://www.sagepublications.com/
ISSN: 1534-6501 (Print)
Digital Object Identifier: 10.1177/1534650103259689
Language: English
Keywords: post-traumatic stress disorder; PTSD; substance abuse;
comorbidity; Acceptance and Commitment Therapy; sexual abuse
Abstract: Although post-traumatic stress disorder (PTSD) and
substance abuse are commonly co-occuring conditions, it is generally
recommended that an individual must first receive successful substance
abuse treatment before posttraumatic symptoms can be addressed. Given
the high comorbidity of these conditions, however, it would be helpful
if more broadly focused therapies were available that simultaneously
targeted common functional processes underlying the multiple problems of
the dually diagnosed. Both PTSD and substance abuse can be
conceptualized as disorders with significant experiential avoidance
components. One treatment that has been specifically developed for the
treatment of experiential avoidance is Acceptance and Commitment Therapy
(ACT). In this case study, application of ACT for an individual with
comorbid PTSD and substance abuse is described, and its effects are
examined.
_____
Record: 7
Title: Is Post-Traumatic Stress Disorder a helpful concept for adults
with intellectual disability?
Author(s): Mitchell, A., Sheffield Care Trust, Sheffield, United
Kingdom
Clegg, Jennifer, University of Nottingham, Nottingham, United Kingdom,
Jennifer.Clegg@Nottingham.ac.uk
Address: Clegg, Jennifer, Clinical Psychology, ADRU, University
Hospital, B Floor, Nottingham, United Kingdom, NG7 2UH,
Jennifer.Clegg@Nottingham.ac.uk
Source: Journal of Intellectual Disability Research, Vol 49(7), Jul
2005. pp. 552-559.
Journal URL:
http://www.blackwellpublishing.com/journal.asp?ref=0964-2633&site=1
Publisher: United Kingdom: Blackwell Publishing
Publisher URL: http://www.blackwellpublishing.com
ISSN: 0964-2633 (Print)
1365-2788 (Electronic)
Digital Object Identifier: 10.1111/j.1365-2788.2005.00705.x
Language: English
Keywords: posttraumatic stress disorder; intellectual disability;
trauma; psychiatric symptoms
Abstract: Background: Research using the concept of Post-Traumatic
Stress Disorder (PTSD) with adults with intellectual disability (ID)
assumes they perceive and react to traumatic events in a similar way to
nondisabled adults. Reactions to trauma displayed by children may be
relevant to adults with ID as well. Methods: Two focus groups were held
with professionals and practitioners to explore the relevance of
criteria from child as well as adult literature to adults with ID who
experience trauma. Descriptive thematic analysis was carried out.
Results: Abuse, parental bereavement, and having children removed were
considered common sources of trauma. Similarities identified between
disabled and non-disabled adults were flashbacks and nightmares;
distressed by reminders; avoidance; hypervigilance and increased
arousal. Differences were the frequent occurrence of multiple rather
than single events, which were considered significant in generating
chronic problems similar to those described as PTSD; also the occurrence
of physical health problems and behavioural re-enactments. Discussion
and Conclusions: Experienced professionals and practitioners considered
most of the ideas from PTSD research with non-disabled adults to be
relevant to adults with ID who experience trauma, but that some
behaviour reported in research with children was also relevant. Topics
and questions for use in clinical and research practice with individuals
who have experienced trauma were proposed.
_____
Record: 8
Title: Trauma, PTSD, and Resilience: A Review of the Literature.
Author(s): Agaibi, Christine E., University of Akron, Akron, OH, US
Wilson, John P., Cleveland State University, Cleveland, OH, US
Source: Trauma, Violence, & Abuse, Vol 6(3), Jul 2005. pp. 195-216.
Publisher: US: Sage Publications
Publisher URL: http://www.sagepublications.com/
ISSN: 1524-8380 (Print)
Language: English
Keywords: posttraumatic stress disorder; emotional trauma;
resilience; stress coping
Abstract: Based on the available literature, this review article
investigates the issue of resilience in relation to trauma and
posttraumatic stress disorder. Resilient coping to extreme stress and
trauma is a multifaceted phenomena characterized as a complex repertoire
of behavioral tendencies. An integrative Person × Situation model is
developed based on the literature that specifies the nature of
interactions among five classes of variables: (a) personality, (b)
affect regulation, (c) coping, (d) ego defenses, and (e) the utilization
and mobilization of protective factors and resources to aid coping.
_____
Record: 9
Title: Enhanced Cortisol Suppression Following Dexamethasone
Administration in Domestic Violence Survivors.
Author(s): Griffin, Michael G., Department of Psychology, Center
for Trauma Recovery, University of Missouri-St. Louis, St. Louis, MO,
US, michael_griffin@umsl.edu
Resick, Patricia A.
Yehuda, Rachel
Address: Griffin, Michael G., University of Missouri-St. Louis,
Center for Trauma Recovery, Kathy J. Weinman Bldg., 8001 Natural Bridge
Rd., St. Louis, MO, US, michael_griffin@umsl.edu
Source: American Journal of Psychiatry, Vol 162(6), Jun 2005. pp.
1192-1199.
Journal URL: http://ajp.psychiatryonline.org/
Publisher: US: American Psychiatric Assn
Publisher URL: http://www.appi.org
ISSN: 0002-953X (Print)
Digital Object Identifier: 10.1176/appi.ajp.162.6.1192
Language: English
Keywords: female domestic violence survivors; enhanced cortisol
suppression; dexamethasone administration; dexamethasone suppression
test; trauma severity; PTSD; depressive symptoms; cortisol levels
Abstract: Objective: The authors compared responses of female
domestic violence survivors and a matched group of nontraumatized
participants to a low-dose (0.5 mg) dexamethasone suppression test
(DST). Method: Seventy female domestic violence survivors and 14
nontraumatized women matched for age and race were recruited.
Participants were assessed for trauma severity, severity of PTSD and
depressive symptoms, and DST cortisol response. Of the domestic violence
survivors who were DST-compliant, comparisons were made among those with
PTSD (N=15), those with PTSD plus depression (N=27), and those with no
PTSD or depression diagnosis (N=8) along with the nontraumatized
comparison subjects (N=14). Results: Domestic violence survivors with
PTSD, regardless of whether or not they had comorbid depression, had
significantly lower baseline cortisol levels at 9:00 a.m. than the
healthy subjects and trauma survivors with no diagnosis. Survivors with
a sole diagnosis of PTSD showed significantly greater cortisol
suppression to dexamethasone than did healthy subjects or the group
diagnosed with PTSD plus depression. Conclusions: These findings agree
with previous studies showing hypothalamicpituitary-adrenal (HPA) axis
abnormalities in PTSD. The findings suggest that the chronic nature of
domestic violence leads to a severe dysregulation of the HPA axis.
_____
Record: 10
Title: Utility of the Trauma Symptom Inventory's Atypical Response
Scale in Detecting Malingered Post-Traumatic Stress Disorder.
Author(s): Elhai, Jon D., Disaster Mental Health Institute,
University of South Dakota, Vermillion, SD, US, jonelhai@hotmail.com
Gray, Matthew J., University of Wyoming, Laramie, WY, US
Naifeh, James A., Disaster Mental Health Institute, University of South
Dakota, Vermillion, SD, US
Butcher, Jimmie J., Clinical Psychology Training Program, Disaster
Mental Health Institute, University of South Dakota, Vermillion, SD, US
Davis, Joanne L., University of Tulsa, Tulsa, OK, US
Falsetti, Sherry A., Department of Family and Community Medicine,
University of Illinois College of Medicine, Rockford, IL, US
Best, Connie L., National Crime Victims Research and Treatment Center,
Medical University of South Carolina, Charleston, SC, US
Address: Elhai, Jon D., Disaster Mental Health Institute,
University of South Dakota, 414 East Clark Street-SDU 114, Vermillion,
SD, US, jelhai@usd.edu
Source: Assessment, Vol 12(2), Jun 2005. pp. 210-219.
Journal URL: http://www.sagepub.com/journal.aspx?pid=339
Publisher: US: Sage Publications
Publisher URL: http://www.sagepublications.com/
ISSN: 1073-1911 (Print)
Digital Object Identifier: 10.1177/1073191105275456
Language: English
Keywords: Trauma Symptom Inventory; post traumatic stress
disorder; atypical response scale; screening; malingering; test validity
Abstract: The authors examined the Trauma Symptom Inventory's
(TSI) ability to discriminate 88 student post-traumatic stress disorder
(PTSD) simulators screened for genuine PTSD from 48 clinical
PTSD-diagnosed outpatients. Results demonstrated between-group
differences on several TSI clinical scales and the Atypical Response
(ATR) validity scale. Discriminant function analysis using ATR revealed
75% correct patient classification but only 48% correct simulator
classification, with an overall correct classification rate of 59%
(positive predictive power [PPP] = .71; negative predictive power [NPP]
= .51). Individual ATR cutoff scores did not yield impressive
classification results, with the optimal cutoff (T score = 61) correctly
classifying only 61% of simulators and patients (PPP = .66, NPP = .54).
Although ATR was not developed as a malingered PTSD screen, instead
serving as a general validity screen, caution is recommended in its
current clinical use for detecting malingered PTSD.
Conference: Annual meeting of the International Society for
Traumatic Stress Studies, 20th, Nov, 2004, New Orleans, LA, US
Conference Notes: Portions of this article were presented at the
aforementioned conference.
_____
Record: 11
Title: A Longitudinal Study of Retirement in Older Male Veterans.
Author(s): Schnurr, Paula P., Veterans Affairs Medical Center,
National Center for Posttraumatic Stress Disorder, White River Junction,
VT, US, paula.schnurr@dartmouth.edu
Lunney, Carole A., Veterans Affairs Medical Center, National Center for
Posttraumatic Stress, White River Junction, VT, US
Sengupta, Anjana, Veterans Affairs Medical Center, National Center for
Posttraumatic Stress, White River Junction, VT, US
Spiro, Avron III, Boston Veterans Affairs Health Care System, Boston,
MA, US
Address: Schnurr, Paula P., National Center for Posttraumatic
Stress Disorder, Veterans Affairs Medical Center, (116D), White River
Junction, VT, US, paula.schnurr@dartmouth.edu
Source: Journal of Consulting and Clinical Psychology, Vol 73(3), Jun
2005. pp. 561-566.
Journal URL: http://www.apa.org/journals/ccp.html
Publisher: US: American Psychological Assn
Publisher URL: http://www.apa.org
ISSN: 0022-006X (Print)
Digital Object Identifier: 10.1037/0022-006X.73.3.561
Language: English
Keywords: retirement; psychological & physical symptoms; male
veterans; trauma exposure; posttraumatic stress disorder
Abstract: In this study, the authors examined the effect of
retirement on psychological and physical symptoms in 404 older male
veterans who were taking part in an ongoing longitudinal study.
Hierarchical linear modeling was used to analyze symptom trajectories
from preretirement, peri-retirement, and postretirement periods in
veterans with either lifetime full or partial posttraumatic stress
disorder (PTSD), trauma exposure only, or no traumatic exposure. As
expected, the PTSD group experienced greater increases in psychological
and physical symptoms during retirement, relative to the other groups.
Retirement due to poor health in the PTSD group did not account for the
findings regarding physical symptoms. Results indicate that clinicians
should recognize and address the potential for older individuals with
PTSD to experience difficulties during retirement.
Conference: Annual Meeting of the International Society for
Traumatic Stress Studies, Nov, 2004, New Orleans, LA, US
Conference Notes: This article was presented at the aforementioned
meeting.
_____
Record: 12
Title: Secondary Traumatization in Partners and Parents of Dutch
Peacekeeping Soldiers.
Author(s): Dirkzwager, Anja J. E., Department of Medical
Psychology, VU University Medical Center, Amsterdam, Netherlands,
anja_dirkzwager@hotmail.com
Bramsen, Inge, Department of Medical Psychology, VU University Medical
Center, Amsterdam, Netherlands
Adèr, Herman, Department of Clinical Epidemiology and Biostatistics, VU
University Medical Center, Amsterdam, Netherlands
van der Ploeg, Henk M., Department of Medical Psychology, VU University
Medical Center, Amsterdam, Netherlands
Address: Dirkzwager, Anja J. E., Department of Medical
Psychology, VU University Medical Center, Van Der Boechorststraat 7,
1081 BT, Amsterdam, Netherlands, anja_dirkzwager@hotmail.com
Source: Journal of Family Psychology, Vol 19(2), Jun 2005. pp. 217-226.
Journal URL: http://www.apa.org/journals/fam.html
Publisher: US: American Psychological Assn
Publisher URL: http://www.apa.org
ISSN: 0893-3200 (Print)
Digital Object Identifier: 10.1037/0893-3200.19.2.217
Language: English
Keywords: secondary traumatization; Dutch Peacekeeping Soldiers;
partners; parents; marital relationship; social support; posttraumatic
stress symptoms; posttraumatic stress disorder; family members
Abstract: This study examines secondary traumatization among 708
partners and 332 parents of Dutch peacekeepers (i.e., personnel who
participated in military actions implemented by international
organizations such as the United Nations). Partners or parents of
peacekeepers with 4 levels of posttraumatic stress symptoms were
compared on posttraumatic stress, health problems, the quality of the
marital relationship, and social support. In comparison with partners of
peacekeepers without posttraumatic stress disorder (PTSD) symptoms,
partners of peacekeepers with PTSD symptoms reported more sleeping and
somatic problems, reported more negative social support, and judged the
marital relationship as less favorable. No significant differences were
found for parents. Thus, peacekeepers' stress reactions were related to
various problems of their partners. A systemic approach to the treatment
of persons with PTSD appears appropriate.
_____
Record: 13
Title: Strangers at Home: Comment on Dirkzwager, Bramsen, Adèr, and van
der Ploeg (2005).
Author(s): Figley, Charles R., Traumatology Institute, Florida
State University, Tallahassee, FL, US, cfigley@fsu.edu
Address: Figley, Charles R., Traumatology Institute, Florida
State University, 1564 Keily Run, Tallahassee, FL, US, cfigley@fsu.edu
Source: Journal of Family Psychology, Vol 19(2), Jun 2005. pp. 227-229.
Journal URL: http://www.apa.org/journals/fam.html
Publisher: US: American Psychological Assn
Publisher URL: http://www.apa.org
ISSN: 0893-3200 (Print)
Digital Object Identifier: 10.1037/0893-3200.19.2.227
Language: English
Keywords: systemic traumatology; Dutch Peacekeeping Soldiers;
peacekeeper families; partners; parents; marital morale; social support;
symptoms; posttraumatic stress disorder; PTSD; family members
Abstract: This comment summarizes the findings of the article by
A. J. E. Dirkzwager, I. Bramsen, H. Adèr, and H. M. van der Ploeg (2005;
see record 2005-06518-006) and notes that it can serve as a reawakening
about the immediate and long-term psychosocial consequences of war, not
only for those troops who are deployed but also for the loved ones who
await their return. The lessons learned once again--that the mental
health of the returning peacekeeper parallels that of his or her
partner, that partners of traumatized soldiers report more posttraumatic
stress disorder symptoms, somatic and sleep problems, negative social
support, and low marital morale than partners of nontraumatized
soldiers--are consistent with systemic traumatology theory. This comment
traces the historical and theoretical foundations that underlie the
concept of secondary trauma (i.e., compassion fatigue) and discusses the
implications for family psychology practice in helping veterans and
their families recover from their ordeals.
_____
Record: 14
Title: Families at Risk: Comment on Dirkzwager, Bramsen, Adèr, and van
der Ploeg (2005).
Author(s): Fairbank, John A., University of California, Los
Angeles-Duke University National Center for Child Traumatic Stress,
Department of Psychiatry and Behavioral Sciences, Duke University
Medical Center, Durham, NC, US, jaf@psych.duhs.duke.edu
Fairbank, Doreen W., Department of Psychology, Meredith College,
Raleigh, NC, US
Address: Fairbank, John A., UCLA-Duke University National Center
for Child Traumatic Stress, Department of Psychiatry and Behavioral
Sciences, Duke University Medical Center, DUMC Box 3438, Durham, NC, US,
jaf@psych.duhs.duke.edu
Source: Journal of Family Psychology, Vol 19(2), Jun 2005. pp. 230-232.
Journal URL: http://www.apa.org/journals/fam.html
Publisher: US: American Psychological Assn
Publisher URL: http://www.apa.org
ISSN: 0893-3200 (Print)
Digital Object Identifier: 10.1037/0893-3200.19.2.230
Language: English
Keywords: secondary traumatization; peacekeepers; soldiers;
partners; parents; marital relationship; social support; symptoms;
posttraumatic stress disorder; family members; intergenerational
research
Abstract: New findings from a study by A. J. E. Dirkzwager, I.
Bramsen, H. Adèr, and H. M. van der Ploeg (2005; see record
2005-06518-006) provide important empirical information on the adverse
psychological and functional adjustment of families of former Dutch
peacekeepers suffering from posttraumatic stress disorder (PTSD). In
this comment the authors consider a few methodological limitations and
issues for future study, including the need for intergenerational
studies of the legacy of peacekeeping-related PTSD. Attention to
considering the treatment needs of families of traumatized former
peacekeepers is encouraged.
_____
Record: 15
Title: When Family Members Go To War--A Systemic Perspective on Harm
and Healing: Comment on Dirkzwager, Bramsen, Adèr, and van der Ploeg
(2005).
Author(s): Fals-Stewart, William, RTI International, Research
Triangle Park, NC, US, wstewart@rti.org
Kelley, Michelle, Department of Psychology, Old Dominion University,
Norfolk, VA, US
Address: Fals-Stewart, William, 3040 Cornwallis Road, Research
Triangle Park, NC, US, wstewart@rti.org
Source: Journal of Family Psychology, Vol 19(2), Jun 2005. pp. 233-236.
Journal URL: http://www.apa.org/journals/fam.html
Publisher: US: American Psychological Assn
Publisher URL: http://www.apa.org
ISSN: 0893-3200 (Print)
Digital Object Identifier: 10.1037/0893-3200.19.2.233
Language: English
Keywords: secondary trauma; Dutch Peacekeeping Soldiers;
peacekeeper personnel; partners; marital relationship adjustment; social
support; posttraumatic stress symptoms; PTSS; trauma transmission;
family
Abstract: The article by A. J. E. Dirkzwager, I. Bramsen, H. Adèr,
and H. M. van der Ploeg (2005; see record 2005-06518-006) provides
compelling evidence of trauma transmission of posttraumatic stress
symptoms (PTSS) from male peacekeepers to their female partners. Given
the rise in troop deployment throughout the globe and increased exposure
of soldiers to combat violence, the investigation is highly relevant,
important and timely, illustrating the broad systemic emotional toll on
couples when partners go to war. The purpose of this comment is to
recommend future research directions (a) to reveal the characteristics
of those individuals, couples, and family members that may be predictive
of vulnerability and resiliency to PTSS and its sequelae; (b) to
understand the interrelationship of PTSS and secondary trauma,
relationship adjustment, and social support; and (c) to develop and test
intervention methods that may be effective in reducing PTSS and other
psychosocial problems among peacekeepers, their partners, and other
family members.
_____
Record: 16
Title: A Comparison of Adolescent Inpatients With and Without a History
of Violence Perpetration: Impulsivity, PTSD, and Violence Risk.
Author(s): Fehon, Dwain C., Department of Psychiatry, Yale
University School of Medicine, New Haven, CT, US
Grilo, Carlos M., Department of Psychiatry, Yale University School of
Medicine, New Haven, CT, US
Lipschitz, Deborah S., Department of Psychiatry, Yale University School
of Medicine, New Haven, CT, US
Address: Fehon, Dwain C., Yale-New Haven Psychiatric Hospital,
184 Liberty Street, New Haven, CT, US
Source: Journal of Nervous & Mental Disease, Vol 193(6), Jun 2005. pp.
405-411.
Journal URL: http://www.jonmd.com/
Publisher: US: Lippincott Williams & Wilkins
Publisher URL: http://www.lww.com/
ISSN: 0022-3018 (Print)
Digital Object Identifier: 10.1097/01.nmd.0000165294.41091.fc
Language: English
Keywords: adolescent inpatients; history of violence perpetration;
impulsivity; posttraumatic stress disorder; violence risk; childhood
maltreatment; victimization
Abstract: How childhood maltreatment and violence victimization
contributes to subsequent violent behavior remains an understudied area.
We examined 130 psychiatrically hospitalized adolescents and compared
those with a history of perpetrating violence to those without a history
of violence perpetration. Perpetrators of physical violence were
significantly more likely to have been a victim and/or witness to family
and community violence and also reported significantly higher levels of
a broad range of psychopathology than nonperpetrators. Correlational
analyses with the study group of violence perpetrators revealed that
higher levels of impulsivity, dissociation, and PTSD were significantly
associated with higher levels of violence. Furthermore, multiple
regression analysis showed that symptoms of impulsivity and PTSD
contributed significantly to the prediction of violence risk. Our
findings demonstrate that violence exposure and childhood maltreatment
are indeed common negative life events among adolescent inpatients, and
that symptoms of PTSD may predispose traumatized youth toward impulsive
violent behavior.
_____
Record: 17
Title: A survey of PTSD screening and referral practices in VA
addiction treatment programs.
Author(s): Young, Helena E., National Center for PTSD, VA Palo Alto
Health Care System, Menlo Park, CA, US, helena.young@med.va.gov
Rosen, Craig S., National Center for PTSD, VA Palo Alto Health Care
System, Menlo Park, CA, US
Finney, John W., VA Sierra-Pacific Mental Illness Research Education and
Clinical Center, Palo Alto, CA, US
Address: Young, Helena E., National Center for PTSD, VA Palo Alto
Health Care System, Menlo Park, CA, US, helena.young@med.va.gov
Source: Journal of Substance Abuse Treatment, Vol 28(4), Jun 2005. pp.
313-319.
Journal URL:
http://www.elsevier.com/inca/publications/store/5/2/5/4/7/5/
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0740-5472 (Print)
Digital Object Identifier: 10.1016/j.jsat.2005.02.006
Language: English
Keywords: posttraumatic stress disorder; substance use disorders;
veterans; addiction treatment programs; comorbidity; screening
Abstract: Veterans with posttraumatic stress disorder (PTSD) and
substance use disorders (SUDs) demonstrate worse outcomes following
treatment for SUDs than do veterans with SUDs only, and so PTSD
treatment may enhance SUD outcomes for patients. A survey of current
practice patterns in VA SUD treatment programs was undertaken to
determine their concurrence with emerging practice guidelines for the
assessment and treatment of SUD-PTSD comorbidity. Clinicians in
outpatient SUD clinics and/or inpatient SUD programs were surveyed in
six VA medical centers in 1999 and 2001 (respondents n = 57 and n = 39,
respectively). Although one half to two thirds of clinicians working
with SUD patients routinely screen for trauma exposure and PTSD, few
assessments are systematically conducted using validated measures.
Routine referrals to PTSD specialty and dual-diagnosis programs and to
veterans' centers are made by between 35% and 60% of providers across
inpatient and outpatient settings. Implications for improvement of
clinical outcomes are discussed.
_____
Record: 18
Title: Americans as Survivors.
Author(s): Lifton, Robert Jay, Department of Psychiatry, Harvard
Medical School, Boston, MA, US
Source: New England Journal of Medicine, Vol 352(22), Jun 2005. pp.
2263-2265.
Journal URL: http://content.nejm.org/
Publisher: US: Massachusetts Medical Society
Publisher URL: http://content.nejm.org/
ISSN: 0028-4793 (Print)
Digital Object Identifier: 10.1056/NEJMp058048
Language: English
Keywords: Americans; collective trauma; psychological trauma;
psychological responses; war; terrorist attacks; survivors;
posttraumatic stress disorder
Abstract: Physicians have always been concerned with how people
survive trauma. Less noted has been the experience of Americans as
survivors of violent collective trauma. We owe this lack of attention to
the relative rarity of large-scale killing and dying on American soil
and to the fact that in wars fought abroad, suffering has usually been
countered by a sense of victorious achievement. All this changed as a
result of the Vietnam War, in which heavy American casualties were
followed by defeat; then the terrorist attacks of September 11, 2001,
which brought large-scale trauma home to Americans; and, now, the war in
Iraq and the anguish and uncertainty associated with it. The collective
psychological responses to these events reverberate throughout our
society--as they would in any society undergoing similar trauma. The
author examines some consistent patterns of psychological trauma in
Americans--a sense of individual and collective fear and vulnerability
and feelings of injured national pride and humiliation.
_____
Record: 19
Title: Posttraumatic obsessive-compulsive disorder: A case series.
Author(s): Sasson, Yehuda, Division of Psychiatry, Chaim Sheba
Medical Center, Tel-Hashomer, Israel
Dekel, Sharon, Division of Psychiatry, Chaim Sheba Medical Center,
Tel-Hashomer, Israel
Nacasch, Nitza, Division of Psychiatry, Chaim Sheba Medical Center,
Tel-Hashomer, Israel
Chopra, Miriam, Division of Psychiatry, Chaim Sheba Medical Center,
Tel-Hashomer, Israel
Zinger, Yaffa, Division of Psychiatry, Chaim Sheba Medical Center,
Tel-Hashomer, Israel
Amital, Daniella, Division of Psychiatry, Chaim Sheba Medical Center,
Tel-Hashomer, Israel
Zohar, Joseph, Division of Psychiatry, Chaim Sheba Medical Center,
Tel-Hashomer, Israel, jzohar@post.tau.ac.il
Address: Zohar, Joseph, Division of Psychiatry, Chaim Sheba
Medical Center, Tel-Hashomer, Israel, 52621, jzohar@post.tau.ac.il
Source: Psychiatry Research, Vol 135(2), Jun 2005. pp. 145-152.
Journal URL:
http://www.elsevier.com/wps/find/journaldescription.cws_home/522773/desc
ription#description
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0165-1781 (Print)
Digital Object Identifier: 10.1016/j.psychres.2004.05.026
Language: English
Keywords: posttraumatic stress disorder; obsessive compulsive
disorder; symptomatology; military veterans
Abstract: This report documents emerging posttraumatic
obsessive-compulsive disorder in 13 Israeli military veterans diagnosed
with both obsessive-compulsive disorder (OCD) and posttraumatic stress
disorder (PTSD), for whom the onset of OCD was clearly associated with
the trauma. Data presented include four detailed case reports that
delineate relations between symptomatology in the two disorders.
Clinical and theoretical implications of these data are discussed.
_____
Record: 20
Title: Alternatives to Debriefing and Modifications to Cognitive
Behavior Therapy for Posttraumatic Stress Disorder.
Author(s): Belaise, Carlotta, Laboratory of Experimental
Psychotherapy, Department of Psychology, University of Bologna, Bologna,
Italy
Fava, Giovanni A., Laboratory of Experimental Psychotherapy, Department
of Psychology, University of Bologna, Bologna, Italy,
giovanniandrea.fava@unibo.it
Marks, Isaac M., Department of Psychiatry, Imperial College School of
Medicine, United Kingdom
Address: Fava, Giovanni A., Dipartimento di Psicologia,
Universita di Bologna, Viale Berti Pichat, 5, IT-40127, Bologna, Italy,
giovanniandrea.fava@unibo.it
Source: Psychotherapy & Psychosomatics, Vol 74(4), Jun 2005. pp.
212-217.
Journal URL: http://www.karger.ch/journals/pps/pps_jh.htm
Publisher: Switzerland: Karger
Publisher URL: http://www.karger.com/
ISSN: 0033-3190 (Print)
1423-0348 (Electronic)
Digital Object Identifier: 10.1159/000085144
Language: English
Keywords: posttraumatic stress disorder; exposure to cues related
to traumatic event; well-being therapy
Abstract: Background: Psychological debriefing uses brief
unsystematic exposure, and is ineffective for posttraumatic stress
symptoms and disorder. Systematic exposure alone and cognitive
restructuring alone are each effective. Other approaches too may be
useful. Methods: The treatment of 3 posttraumatic stress disorder (PTSD)
patients is detailed in which there was no exposure to the main
traumatic event. There was exposure to related cues in case 1, exposure
to related and other cues followed by well-being therapy (WBT) in case 2
and WBT in case 3. Results: The 3 patients improved enduringly,
confirming earlier findings that exposure to the main trauma is not
essential for PTSD to improve. Conclusions: A study is needed of
therapeutic mechanisms in PTSD and of the value of WBT in a randomized
controlled trial.
_____
Record: 21
Title: Delayed Onset of Posttraumatic Stress Disorder Among Male Combat
Veterans: A Case Series.
Author(s): Ruzich, Michelle J., Medical School, Australian National
University, Canberra, ACT, Australia, michelle.ruzich@act.gov.au
Looi, Jeffrey Chee Leong, Medical School, Australian National
University, Canberra, ACT, Australia
Robertson, Michael David, Mayo Healthcare Group, Taree, Australia
Address: Ruzich, Michelle J., Research Centre for the
Neurosciences of Ageing (RESCENA), Older Persons Mental Health (ACT
Health), Calvary Hospital, Level 1, Lewisham Bldg., Bruce, ACT,
Australia, 2617, michelle.ruzich@act.gov.au
Source: American Journal of Geriatric Psychiatry, Vol 13(5), May 2005.
pp. 424-427.
Journal URL: http://ajgp.psychiatryonline.org/
Publisher: US: American Psychiatric Assn
Publisher URL: http://www.appi.org
ISSN: 1064-7481 (Print)
Digital Object Identifier: 10.1176/appi.ajgp.13.5.424
Language: English
Keywords: posttraumatic stress disorder; disorder onset; combat
veterans; cognitive functioning; emotional functioning
Abstract: Objective: Authors investigated the nature of
delayed-onset posttraumatic stress disorder (PTSD) among combat
veterans. Methods: PTSD, along with cognitive and emotional functioning,
was assessed in a case series of elderly Australian war veterans.
Results: Fifteen elderly male subjects consecutively referred to an
outpatient psychiatric clinic were identified as having PTSD with
significantly delayed onset. In most cases, the onset of PTSD symptoms
was associated with unrelated medical complaints, psychosocial stress,
and/or mild cognitive impairment. Conclusion: Environmental stressors,
coupled with age-related neurodegeneration, may potentially contribute
to the late-life recrudescence or emergence of PTSD symptoms in veterans
exposed to combat-related trauma.
_____
Record: 22
Title: Does Memory of a Traumatic Event Increase the Risk for
Posttraumatic Stress Disorder in Patients With Traumatic Brain Injury? A
Prospective Study.
Author(s): Gil, Sharon
Caspi, Yael
Ben-Ari, Irit Zilberman
Koren, Danny
Klein, Ehud, e_klein@rambam.health.gov.il
Address: Klein, Ehud, Department of Psychiatry, Rambam Medical
Center, P.O. Box 9602, Haifa, Israel, 31096,
e_klein@rambam.health.gov.il
Source: American Journal of Psychiatry, Vol 162(5), May 2005. pp.
963-969.
Journal URL: http://ajp.psychiatryonline.org/
Publisher: US: American Psychiatric Assn
Publisher URL: http://www.appi.org
ISSN: 0002-953X (Print)
Digital Object Identifier: 10.1176/appi.ajp.162.5.963
Language: English
Keywords: traumatic event memory; prediction; development of
posttraumatic stress disorder; patients with mild traumatic brain injury
Abstract: Objective: The present study examined prospectively the
relationship between memory of the traumatic event and subsequent
development of posttraumatic stress disorder (PTSD). More specifically,
the aims of this study were to 1) investigate the possibility that lack
of memory of the traumatic event might be a protective factor; 2 assess
whether memory of the traumatic event equally affects the three symptom
clusters of PTSD: reexperiencing, avoidance, and hyperarousal; and 3)
explore the predictive value of memory of the traumatic event for the
development of subsequent PTSD in the immediate aftermath of the event.
Method: One hundred twenty subjects with mild traumatic brain injury who
were hospitalized for observation were assessed immediately after the
trauma and followed up 1 week, 3 months, and 6 months later. All
participants underwent psychiatric evaluation and self-assessment of
their memory of the traumatic event. Results: Overall, 17 (14%) of the
participants met full criteria for PTSD at 6 months. Subjects with
memory of the traumatic event were significantly more likely to develop
PTSD than those without memory of the traumatic event; the difference
between the groups resulted primarily from the reexperiencing cluster.
Logistic regression analysis revealed that memory of the traumatic event
within the first 24 hours is a strong predictor of PTSD 6 months after
the event. Conclusions: Our study indicated that memory of a traumatic
event is a strong predictor and a potential risk factor for subsequent
development of PTSD. Future studies are needed to show whether these
findings can be generalized to other traumatic conditions.
_____
Record: 23
Title: Circadian Rhythm of Salivary Cortisol in Holocaust Survivors
With and Without PTSD.
Author(s): Yehuda, Rachel, rachel.yehuda@med.va.gov
Golier, Julia A.
Kaufman, Shira
Address: Yehuda, Rachel, Psychiatry OOMH, Bronx VA Medical
Center, 130 W. Kingsbridge Rd., Bronx, NY, US, rachel.yehuda@med.va.gov
Source: American Journal of Psychiatry, Vol 162(5), May 2005. pp.
998-1000.
Journal URL: http://ajp.psychiatryonline.org/
Publisher: US: American Psychiatric Assn
Publisher URL: http://www.appi.org
ISSN: 0002-953X (Print)
Digital Object Identifier: 10.1176/appi.ajp.162.5.998
Language: English
Keywords: salivary cortisol; circadian rhythms; posttraumatic
stress disorder; geriatric trauma survivors; Holocaust
Abstract: Objective: The authors' goal was to determine whether
cortisol circadian rhythm alterations observed in younger subjects with
posttraumatic stress disorder (PTSD) are also present in geriatric
trauma survivors with PTSD. Method: Salivary cortisol levels were
measured at six intervals from awakening until bedtime in 23 Holocaust
survivors with PTSD, 19 Holocaust survivors without PTSD, and 25
subjects who had not been exposed to the Holocaust. Thirty-three of the
subjects were men, and 34 were women. Results: Cortisol levels were
significantly lower at awakening, at 8:00 a.m., and at 8:00 p.m. in
Holocaust survivors with PTSD than in nonexposed subjects, resulting in
a flatter circadian rhythm, similar to what has been observed in aging
but different from what has been reported in younger subjects with PTSD.
Conclusions: These data provide evidence of differential neuroendocrine
alterations in geriatric PTSD.
_____
Record: 24
Title: Posttraumatic Stress Disorders in Children and Adolescents
Handbook.
Author(s): Ordoña, Truce TG.
Source: American Journal of Psychiatry, Vol 162(5), May 2005. pp.
1035-1036.
Journal URL: http://ajp.psychiatryonline.org/
Publisher: US: American Psychiatric Assn
Publisher URL: http://www.appi.org
Reviewed Item: Raul R. Silva (Ed.) (No Year Given). Posttraumatic
Stress Disorders in Children and Adolescents Handbook; New York, W.W.
Norton & Co., 371 pp., $22.95 (paper)
ISSN: 0002-953X (Print)
Language: English
Keywords: posttraumatic stress disorders; children; adolescents
Abstract: Reviews the book, Posttraumatic Stress Disorders in
Children and Adolescents Handbook. With 28 contributors from New York
City and six from Lebanon, this book's 15 chapters cover every
conceivable nook and cranny of PTSD, a much ignored psychiatric
condition. Topics covered include 1) epidemiology, 2) resiliency and
vulnerability factors, 3) risk factors, 4) legal aspects, 5)
neurobiology, 6 etiology and pathogenesis, 7) clinical findings, 8)
gender differences, 9) intergenerational links between mothers and
children with PTSD spectrum illness, 10) assessment, 11) differential
diagnosis, 12) childhood versus adult PTSD, 13) treatment of children
exposed to trauma, 14) clinical case examples, and 15) PTSD in children
and adolescents following war. The editor shows an uncanny sense of
reverence and irreverence for traditional views of PTSD and, in the
process, gives coherent meaning to the often conflicting and muddled
views of this disorder, which all mental health professionals deal with.
The aggregate impact of this handbook is in shedding light not only on
what makes humans break down but also on what makes humans bounce back.
_____
Record: 25
Title: Early Intervention for Trauma and Traumatic Loss.
Author(s): Herman, Judith L.
Source: American Journal of Psychiatry, Vol 162(5), May 2005. pp.
1036-1037.
Journal URL: http://ajp.psychiatryonline.org/
Publisher: US: American Psychiatric Assn
Publisher URL: http://www.appi.org
Reviewed Item: Brett T. Litz (Ed.) (2004). Early Intervention for
Trauma and Traumatic Loss; New York, Guilford Publications, 2004, 338
pp., $40.00
ISSN: 0002-953X (Print)
Language: English
Keywords: trauma; traumatic loss; early intervention; critical
incident stress debriefing; psychological first aid
Abstract: Reviews the book, Early Intervention for Trauma and
Traumatic Loss (see record 2004-95079-000). The authors offer a critique
of critical incident stress debriefing in the aftermath of traumatic
events. Although this type of group intervention has become an
established practice, even mandatory in many first-responder
organizations, rigorous clinical trials suggest that critical incident
stress debriefing is ineffective for preventing the development of
posttraumatic stress disorder. One problem with interventions such as
critical incident stress debriefing is that most people may neither want
nor need this sort of professional "help." Although extreme distress is
common in the immediate aftermath of a traumatic event, most survivors
will recover spontaneously, with support from the people they know and
trust. Litz recommends a minimally intrusive crisis response called
"psychological first aid": providing information and practical
problem-solving assistance and comforting survivors without pressuring
them to explore the details of the traumatic event. This sensible
approach respects the privacy and resiliency of survivors. The reviewer
notes that individual treatments are the only alternative proposed in
place of the discredited large-group interventions. Participatory models
of intervention that engage members of a traumatized community in
designing their own crisis responses are simply ignored. Despite these
limitations, she feels that this book will be of interest to researchers
and policy makers seeking to develop an evidence-based approach to early
intervention and disaster planning.
_____
Record: 26
Title: Posttraumatic Stress Disorder: Malady or Myth?
Author(s): Denton, Donald D. Jr.
Source: American Journal of Psychiatry, Vol 162(5), May 2005. pp. 1036.
Journal URL: http://ajp.psychiatryonline.org/
Publisher: US: American Psychiatric Assn
Publisher URL: http://www.appi.org
Reviewed Item: Chris R. Brewin (2003). Posttraumatic Stress Disorder:
Malady or Myth?; New Haven, Conn., Yale University Press, 2003, 271 pp.,
$40.00
ISSN: 0002-953X (Print)
Language: English
Keywords: posttraumatic stress disorder; trauma's impact on memory
Abstract: Reviews the book, Posttraumatic Stress Disorder: Malady
or Myth? (see record 2003-07155-000). The reviewer feels that this
volume is well organized, is clearly written, and uses the current
research about trauma's impact on memory. Beginning with an overview of
the clinical and cultural aspects of the disorder, Brewin moves to
detailed discussions of trauma's impact on identity, the puzzling ways
in which trauma is remembered, and the debates around the false memory
syndrome. He outlines the dual task for both survivor and therapist:
addressing the posttrauma intrusive memories and reformulating the
posttrauma identity. The author's distinction between declarative and
nondeclarative forms of memory provides us with a helpful way to
understand how trauma continues to affect a patient's life. Finally,
Brewin presents a three-step schema around which responses to survivors
of large-scale trauma may be implemented. Brewin asks clinicians and
researchers to show "the same flexibility and resourcefulness shown by
survivors" as they provide comfort and counsel to people "suddenly
confronted with the unexpected, the unwanted and the unimaginable."
_____
Record: 27
Title: Pathways to Recurrent Trauma Among Young Black Men: Traumatic
Stress, Substance Use, and the "Code of the Street".
Author(s): Rich, John A., Department of Medicine, Boston University
School of Medicine, Boston, MA, US, jrich@bu.edu
Grey, Courtney M., Department of Medicine, Boston University School of
Medicine, Boston, MA, US
Address: Rich, John A., 1010 Massachusetts Ave, 6th Floor,
Boston, MA, US, jrich@bu.edu
Source: American Journal of Public Health, Vol 95(5), May 2005. pp.
816-824.
Journal URL: http://www.ajph.org
Publisher: US: American Public Health Assn
Publisher URL: http://www.ajph.org
ISSN: 0090-0036 (Print)
1541-0048 (Electronic)
Language: English
Keywords: black men; traumatic stress; recurrent interpersonal
violence; substance use; reinjury; prevention
Abstract: Recurrent interpersonal violence is a major cause of
death and disability among young Black men. Quantitative studies have
uncovered factors associated with reinjury, but little is known about
how these factors work together. We interviewed young Black male victims
to understand their experience of violence. Qualitative analysis of
their narratives revealed how their struggle to reestablish safety
shaped their response to injury. Aspects of the "code of the street"
(including the need for respect) and lack of faith in the police
combined with traumatic stress and substance use to accentuate their
sense of vulnerability. Victims then reacted to protect themselves in
ways that could increase their risk of reinjury. We describe a model
with implications for reducing rates of recurrent violent injuries.
_____
Record: 28
Title: Psychopathology Among New York City Public School Children 6
Months After September 11.
Author(s): Hoven, Christina W., Department of Epidemiology, Mailman
School of Public Health, Columbia University-New York State Psychiatric
Institute, New York, NY, US, ch42@columbia.edu
Duarte, Cristiane S., Department of Epidemiology, Mailman School of
Public Health, Columbia University-New York State Psychiatric Institute,
New York, NY, US
Lucas, Christopher P., Department of Psychiatry, College of Physicians
and Surgeons, Columbia University-New York State Psychiatric Institute,
New York, NY, US
Wu, Ping, Department of Epidemiology, Mailman School of Public Health,
Columbia University-New York State Psychiatric Institute, New York, NY,
US
Mandell, Donald J., Department of Epidemiology, Mailman School of Public
Health, Columbia University-New York State Psychiatric Institute, New
York, NY, US
Goodwin, Renee D., Department of Epidemiology, Mailman School of Public
Health, Columbia University-New York State Psychiatric Institute, New
York, NY, US
Cohen, Michael, The Michael Cohen Group, LLC, US
Balaban, Victor, National Center for Chronic Disease Prevention and
Health Promotion, Centers for Disease Control and Prevention, Atlanta,
GA, US
Woodruff, Bradley A., National Center for Chronic Disease Prevention and
Health Promotion, Centers for Disease Control and Prevention, Atlanta,
GA, US
Bin, Fan, Columbia University-New York State Psychiatric Institute, New
York, NY, US
Musa, George J., Columbia University-New York State Psychiatric
Institute, New York, NY, US
Mei, Lori, New York City Department of Education, New York, NY, US
Cantor, Pamela A., Children's Mental Health Alliance, US
Aber, J. Lawrence, Department of Psychology, New York University, New
York, NY, US
Cohen, Patricia, Department of Epidemiology, Mailman School of Public
Health, Columbia University-New York State Psychiatric Institute, New
York, NY, US
Susser, Ezra, Department of Epidemiology, Mailman School of Public
Health, Columbia University-New York State Psychiatric Institute, New
York, NY, US
Address: Hoven, Christina W., Child Psychiatric Epidemiology
Group, Columbia University- New York State Psychiatric Institute, 1051
Riverside Dr, Unit 43, New York, NY, US, ch42@columbia.edu
Source: Archives of General Psychiatry, Vol 62(5), May 2005. pp.
545-552.
Journal URL: http://archpsyc.ama-assn.org/
Publisher: US: American Medical Assn
Publisher URL: http://www.amapublications.com
ISSN: 0003-990X (Print)
Digital Object Identifier: 10.1001/archpsyc.62.5.545
Language: English
Keywords: psychopathology; public school children; September 11;
mental disorders; traumatic event
Abstract: Children exposed to a traumatic event may be at higher
risk for developing mental disorders. The prevalence of child
psychopathology, however, has not been assessed in a population-based
sample exposed to different levels of mass trauma or across a range of
disorders. The objective of this study is to determine prevalence and
correlates of probable mental disorders among New York City, NY, public
school students 6 months following the September 11, 2001, World Trade
Center attack. A survey was used as the study design using participants
from a citywide, random, representative sample of 8236 students from New
York City public schools in grades 4 through 12, including over-sampling
in closest proximity to the World Trade Center site (ground zero) and
other high-risk areas. Children were screened for probable mental
disorders with the Diagnostic Interview Schedule for Children Predictive
Scales. One or more of 6 probable anxiety/depressive disorders were
identified in 28.6% of all children. The most prevalent were probable
agoraphobia (14.8%), probable separation anxiety (12.3%), and probable
posttraumatic stress disorder (10.6%). Higher levels of exposure
correspond to higher prevalence for all probable anxiety/depressive
disorders. Girls and children in grades 4 and 5 were the most affected.
In logistic regression analyses, child's exposure (adjusted odds ratio,
1.62), exposure of a child's family member (adjusted odds ratio, 1.80),
and the child's prior trauma (adjusted odds ratio, 2.01) were related to
increased likelihood of probable anxiety/ depressive disorders. Results
were adjusted for different types of exposure, sociodemographic
characteristics, and child mental health service use. A high proportion
of New York City public school children had a probable mental disorder 6
months after September 11, 2001. The data suggest that there is a
relationship between level of exposure to trauma and likelihood of child
anxiety/depressive disorders in the community. The results support the
need to apply wide-area epidemiological approaches to mental health
assessment after any large-scale disaster.
_____
Record: 29
Title: Post-traumatic Stress Disorder, Crime, and Trance.
Author(s): Perkins, Meg
Address: Perkins, Meg, Maranatha Counselling Centre, 19 Whitton
Road, Indooroopilly, QLD, Australia, 4068
Source: Australian Journal of Clinical & Experimental Hypnosis, Vol
33(1), May 2005. pp. 93-97.
Publisher: Australia: Australian Society of Hypnosis
Publisher URL: http://www.ozhypnosis.com.au
ISSN: 0156-0417 (Print)
Language: English
Keywords: posttraumatic stress disorder; crime; trance;
correctional center; dissociation; offender rehabilitation; trauma
therapy
Abstract: In late 1991, I was employed as the psychologist at a
correctional centre in Queensland which housed a relatively large number
of "lifers"--prisoners who had been given a mandatory life sentence
after pleading guilty to, or being found guilty of, murder. Many of the
lifers were approaching the date at which they would be eligible to
apply for parole. The task was assigned to me to interview each of the
lifers and to make an assessment as to whether they were suitable for
parole. This assessment was to be based on such factors as their
addressing the issues that led to the offending behaviour, the presence
or absence of remorse in their presentation, and their ability to
demonstrate empathy with the victim. It was interesting to note that
many of the lifers did not remember committing the crime. There appears
to be a definite link between PTSD and dissociative states and crime.
There is a role for hypnosis researchers to determine at what point the
trance states commence and how they are activated in terms of offender
rehabilitation programs. Perhaps also trauma therapy for first offenders
may prevent further acts of crime for these victims.
_____
Record: 30
Title: Peritraumatic dissociation and experiential avoidance as
predictors of posttraumatic stress symptomatology.
Author(s): Marx, Brian P., Department of Psychology, Temple
University, Philadelphia, PA, US, bmarx@temple.edu
Sloan, Denise M., Department of Psychology, Temple University,
Philadelphia, PA, US
Address: Marx, Brian P., Department of Psychology, Temple
University, Weiss Hall, Philadelphia, PA, US, bmarx@temple.edu
Source: Behaviour Research & Therapy, Vol 43(5), May 2005. pp. 569-583.
Journal URL: http://www.elsevier.com/inca/publications/store/2/6/5/
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0005-7967 (Print)
Digital Object Identifier: 10.1016/j.brat.2004.04.004
Language: English
Keywords: peritraumatic dissociation; risk factors; posttraumatic
stress disorder; experiential avoidance
Abstract: This study examined whether peritraumatic dissociation
serves as a proxy risk factor for experiential avoidance in its
relationship with posttraumatic stress disorder (PTSD) symptomatology.
One hundred eighty-five trauma survivors completed measures that
assessed for peritraumatic dissociation, experiential avoidance, and
PTSD symptom severity. The results indicated that peritraumatic
dissociation and experiential avoidance were significantly related to
PTSD symptomatology at baseline. However, after initial levels of PTSD
symptomatology were taken into account, only experiential avoidance was
related to PTSD symptoms both 4- and 8-weeks later. These results
indicate that peritraumatic dissociation is not a proxy risk factor for
experiential avoidance and contributes to the growing body of literature
indicating that experiential avoidance is an important factor related to
the psychological symptoms experienced by trauma survivors.
_____
Record: 31
Title: Unwanted memories of assault: What intrusion characteristics are
associated with PTSD?
Author(s): Michael, T., Department of Psychology, Institute of
Psychiatry, London, United Kingdom
Ehlers, A., Department of Psychology, Institute of Psychiatry, London,
United Kingdom, a.ehlers@iop.kcl.ac.uk
Halligan, S. L., Department of Psychology, Institute of Psychiatry,
London, United Kingdom
Clark, D. M., Department of Psychology, Institute of Psychiatry, London,
United Kingdom
Address: Ehlers, A., Department of Psychology, Institute of
Psychiatry, PO77, De Crespigny Park, London, United Kingdom, SE5 8AF,
a.ehlers@iop.kcl.ac.uk
Source: Behaviour Research & Therapy, Vol 43(5), May 2005. pp. 613-628.
Journal URL: http://www.elsevier.com/inca/publications/store/2/6/5/
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0005-7967 (Print)
Digital Object Identifier: 10.1016/j.brat.2004.04.006
Language: English
Keywords: trauma memories; posttraumatic stress disorder;
intrusive memories; symptom severity; assault; physical abuse; sexual
abuse
Abstract: Intrusive memories are common in the immediate aftermath
of traumatic events, but neither their presence or frequency are good
predictors of the persistence of posttraumatic stress disorder (PTSD).
Two studies of assault survivors, a cross-sectional study (N = 81) and a
6-month prospective longitudinal study (N = 73), explored whether
characteristics of the intrusive memories improve the prediction.
Intrusion characteristics were assessed with an Intrusion Interview and
an Intrusion Provocation Task. The distress caused by the intrusions,
their "here and now" quality, and their lack of a context predicted PTSD
severity. The presence of intrusive memories only explained 9% of the
variance of PTSD severity at 6 months after assault. Among survivors
with intrusions, intrusion frequency only explained 8% of the variance
of PTSD symptom severity at 6 months. Newness, distress and lack of
context explained an additional 43% of the variance. These intrusion
characteristics also predicted PTSD severity at 6 months over and above
what could be predicted from PTSD diagnostic status at initial
assessment. Further predictors of PTSD severity were rumination about
the intrusive memories, and the ease and persistence with which
intrusive memories could be triggered by photographs depicting assaults.
The results have implications for the early identification of trauma
survivors at risk of chronic PTSD.
_____
Record: 32
Title: Thyroid Hormone Alterations Among Women with Posttraumatic
Stress Disorder Due to Childhood Sexual Abuse.
Author(s): Friedman, Matthew J., Department of Psychiatry,
Dartmouth Medical School, Hanover, Germany,
Matthew.Friedman@Dartmouth.Edu
Wang, Sheila, Emotions and Quantitative Psychophysiology Section,
Laboratory of Personality and Cognition, National Institute on Aging,
Baltimore, MD, US
Jalowiec, John E., Department of Psychiatry, Dartmouth Medical School,
Hanover, Germany
McHugo, Gregory J., Department of Psychiatry, Dartmouth Medical School,
Hanover, Germany
McDonagh-Coyle, Annmarie, Department of Psychiatry, Dartmouth Medical
School, Hanover, Germany
Address: Friedman, Matthew J., National Center for PTSD, VA
Medical Center, 215 North Main Street, White River Junction, VT, US,
Matthew.Friedman@Dartmouth.Edu
Source: Biological Psychiatry, Vol 57(10), May 2005. pp. 1186-1192.
Journal URL:
http://www.elsevier.com/inca/publications/store/5/0/5/7/5/0/
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0006-3223 (Print)
Digital Object Identifier: 10.1016/j.biopsych.2005.01.019
Language: English
Keywords: thyroid hormone alterations; posttraumatic stress
disorder; childhood sexual abuse; triiodothyronine
Abstract: Background: Research on thyroid activity among male
combat veterans with posttraumatic stress disorder (PTSD) has
consistently shown elevations in total triiodothyronine (TT-sub-3) and
inconsistent elevations of other thyroid variables. This study is the
first large scale investigation of thyroid function in women with PTSD.
Methods: Thyroid function was measured in 63 women with PTSD due to
childhood sexual abuse (PTSD-CSA) in comparison with a community sample
of 42 women without current PTSD-CSA. Clinical measures included the
Clinician Administered PTSD Scale (CAPS), the Evaluation of Lifetime
Stressors, the Trauma Assessment for Adults and the Beck Depression
Inventory. Results: Women with PTSD-CSA showed significant elevations in
Total T-sub-3 and the TT-sub-3/free thyroxine (TT-sub-3/FT-sub-4) ratio,
the FT-sub-3TT-sub-3 ratio, and modest reductions in thyroid stimulating
hormone relative to our community sample. These findings could not be
explained by the influence of prior trauma, lifetime PTSD or depressive
symptoms. Conclusions: Altered thyroid activity, especially elevated
Total T-sub-3 levels, was found in women with PTSD associated with
childhood sexual abuse.
_____
Record: 33
Title: Preliminary evidence for lymphocyte distribution differences at
rest and after acute psychological stress in PTSD-symptomatic women.
Author(s): Glover, Dorie A., Division of Child and Adolescent
Psychiatry, Department of Psychiatry and Biobehavioral Sciences, UCLA
Neuropsychiatric Institute, Los Angeles, CA, US, dglover@mednet.ucla.edu
Steele, Amber C., Division of Child and Adolescent Psychiatry,
Department of Psychiatry and Biobehavioral Sciences, UCLA
Neuropsychiatric Institute, Los Angeles, CA, US
Stuber, Margaret L., Division of Child and Adolescent Psychiatry,
Department of Psychiatry and Biobehavioral Sciences, UCLA
Neuropsychiatric Institute, Los Angeles, CA, US
Fahey, John L., Microbiology, Immunology and Molecular
Genetics-CIRID/Med-CIA, UCLA Geffen School of Medicine, Los Angeles, CA,
US
Address: Glover, Dorie A., Division of Child and Adolescent
Psychiatry, Department of Psychiatry and Biobehavioral Sciences, UCLA
Neuropsychiatric Institute, Los Angeles, CA, US, dglover@mednet.ucla.edu
Source: Brain, Behavior & Immunity, Vol 19(3), May 2005. pp. 243-251.
Journal URL: http://www.academicpress.com/bbi
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0889-1591 (Print)
Digital Object Identifier: 10.1016/j.bbi.2004.08.002
Language: English
Keywords: lymphocyte distribution differences; psychological
stress; posttraumatic stress disorder; natural killer cells; cancer
survivors
Abstract: This study investigated circulating natural killer (NK),
CD4+ and CD8+ cells in response to acute psychological challenge among
mothers of child cancer survivors with and without posttraumatic stress
symptoms (PTSS). Control mothers of healthy children (n = 9) were
compared to 17 cancer mothers with (PTSS: n = 9) and without PTSS (No
PTSS: n = 7) under conditions of rest, after a generic stressor (MAT:
mental arithmetic task) and a personalized stressor (script-driven
trauma imagery), and after recovery from each stressor. Results indicate
the PTSS group had higher percentage CD4+ and lower CD8+ levels than
non-symptomatic women and blunted NK reactivity to generic challenge.
Multiple regression analyses indicated PTSS effects were independent of
self-reported distress. Contrary to expectations, cancer mothers without
PTSS were not significantly different from controls on tonic or phasic
immune outcomes. Also unlike predictions, reactivity to challenge was
greatest to the non-social MAT stressor compared to the personalized
challenge for all groups. Conclusions are constrained by study
limitations (e.g., small sample size and potential phase order effects).
Nonetheless, results are consistent with an emerging literature on
PTSS-associated immune differences and further suggest these effects may
be distinct from that associated with subjective distress more
generally.
_____
Record: 34
Title: Symptoms of Distress and Posttraumatic Stress among South
African Former Political Detainees.
Author(s): Kagee, Ashraf, Department of Psychology, University of
Stellenbosch, Matieland, South Africa, skagee@sun.ac.za
Address: Kagee, Ashraf, Department of Psychology, University of
Stellenbosch, Private Bag X1, Matieland, South Africa, 7602,
skagee@sun.ac.za
Source: Ethnicity & Health, Vol 10(2), May 2005. pp. 169-179.
Journal URL: http://www.tandf.co.uk/journals/carfax/13557858.html
Publisher: United Kingdom: Taylor & Francis
Publisher URL: http://www.taylorandfrancis.com/
ISSN: 1355-7858 (Print)
1465-3419 (Electronic)
Language: English
Keywords: distress symptoms; posttraumatic stress; South Africa;
political detainees; long term traumatization; torture; abuse
Abstract: Considerable debate has centred on the question of
traumatisation among individuals who have survived human rights
violations in societies that have undergone political conflict. In order
to gain an estimate of the extent of long-term traumatisation among
political activists who experienced torture and abuse in detention
during the apartheid era in South Africa, a sample of 148 survivors of
such experiences were recruited in a cross-sectional study and asked to
complete the Hopkins Symptom Checklist (HSCL), the Impact of Event Scale
(IES), and the Trauma Symptoms section of the Harvard Trauma
Questionnaire (HTQ). The proportions of the sample that scored above the
clinical cut-points on these measures were calculated. On the HSCL,
14.19% of the sample scored above the cut-point for clinical
significance of 44; on the IES, 17.57% scored above the clinical
cut-point of 44; and on the HTQ, 37.83% scored above the cut-point of
75. Moreover, the sample's mean scores were significantly higher than
the cut-point for clinically significant distress on the HSCL (p
<0.001); significantly lower than the cut-point for severe
traumatisation on the IES (p < 0.001); and non-significantly lower than
the cut-point for clinically significant traumatisation on the HTQ (p =
0.074). These results are considered in terms of current theoretical
debates on the relevance and applicability of posttraumatic stress
disorder as a circumscribed nosological entity in developing countries
that are in the process of coming to terms with a history of political
conflict.
_____
Record: 35
Title: Improving primary care for military personnel and veterans with
posttraumatic stress disorder--the road ahead.
Author(s): Engel, Charles C., F. Edward Hébert School of Medicine,
Bethesda, MD, US, cengel@usuhs.mil
Address: Engel, Charles C., F. Edward Hebert School of Medicine,
Bethesda, MD, US, cengel@usuhs.mil
Source: General Hospital Psychiatry, Vol 27(3), May-Jun 2005. pp.
158-160.
Journal URL:
http://www.elsevier.com/inca/publications/store/5/0/5/7/6/1/
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0163-8343 (Print)
Digital Object Identifier: 10.1016/j.genhosppsych.2005.01.001
Language: English
Keywords: military personnel; posttraumatic stress disorder;
specialty care settings; health policy; veteran primary care settings;
mental health services
Abstract: In this editorial, the author attempts to formulate a
clinical and health policy response to psychological trauma care,
particularly with respect to military personnel experiencing
posttraumatic stress disorder (PTSD). In his analysis, the author points
to an excellent study appearing in this issue of the General Hospital
Psychiatry. Magruder et al report on a systematic regional VA primary
care sample of military veterans and find that 11.5% of the subjects
meet research interview criteria for PTSD. This is the largest study of
PTSD in primary care to date and reveals substantial room for
improvement in services. While almost all clinical PTSD research have
been done in specialty care settings, Magruder et al. find that only 48%
of VA primary care patients with PTSD received specialty mental health
care. The challenges associated with improving PTSD care in primary care
settings are arguably even more formidable in the defense health system.
Magruder et al's research represents one more important step toward a
population health approach to PTSD prevention and management for
military personnel and veterans.
_____
Record: 36
Title: Prevalence of posttraumatic stress disorder in Veterans Affairs
primary care clinics.
Author(s): Magruder, Kathryn M., Mental Health Service, Ralph H.
Johnson Veterans Affairs Medical Center, Charleston, SC, US,
magrudkm@musc.edu
Frueh, B. Christopher, Mental Health Service, Ralph H. Johnson Veterans
Affairs Medical Center, Charleston, SC, US
Knapp, Rebecca G., Department of Biostatistics, Bioinformatics and
Epidemiology, Medical University of South Carolina, Charleston, SC, US
Davis, Lori, Veterans Affairs Medical Center, Tuscaloosa, AL, US
Hamner, Mark B., Mental Health Service, Ralph H. Johnson Veterans
Affairs Medical Center, Charleston, SC, US
Martin, Renée Hebert, Department of Biostatistics, Bioinformatics and
Epidemiology, Medical University of South Carolina, Charleston, SC, US
Gold, Paul B., Department of Psychiatry and Behavioral Sciences, Medical
University of South Carolina, Charleston, SC, US
Arana, George W., Mental Health Service, Ralph H. Johnson Veterans
Affairs Medical Center, Charleston, SC, US
Address: Magruder, Kathryn M., Mental Health Service (116), Ralph
H. Johnson Veterans Affairs Medical Center, 109 Bee Street, Charleston,
SC, US, magrudkm@musc.edu
Source: General Hospital Psychiatry, Vol 27(3), May-Jun 2005. pp.
167-179.
Journal URL:
http://www.elsevier.com/inca/publications/store/5/0/5/7/6/1/
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0163-8343 (Print)
Language: English
Keywords: posttraumatic stress disorder; primary care settings;
Veterans Affairs; comorbidity
Abstract: Although posttraumatic stress disorder (PTSD) is
relatively common in community epidemiologic surveys (5-6% for men,
10-12% for women), and psychiatric patients with PTSD are known to have
poor functioning and high levels of psychiatric comorbidity, there are
no studies that address PTSD prevalence, functioning, and burden in
primary care settings. This article reports on (1) the prevalence of
PTSD using Diagnostic and Statistical Manual of Mental Disorders-Fourth
Edition diagnostic criteria in Veterans Affairs (VA) primary care
settings, (2) associated sociodemographic characteristics and
comorbidities, (3) functional status related to PTSD, (4) the extent to
which PTSD was recognized by providers and (5) health services use
patterns (including specialty mental health) of PTSD patients. Patients
were randomly selected from those who had an outpatient visit in FY 1999
at one of four VA hospitals; 888 patients consented (74.1% of 1198
contacted); 746 patients (84.0% of consenting patients; 62.3% of
contacted patients) were reached for telephone diagnostic interviews.
Diagnostic interviews with the Clinician Administered PTSD Scale yielded
estimates of current PTSD prevalence of 11.5%. At statistically
significant levels, PTSD was positively associated with a variety of
comorbid psychiatric disorders, war zone service, age <65 years, not
working, less formal education and decreased functioning. Of patients
diagnosed with PTSD by study procedures, 12-month medical record review
indicated that providers identified only 46.5% and only 47.7% had used
mental health specialty services. PTSD-positive [PTSD(+)] patients who
used mental health care in the past 12 months were more apt to be
identified as having PTSD than nonmental health service users (78.0% vs.
17.8%). Although PTSD(+) patients had more medical record diagnoses than
PTSD-negative [PTSD(-)] patients (6.28 vs. 4.95), their use of primary
care, urgent care and inpatient care was not different from PTSD(-)
patients.
_____
Record: 37
Title: Learning and Memory in Aging Combat Veterans with PTSD.
Author(s): Yehuda, Rachel, Traumatic Stress Studies Program,
Psychiatry Department, Mount Sinai School of Medicine, Bronx Veterans
Affairs, New York, NY, US, Rachel.Yehuda@med.va.gov
Golier, Julia A., Traumatic Stress Studies Program, Psychiatry
Department, Mount Sinai School of Medicine, Bronx Veterans Affairs, New
York, NY, US
Tischler, Lisa, Traumatic Stress Studies Program, Psychiatry Department,
Mount Sinai School of Medicine, Bronx Veterans Affairs, New York, NY, US
Stavitsky, Karina, Traumatic Stress Studies Program, Psychiatry
Department, Mount Sinai School of Medicine, Bronx Veterans Affairs, New
York, NY, US
Harvey, Philip D., Traumatic Stress Studies Program, Psychiatry
Department, Mount Sinai School of Medicine, Bronx Veterans Affairs, New
York, NY, US
Address: Yehuda, Rachel, Bronx VA OOMH, 130 West Kingsbridge
Road, Bronx, NY, US, Rachel.Yehuda@med.va.gov
Source: Journal of Clinical & Experimental Neuropsychology, Vol 27(4),
May 2005. pp. 504-515.
Journal URL: http://www.swets.nl/sps/journals/jcen.html
Publisher: United Kingdom: Taylor & Francis
Publisher URL: http://www.taylorandfrancis.com/
ISSN: 1380-3395 (Print)
Language: English
Keywords: learning; memory; aging; combat veterans; posttraumatic
stress disorder
Abstract: The California Verbal Learning Test (CVLT) was
administered to examine learning and memory performance in aging combat
veterans with (n=30) and without PTSD (n=20), and veterans unexposed to
combat (n=15). Combat veterans with PTSD (PTSD+) showed many impairments
compared to non-exposed veterans, but only long-delay free recall
consistently discriminated the PTSD+ group from combat-exposed subjects
without PTSD (PTSD-), when data were corrected for subscale scores on
the WAIS (Vocabulary, Block Design). Alterations in total learning were
associated with PTSD when controlling for substance abuse and
depression. Two contrast measures, proactive interference and
recognition hits, distinguished combat from noncombat veterans, and may
be related to trauma exposure. Impairments in total learning are similar
to what has been observed in Holocaust survivors. However, increased
severity of rapid forgetting may be a specific alteration in older
combat veterans, likely reflecting aspects of both combat exposure and
aging.
_____
Record: 38
Title: Editorial: Peripheral is Central to the question.
Author(s): Wong, M. -L., Center for Pharmacogenomics, University of
California, Los Angeles, CA, US, mali@ucla.edu
Licinio, J., Center for Pharmacogenomics, University of California, Los
Angeles, CA, US
Address: Wong, M. -L., mali@ucla.edu
Source: Molecular Psychiatry, Vol 10(5), May 2005. pp. 421-422.
Journal URL: http://www.nature.com/mp
Publisher: United Kingdom: Nature Publishing
Publisher URL: http://www.nature.com/
ISSN: 1359-4184 (Print)
Digital Object Identifier: 10.1038/sj.mp.4001674
Language: English
Keywords: peripheral blood mononuclear cell gene expression;
posttraumatic stress disorder; trauma survivors
Abstract: This editorial comments on an article by Segman et al
(see record 2005-04778-014) that examined gene expression profiles of
peripheral blood mononuclear cells (PBMCs) collected from trauma
survivors, and identified a gene expression 'signature' for
post-traumatic stress disorder (PTSD). Patients were studied immediately
following a traumatic event, 1 month, and 4 months later. Upon reading
their work it seems clear why PTSD would be the ideal condition to
attempt such a conceptually bold study: The traumatic event is clearly
identifiable; therefore, sequential time course samples can be obtained
and studied in a systematic way. It is particularly amazing that
exemplar research design can emerge from and be directly related to an
unstable sociopolitical milieu. This work by Segman et al carries the
promise to bring a Renaissance to the field. They have revisited the
question of finding psychiatric correlates in peripheral blood and their
rigorous experimental design and data analysis have propelled research
in PTSD to the 21st century.
_____
Record: 39
Title: Peripheral blood mononuclear cell gene expression profiles
identify emergent post-traumatic stress disorder among trauma survivors.
Author(s): Segman, R. H., Department of Psychiatry, Hadassah
University Hospital, Jerusalem, Israel, sronen@md2.huji.ac.il
Shefi, N., School of Computer Science and Engineering, Hebrew
University, Jerusalem, Israel
Goltser-Dubner, T., Department of Psychiatry, Hadassah University
Hospital, Jerusalem, Israel
Friedman, N., School of Computer Science and Engineering, Hebrew
University, Jerusalem, Israel, nir@cs.huji.ac.il
Kaminski, N., Functional Genomics Unit, Chaim Sheba Medical Center,
Israel
Shalev, A. Y., Department of Psychiatry, Hadassah University Hospital,
Jerusalem, Israel, ashalev@cc.huji.ac.il
Address: Segman, R. H., Department of Psychiatry, Hadassah-Hebrew
University Medical Center, Hadassah University Hospital, PO Box 12000,
Ein Karem, Jerusalem, Israel, 91120, sronen@md2.huji.ac.il
Source: Molecular Psychiatry, Vol 10(5), May 2005. pp. 500-513.
Journal URL: http://www.nature.com/mp
Publisher: United Kingdom: Nature Publishing
Publisher URL: http://www.nature.com/
ISSN: 1359-4184 (Print)
Digital Object Identifier: 10.1038/sj.mp.4001636
Language: English
Keywords: peripheral blood mononuclear cell gene expression;
posttraumatic stress disorder; trauma survivors
Abstract: Trauma survivors show marked differences in the severity
and persistence of post-traumatic stress disorder (PTSD) symptoms. Early
symptoms subside in most, but persist as acute and chronic PTSD in a
significant minority. The underlying molecular mechanisms or outcome
predictors determining these differences are not known. Molecular
markers for identifying any mental disorder are currently lacking. Gene
expression profiling during the triggering and development of PTSD may
be informative of its onset and course. We used oligonucleotide
microarrays to measure peripheral blood mononuclear cell (PBMC) gene
expression of trauma survivors at the emergency room and 4 months later.
Gene expression signatures at both time points distinguished survivors
who met DSM-IV diagnostic criteria for PTSD at 1 and 4 months, from
those who met no PTSD criterion. Expression signatures at both time
points correlated with the severity of each of the three PTSD symptom
clusters assessed 4 months following exposure among all survivors.
Results demonstrate a general reduction in PBMCs' expression of
transcription activators among psychologically affected trauma
survivors. Several differentiating genes were previously described as
having a role in stress response. These findings provide initial
evidence that peripheral gene expression signatures following trauma
identify an evolving neuropsychiatric disorder and are informative of
its key clinical features and outcome. Replications in larger samples,
as well as studies focusing on specific markers within the signatures
discovered, are warranted to confirm and extend the diagnostic utility
and pathogenetic implications of our results.
_____
Record: 40
Title: Corrigendum: Peripheral blood mononuclear cell gene expression
profiles identify emergent post-traumatic stress disorder among trauma
survivors.
Author(s): Segman, R. H., Department of Psychiatry, Hadassah
University Hospital, Jerusalem, Israel, sronen@md2.huji.ac.il
Shefi, N., School of Computer Science and Engineering, Hebrew
University, Jerusalem, Israel
Goltser-Dubner, T., Department of Psychiatry, Hadassah University
Hospital, Jerusalem, Israel
Friedman, N., School of Computer Science and Engineering, Hebrew
University, Jerusalem, Israel, nir@cs.huji.ac.il
Kaminski, N., Functional Genomics Unit, Chaim Sheba Medical Center,
Israel
Shalev, A. Y., Department of Psychiatry, Hadassah University Hospital,
Jerusalem, Israel, ashalev@cc.huji.ac.il
Address: Segman, R. H., Department of Psychiatry, Hadassah-Hebrew
University Medical Center, Hadassah University Hospital, PO Box 12000,
Ein Karem, Jerusalem, Israel, 91120, sronen@md2.huji.ac.il
Source: Molecular Psychiatry, Vol 10(5), May 2005. pp. 514.
Journal URL: http://www.nature.com/mp
Publisher: United Kingdom: Nature Publishing
Publisher URL: http://www.nature.com/
ISSN: 1359-4184 (Print)
Digital Object Identifier: 10.1038/sj.mp.4001654
Language: English
Keywords: peripheral blood mononuclear cell gene expression;
posttraumatic stress disorder; trauma survivors
Abstract: Reports an error in the original article by R.H. Segman
et al (Molecular Psychiatry, 2005[May], Vol 10[5], 500-513). In the
Supplementary Notes of this article, the password and username of the
GEO deposit were included by mistake. The only information required to
access the data are the GEO serial numbers provided. The username and
password are not required. (The following abstract of this article
originally appeared in record 2005-04778-014.) Trauma survivors show
marked differences in the severity and persistence of post-traumatic
stress disorder (PTSD) symptoms. Early symptoms subside in most, but
persist as acute and chronic PTSD in a significant minority. The
underlying molecular mechanisms or outcome predictors determining these
differences are not known. Molecular markers for identifying any mental
disorder are currently lacking. Gene expression profiling during the
triggering and development of PTSD may be informative of its onset and
course. We used oligonucleotide microarrays to measure peripheral blood
mononuclear cell (PBMC) gene expression of trauma survivors at the
emergency room and 4 months later. Gene expression signatures at both
time points distinguished survivors who met DSM-IV diagnostic criteria
for PTSD at 1 and 4 months, from those who met no PTSD criterion.
Expression signatures at both time points correlated with the severity
of each of the three PTSD symptom clusters assessed 4 months following
exposure among all survivors. Results demonstrate a general reduction in
PBMCs' expression of transcription activators among psychologically
affected trauma survivors. Several differentiating genes were previously
described as having a role in stress response. These findings provide
initial evidence that peripheral gene expression signatures following
trauma identify an evolving neuropsychiatric disorder and are
informative of its key clinical features and outcome. Replications in
larger samples, as well as studies focusing on specific markers within
the signatures discovered, are warranted to confirm and extend the
diagnostic utility and pathogenetic implications of our results.
_____
Record: 41
Title: Symptoms of post-traumatic stress disorder after non-traumatic
events: Evidence from an open population study.
Author(s): Mol, Saskia S. L., Department of General Practice,
Maastricht University, Utrecht, Netherlands, s.s.l.mol@umcutrecht.nl
Arntz, Arnoud, Department of Medical, Clinical and Experimental
Psychology, Maastricht University, Utrecht, Netherlands
Metsemakers, Job F. M., Department of General Practice, Maastricht
University, Utrecht, Netherlands
Dinant, Geert-Jan, Department of General Practice, Maastricht
University, Utrecht, Netherlands
Vilters-Van Montfort, Pauline A. P., Department of General Practice,
Maastricht University, Utrecht, Netherlands
Knottnerus, J. André, Department of General Practice, Maastricht
University, Utrecht, Netherlands
Address: Mol, Saskia S. L., Department of General Practice, UMC
Utrecht, Julius Centre, Stratenum 6.108, Postbox 85060, 3508 AB,
Utrecht, Netherlands, s.s.l.mol@umcutrecht.nl
Source: British Journal of Psychiatry, Vol 186(6), Jun 2005. pp.
494-499.
Journal URL: http://bjp.rcpsych.org/
Publisher: United Kingdom: Royal College of Psychiatrists
Publisher URL: http://www.rcpsych.ac.uk/
ISSN: 0007-1250 (Print)
1472-1465 (Electronic)
Digital Object Identifier: 10.1192/bjp.186.6.494
Language: English
Keywords: symptoms; posttraumatic stress disorder; non-traumatic
events; life-events; demographic characteristics; history of stressful
events
Abstract: Background: Post-traumatic stress disorder (PTSD) is the
only psychiatric condition that requires a specific event to have
occurred for its diagnosis. Aims: To gather evidence from the adult
general population on whether life events (e.g. divorce, unemployment)
generate as many symptoms of post-traumatic stress as traumatic events
(e.g. accidents, abuse). Method: Data on demographic characteristics and
history of stressful events were collected through a written
questionnaire sent to a random sample of 2997 adults. Respondents also
filled out a PTSD symptom checklist, keeping in mind their worst event.
Mean PTSD scores were compared, controlling for differences between the
two groups. Differences in item scores and in the distribution of the
total PTSD scores were analysed. Results: Of the 1498 respondents, 832
were eligible for inclusion in our analysis. For events from the past 30
years the PTSD scores were higher after life events than after traumatic
events; for earlier events the scores were the same for both types of
events. These findings could not be explained by differences in
demographics, history of stressful events, individual item scores, or
the distribution of the total PTSD scores. Conclusions: Life events can
generate at least as many PTSD symptoms as traumatic events. Our
findings call for further studies on the specificity of traumatic events
as a cause of PTSD.
_____
Record: 42
Title: Hopelessness as a Risk Factor for Post-traumatic Stress Disorder
Symptoms Among Interpersonal Violence Survivors.
Author(s): Scher, Christine D., California State University, San
Bernardino, CA, US, cscher@csusb.edu
Resick, Patricia A., University of Missouri, St Louis, MO, US
Address: Scher, Christine D., Department of Psychology,
California State University, 5500 University Parkway, San Bernardino,
CA, US, cscher@csusb.edu
Source: Cognitive Behaviour Therapy, Vol 34(2), Jun 2005. pp. 99-107.
Journal URL: http://www.tandf.co.uk/journals/tfs/02845717.html
Publisher: United Kingdom: Taylor & Francis
Publisher URL: http://www.taylorandfrancis.com/
ISSN: 1650-6073 (Print)
Language: English
Keywords: posttraumatic stress disorder; risk factors;
hopelessness; interpersonal violence; female survivors
Abstract: Post-traumatic stress disorder often co-occurs with
depression, and they may share common risk factors. One possible common
cognitive risk factor is hopelessness. Thus, we examined whether
hopelessness was related to symptoms of post-traumatic stress disorder.
Participants were 202 female survivors of interpersonal violence.
Relationships between self-reported and interviewer-rated measures of
hopelessness gathered at 2 weeks post-trauma and self-reported and
interviewer-rated symptoms of post-traumatic stress disorder gathered at
2 weeks and 3 months post-trauma were examined. Hierarchical,
simultaneous regression analyses that co-varied trauma type revealed
that hopelessness was related to self-reported symptoms of
post-traumatic stress disorder, both concurrently and prospectively.
Follow-up analyses revealed that relationships between hopelessness and
symptoms of post-traumatic stress disorder were due almost entirely to
shared variance with depression. No relationships were found between
hopelessness and interviewer-rated symptoms of post-traumatic stress
disorder.
_____
Record: 43
Title: Trauma Groups: An Overview.
Author(s): Weinberg, Haim, Beit Berl College, Israel,
haimw@netvision.net.il
Nuttman-Shwartz, Orit, Social Work Department, Sapir Academic College,
Israel, Orits@makash.ac.il
Gilmore, Martha, Private Practice, Davis, CA, US, m1gilmore@ucdavis.edu
Address: Weinberg, Haim, 6 Hardoof Street, Tel Aviv, Israel,
69930, haimw@netvision.net.il
Source: Group Analysis, Vol 38(2), Jun 2005. pp. 187-202.
Publisher: US: Sage Publications
Publisher URL: http://www.sagepublications.com/
ISSN: 0533-3164 (Print)
1461-717X (Electronic)
Digital Object Identifier: 10.1177/0533316405052378
Language: English
Keywords: trauma; post-traumatic stress disorder; group treatment
Abstract: Beginning with a brief review of trauma and
post-traumatic stress disorder, the authors consider the role of group
treatment of trauma. Several models of groups are discussed along with
available research regarding efficacy. A discussion of the special
dynamics of trauma groups and important considerations for group
conducting follows and the issue of vicarious traumatization for the
group conductor is addressed. A short discussion regarding the need to
integrate traumatized individuals back into society concludes the paper.
_____
Record: 44
Title: On the Job after 9/11: Looking at Worker's Block Through a Group
Lens.
Author(s): Kleinberg, Jeffrey, Private Practice, New York, NY, US,
JKleinberg@aol.com
Address: Kleinberg, Jeffrey, 35 East 35th Street, New York, NY,
US, JKleinberg@aol.com
Source: Group Analysis, Vol 38(2), Jun 2005. pp. 203-218.
Publisher: US: Sage Publications
Publisher URL: http://www.sagepublications.com/
ISSN: 0533-3164 (Print)
1461-717X (Electronic)
Digital Object Identifier: 10.1177/0533316405052379
Language: English
Keywords: terrorism; September 11; posttraumatic effect; Worker's
Block; organizations
Abstract: The terror attacks of 11 September 2001 have produced a
posttraumatic effect in many workers. They have developed what the
author defines as 'Worker's Block', an emotional disengagement from
their job. The author suggests that factors contributing to this
vocational crisis include the nature of the stressor, deficits in the
individual's resiliency and the hardiness of one's employer. From his
group-centered perspective, the author discusses ways to strengthen
individuals and their organizations in order to minimize the damaging
effects of future attacks on the workforce.
_____
Record: 45
Title: Book Review: Group Psychotherapy for Psychological Trauma.
Author(s): Brom, Danny
Source: Group Analysis, Vol 38(2), Jun 2005. pp. 324-325.
Publisher: US: Sage Publications
Publisher URL: http://www.sagepublications.com/
Reviewed Item: R. H. Klein and V. L. Schermer (eds) (2000). Group
Psychotherapy for Psychological Trauma; The Guilford Press, New York.
2000. pp. 364 Hb. US$50
ISSN: 0533-3164 (Print)
1461-717X (Electronic)
Digital Object Identifier: 10.1177/0533316405056893
Language: English
Keywords: group psychotherapy; psychological trauma; posttraumatic
stress disorder
Abstract: Group Psychotherapy for Psychological Trauma (see record
2000-03901-000), edited by R. H. Klein and V. L. Schermer, is a complete
and comprehensive book on group treatment, reviewing the concepts of
trauma and post-traumatic psychopathology and giving a wide range of
options of group interventions within the spectrum of post traumatic
disorders. The book starts with a thorough description of the
consequences of trauma for the individual, describing not only the
phenomenology of post traumatic disorders, including the Post Traumatic
Stress Disorder (PTSD) clusters, but also cognitive changes and changes
in object relations and different influences on the self. Group therapy
for trauma victims is introduced in an equally thorough and
comprehensive manner, and presents a range of ways to use the group
setting for engendering healing of the various injuries caused by
traumatic experiences. The second part of the book focuses on different
traumatized populations, from severe illness through disaster to
torture. Each chapter is well laid out, giving a thorough description of
the problem and then focusing on the technical aspects of the treatment
and ending with clinical examples. The only missing topic in this book
is the evidence base for the effectiveness of group therapy for trauma.
But even without this, this book is an excellent guide and resource for
all interested in the field of group therapy for the traumatized.
_____
Record: 46
Title: Psychopathology following trauma: The role of subjective
experience.
Author(s): Creamer, Mark, Australian Centre for Posttraumatic
Mental Health, University of Melbourne, West Heidelberg, VIC, Australia,
markcc@unimelb.edu.au
McFarlane, Alexander C., University of Adelaide, Australia
Burgess, Philip, Centre for Mental Health Research, University of
Queensland, Brisbane, QLD, Australia
Address: Creamer, Mark, Australian Centre for Posttraumatic
Mental Health, University of Melbourne, A&RMC Repat Campus, P.O. Box
5444, West Heidelberg, VIC, Australia, 3081, markcc@unimelb.edu.au
Source: Journal of Affective Disorders, Vol 86(2-3), Jun 2005. pp.
175-182.
Journal URL:
http://www.elsevier.com/inca/publications/store/5/0/6/0/7/7/
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0165-0327 (Print)
Digital Object Identifier: 10.1016/j.jad.2005.01.015
Language: English
Keywords: psychopathology; trauma; posttraumatic stress disorder
Abstract: Background: The DSM-IV definition of posttraumatic
stress disorder (PTSD) widened the stressor criterion to include
objective (A1) and subjective (A2) components. The prevalence of
Criterion A2, and its association with traumatic memory and
psychopathology, was examined in a large community sample. Method: The
presence of Criterion A2 and traumatic memories, as well as DSM-IV
anxiety, affective and substance use disorders, were examined in a
community sample of 6104 adults with a history of traumatic exposure.
Results: Most individuals met Criterion A2 (76%), with higher prevalence
in females (81%) than males (69%). A2 was more common following certain
traumas (such as assaultive violence). Excluding those people with PTSD,
prevalence of most psychiatric disorders was higher in those who met
Criterion A2 than in those who only met Criterion A1. Only 3% of those
who did not meet A2 went on to suffer persistent traumatic memories. The
prevalence of psychiatric disorders was higher in those with A2 and
traumatic memories than in those with A2 and no traumatic memories.
Limitations: The retrospective nature of the data raises the potential
for reporting biases. The data set allowed only one of several possible
predictors of posttraumatic adjustment to be examined and only 12-month,
and not lifetime, prevalence of psychiatric conditions was available.
Conclusions: The experience of powerful emotions at the time of
traumatic exposure is common and is associated with increased prevalence
not only of PTSD, but also of a range of other psychiatric conditions.
Traumatic memories may mediate this association.
_____
Record: 47
Title: Resolution of trauma-related guilt following treatment of PTSD
in female rape victims: A result of cognitive processing therapy
targeting comorbid depression?
Author(s): Nishith, Pallavi, Center for Trauma Recovery, University
of Missouri, St. Louis, MO, US
Nixon, Reginald D. V., School of Psychology, Flinders University,
Adelaide, SA, Australia, reg.nixon@flinders.edu.au
Resick, Patricia A., Center for Trauma Recovery, University of Missouri,
St. Louis, MO, US
Address: Nixon, Reginald D. V., School of Psychology, Flinders
University, GPO Box 2100, Adelaide, SA, Australia, 5001,
reg.nixon@flinders.edu.au
Source: Journal of Affective Disorders, Vol 86(2-3), Jun 2005. pp.
259-265.
Journal URL:
http://www.elsevier.com/inca/publications/store/5/0/6/0/7/7/
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0165-0327 (Print)
Digital Object Identifier: 10.1016/j.jad.2005.02.013
Language: English
Keywords: trauma related guilt; posttraumatic stress disorder;
female rape victims; cognitive processing therapy; comorbidity; major
depressive disorder; treatment
Abstract: Background and methods: Although Resick et al. (2002)
[Resick, P.A., Nishith, P., Weaver, T.L., Astin, M.C., Feuer, C.A.,
2002. A comparison of cognitive-processing therapy with prolonged
exposure and a waiting condition for the treatment of chronic
posttraumatic stress disorder in female rape victims. J. Consult. Clin.
Psychol. 70, 867-879.] reported comparable results for treating
rape-related posttraumatic stress disorder (PTSD) using either
cognitive-processing therapy (CPT) or prolonged exposure (PE), there was
some suggestion that CPT resulted in better outcomes than PE for certain
aspects of trauma-related guilt. The present study revisited these
findings to examine whether this effect was a function of improvement in
a subset of participants with both PTSD and major depressive disorder
(MDD). Results: Results indicated that CPT was just as effective in
treating 'pure' PTSD and PTSD with comorbid MDD in terms of guilt.
Clinical significance testing underscored that CPT was more effective in
reducing certain trauma-related guilt cognitions than PE. Limitations:
Findings cannot be generalized to men, and only one measure of guilt was
used. Conclusions: The observed superiority of CPT over PE for treating
certain guilt cognitions was not due to participant comorbidity. Further
research is recommended to untangle the relationship between guilt,
depression and differential response to treatment in PTSD following
sexual assault trauma.
_____
Record: 48
Title: Childhood Traumatic Grief: An Exploration of the Construct in
Children Bereaved on September 11.
Author(s): Brown, Elissa J., St. John's University, Queens, NY, US,
browne@stjohns.edu
Goodman, Robin F., National Child Traumatic Stress Network, US
Address: Brown, Elissa J., Department of Psychology, St. John's
University, 8000 Utopia Parkway, Queens, NY, US, browne@stjohns.edu
Source: Journal of Clinical Child & Adolescent Psychology, Vol 34(2),
Jun 2005. pp. 248-259.
Journal URL:
https://www.erlbaum.com/shop/tek9.asp?pg=products&specific=1537-4416
Publisher: US: Lawrence Erlbaum
Publisher URL: http://www.erlbaum.com/
ISSN: 1537-4416 (Print)
1532-7639 (Electronic)
Digital Object Identifier: 10.1207/s15374424jccp3402_4
Language: English
Keywords: childhood traumatic grief; demographic characteristics;
trauma exposure; coping strategies; psychiatric symptoms; self esteem;
September 11 attacks
Abstract: This study is an exploration of the measurement and
correlates of childhood traumatic grief (CTG). Eighty-three children of
uniformed service personnel who died during the World Trade Center
attack on September 11, 2001, were assessed using measures of
demographic characteristics, trauma exposure (physical proximity,
emotional proximity, and secondary adversities), use of coping
strategies, psychiatric symptoms (posttraumatic stress disorder [PTSD],
general anxiety, depression), self-esteem, and traumatic grief. An
exploratory factor analysis of the Extended Grief Inventory (EGI; Layne,
Savjak, Saltzman, & Pynoos, 2001) indicated distinct constructs of
normal versus traumatic grief. CTG factor scores were correlated with
secondary adversities from the traumatic event, symptoms of PTSD,
anxiety, depression, and coping responses, underscoring the theoretical
and clinical utility of the content of the measure. Study limitations
and future research recommendations are discussed.
_____
Record: 49
Title: Cognitive-Behavioral Therapy for PTSD in the Real World: Do
Interpersonal Relationships Make a Real Difference?
Author(s): Monson, Candice M., VA National Center for PTSD, Boston,
MA, US, candice.monson@med.va.gov
Rodriguez, Benjamin F., Southern Illinois University at Carbondale,
Carbondale, IL, US
Warner, Reid, Dartmouth College, Hanover, NH, US
Address: Monson, Candice M., VA National Center for PTSD, Women's
Health Sciences Division, VA Boston Healthcare System, 150 South
Huntington Avenue (1168), Boston, MA, US, candice.monson@med.va.gov
Source: Journal of Clinical Psychology, Vol 61(6), Jun 2005. pp.
751-761.
Journal URL: http://www.interscience.wiley.com/jpages/0021-9762/
Publisher: US: John Wiley & Sons
Publisher URL: http://www.wiley.com/WileyCDA/
ISSN: 0021-9762 (Print)
1097-4679 (Electronic)
Digital Object Identifier: 10.1002/jclp.20096
Language: English
Keywords: veterans; posttraumatic stress disorder; interpersonal
relationships; relationship functioning; cognitive behavioral therapy;
trauma-focused; skills-focused; treatment effectiveness
Abstract: The goal of this effectiveness study was to investigate
the role of pre-treatment interpersonal relationship functioning in two
forms of group cognitive-behavioral treatment (CBT) for veterans with
PTSD. Analysis of data from 45 veterans who completed either trauma- or
skills-focused CBT indicated no overall differences between the two
treatments in PTSD symptomatology, alcohol abuse, or violence
perpetration at four months post-treatment. However, there was a
stronger inverse relationship between intimate relationship functioning
and violence outcomes in the trauma-focused group versus the
skills-focused group. While no differences in violence outcomes were
found between the treatments at poorer levels of pre-treatment intimate
relationship functioning, those receiving trauma-focused treatment with
better pre-treatment intimate relationships reported less violence.
Extended relationship functioning and violence outcomes were less
strongly associated in the trauma-focused group versus the
skills-focused group. The theoretical implications of these results, as
well as the clinical opportunities to improve CBT for PTSD by
capitalizing on patients' relationships, are discussed.
Conference: Annual Meeting of the International Society for
Traumatic Stress Studies, 2002
Conference Notes: Portions of this research were presented at the
aforementioned conference.
_____
Record: 50
Title: Further Examination of the Exposure Model Underlying the
Efficacy of Written Emotional Disclosure.
Author(s): Sloan, Denise M., Department of Psychology, Temple
University, Philadelphia, PA, US, dsloan@temple.edu
Marx, Brian P., Department of Psychology, Temple University,
Philadelphia, PA, US
Epstein, Eva M., Department of Psychology, Temple University,
Philadelphia, PA, US
Address: Sloan, Denise M., Department of Psychology, Temple
University, Weiss Hall, Philadelphia, PA, US, dsloan@temple.edu
Source: Journal of Consulting and Clinical Psychology, Vol 73(3), Jun
2005. pp. 549-554.
Journal URL: http://www.apa.org/journals/ccp.html
Publisher: US: American Psychological Assn
Publisher URL: http://www.apa.org
ISSN: 0022-006X (Print)
Digital Object Identifier: 10.1037/0022-006X.73.3.549
Language: English
Keywords: emotion; written disclosure; salivary cortisol; trauma;
posttraumatic stress symptoms; exposure hypothesis
Abstract: In the current study, the authors examined the effects
of systematically varying the writing instructions for the written
emotional disclosure procedure. College undergraduates with a trauma
history and at least moderate posttraumatic stress symptoms were asked
to write about (a) the same traumatic experience, (b) different
traumatic experiences, or (c) nontraumatic everyday events across 3
written disclosure sessions. Results show that participants who wrote
about the same traumatic experience reported significant reductions in
psychological and physical symptoms at follow-up assessments compared
with other participants. These findings suggest that written emotional
disclosure may be most effective when individuals are instructed to
write about the same traumatic or stressful event at each writing
session, a finding consistent with exposure-based treatments.
_____
_____
Record: 1
Title: Complex Trauma in Children and Adolescents.
Author(s): Cook, Alexandra, National Center on Family Homelessness,
Justice Resource Institute, The Trauma Center, Boston, MA, US
Spinazzola, Joseph, National Center on Family Homelessness, Justice
Resource Institute, The Trauma Center, Boston, MA, US,
spinazzola@traumacenter.org
Ford, Julian, University of Connecticut Health Center, Department of
Psychiatry, Farmington, CT, US
Lanktree, Cheryl, Miller Children's Abuse and Violence Intervention
Center, Long Beach, CA, US
Blaustein, Margaret, National Center on Family Homelessness, Justice
Resource Institute, The Trauma Center, Boston, MA, US
Cloitre, Marylene, New York University Child Study Center Institute for
Urban Trauma & Stress, New York, NY, US
DeRosa, Ruth, North Shore University Hospital Adolescent Trauma
Treatment Development Center, Manhasset, NY, US
Hubbard, Rebecca, Directions for Mental Health, Clearwater, FL, US
Kagan, Richard, Parsons Child Trauma Study Center, Albany, NY, US
Liautaud, Joan, Heartland Health Outreach: International FACES, Chicago,
IL, US
Mallah, Karen, Mental Health Center of Denver, Family Trauma Treatment
Program, Denver, CO, US
Olafson, Erna, Cincinnati Children's Hospital, Child Abuse Trauma
Treatment Replication Center, Cincinnati, OH, US
van der Kolk, Bessel, Boston University Medical School, Boston, MA, US
Address: Spinazzola, Joseph, The Trauma Center at Justice
Resource Institute, 545 Boylston St., Boston, MA, US,
spinazzola@traumacenter.org
Source: Psychiatric Annals, Vol 35(5), May 2005. pp. 390-398.
Publisher: US: SLACK
Publisher URL: http://www.slackinc.com/
ISSN: 0048-5713 (Print)
Language: English
Keywords: complex trauma; children; adolescents; assessment;
intervention; maltreatment; abuse; attachment; interpersonal relations
Abstract: The immediate and long-term consequences of children's
exposure to maltreatment and other traumatic experiences are
multifaceted. Emotional abuse and neglect, sexual abuse, and physical
abuse, as well as witnessing domestic violence, ethnic cleansing, or
war, can interfere with the development of a secure attachment within
the caregiving system. Complex trauma exposure results in a loss of core
capacities for self-regulation and interpersonal relatedness. Children
exposed to complex trauma often experience lifelong problems that place
them at risk for additional trauma exposure and cumulative impairment
(e.g., psychiatric and addictive disorders; chronic medical illness;
legal, vocational, and family problems). These problems may extend from
childhood through adolescence and into adulthood. This article describes
a new theoretical framework for understanding complex trauma in
children, explains how to apply the new framework to assessment of
traumatized children and families, and discusses intervention models
designed specifically for traumatized children and their families.
_____
Record: 2
Title: Treatment Implications of Altered Affect Regulation and
Information Processing Following Child Maltreatment.
Author(s): Ford, Julian D., University of Connecticut Health
Center, Department of Psychiatry, Farmington, CT, US
Address: Ford, Julian D., Department of Psychiatry, MC1410,
University of Connecticut Health Center, 263 Farmington Ave.,
Farmington, CT, US
Source: Psychiatric Annals, Vol 35(5), May 2005. pp. 410-419.
Publisher: US: SLACK
Publisher URL: http://www.slackinc.com/
ISSN: 0048-5713 (Print)
Language: English
Keywords: child maltreatment; diagnosis; treatment;
developmentally adverse interpersonal trauma; altered affect regulation;
information processing abilities; neurobiology
Abstract: The purpose of this article is to (1) identify the
affect regulation processes that may be affected by childhood
maltreatment, (2) discuss how information processing may be altered by
childhood maltreatment, and (3) describe how psychiatric diagnosis or
treatment can be enhanced by assessing dysregulation of emotion or
information processing in survivors of maltreatment. Research is needed
to further deconstruct and define the neurobiological substrates of
specific components of self-regulation in relation to early childhood
trauma-related PTSD. Brain activation patterns related to dissociation
have been investigated preliminarily and similar studies are needed to
provide greater specificity than that provided by categorical diagnoses
(e.g., PTSD). Self-regulation can provide a basis for theoretical models
and interventions that focus on posttraumatic resilience. Future success
in developing effective treatments for children and adults who
experience complex biopsychosocial impairments following exposure to
early life "developmentally adverse interpersonal trauma" (DAIT) depends
upon continued dialogue between scientists and clinicians who share a
focus on the nature, neurobiology, and development of affective and
cognitive self-regulation.
_____
Record: 3
Title: Comprehensive Care for Traumatized Children.
Author(s): Saxe, Glenn N., Boston University Medical Center,
Department of Child and Adolescent Psychiatry, Boston, MA, US,
glenn.saxe@bmc.org
Ellis, B. Heidi, Boston University Medical Center, Department of Child
and Adolescent Psychiatry, Boston, MA, US
Fogler, Jason, Boston University Medical Center, Department of Child and
Adolescent Psychiatry, Boston, MA, US
Hansen, Susan, Ulster County, Family and Child Unit, Mental Health
Department, NY, US
Sorkin, Barbara, Ulster County, Department of Social Services, NY, US
Address: Saxe, Glenn N., Department of Child and Adolescent
Psychiatry, Dowling 1 North, One Boston Medical Center Place, Boston,
MA, US, glenn.saxe@bmc.org
Source: Psychiatric Annals, Vol 35(5), May 2005. pp. 443-448.
Publisher: US: SLACK
Publisher URL: http://www.slackinc.com/
ISSN: 0048-5713 (Print)
Language: English
Keywords: traumatized children; interventions; social environment;
trauma systems therapy
Abstract: One of the primary challenges in the development of
effective interventions for traumatized children is that the same
factors that place a child at risk for exposure to traumatic events also
contribute to an unstable social environment. Traumatized children
frequently live in environments characterized by domestic violence,
child maltreatment, parental mental illness, and substance
abuse--conditions that have been demonstrated to be detrimental to child
development. This article describes the results of an open trial of an
innovative model of care for traumatized children, trauma systems
therapy (TST). TST is designed to address both a child's trauma-related
symptoms and the perpetuating factors in the social environment.
_____
Record: 4
Title: Do personality traits predict post-traumatic stress?: A
prospective study in civilians experiencing air attacks.
Author(s): Knezevic, Goran, Psychosocial Centre and Centre for
Rehabilitation of Torture Victims, International Aid Network, Belgrade,
Serbia and Montenegro
Opacic, Goran, Psychosocial Centre and Centre for Rehabilitation of
Torture Victims, International Aid Network, Belgrade, Serbia and
Montenegro
Savic, Danka, Psychosocial Centre and Centre for Rehabilitation of
Torture Victims, International Aid Network, Belgrade, Serbia and
Montenegro
Priebe, Stefan, Unit for Social and Community Psychiatry, Barts and the
Royal London School of Medicine, Queen Mary, University of London,
London, United Kingdom, s.priebe@qmul.ac.uk
Address: Priebe, Stefan, Unit for Social & Community Psychiatry,
Academic Unit, Newham Centre for Mental Health, London, United Kingdom,
E13 8SP, s.priebe@qmul.ac.uk
Source: Psychological Medicine, Vol 35(5), May 2005. pp. 659-663.
Journal URL: http://uk.cambridge.org/journals/psm/
Publisher: US: Cambridge Univ Press
Publisher URL: http://www.cup.org
ISSN: 0033-2917 (Print)
Digital Object Identifier: 10.1017/S0033291704004131
Language: English
Keywords: posttraumatic stress; traumatic event; personality
traits; civilians
Abstract: Background: Previous studies have suggested an
association between personality traits and posttraumatic stress. These
studies either focused exclusively on military veterans or assessed
personality traits after the traumatic event. This study investigates to
what extent personality traits as assessed before the traumatic
experience predict post-traumatic stress in civilians experiencing air
attacks at the end of the exposure to stressful events and 1 year later.
Method: The revised version of the NEO Personality Inventory was
administered to 70 students in Belgrade, Yugoslavia. In 1999, 1 or 2
years after the assessment, all students were exposed to air attacks for
11 weeks. At the end of the attacks and 1 year later post-traumatic
stress was measured on the Impact of Event Scale. Results: Pre-trauma
personality predicted 13% of the variance of intrusion scores 1 year
after the attacks. There was no significant correlation between
personality traits and subsequent avoidance scores at any point of time.
Conclusions: Personality traits that are assessed before a traumatic
event can, to a limited extent, predict intrusive symptoms in a
non-clinical sample of civilians. Pre-trauma assessments of personality
might be less strongly associated with post-traumatic stress than
personality traits obtained after the traumatic event.
_____
Record: 5
Title: Long-term behavioural alterations in female rats after a single
intense footshock followed by situational reminders.
Author(s): Louvart, Hèléne, Laboratory of Perinatal Stress,
University of Lille 1, Villeneuve d'Ascq, France
Maccari, Stefania, Laboratory of Perinatal Stress, University of Lille
1, Villeneuve d'Ascq, France
Ducrocq, François, Department of Psychiatry, School of Medicine,
University of Lille 2, Lille, France
Thomas, Pierre, Department of Psychiatry, School of Medicine, University
of Lille 2, Lille, France
Darnaudéry, Muriel, Laboratory of Perinatal Stress, University of Lille
1, Villeneuve d'Ascq, France, muriel.darnaudery@univ-lille1.fr
Address: Darnaudéry, Muriel, Laboratory of Perinatal Stress,
University of Lille 1, JE 2365, Bat SN4-1, 59655, Villeneuve d'Ascq,
France, Cedex, muriel.darnaudery@univ-lille1.fr
Source: Psychoneuroendocrinology, Vol 30(4), May 2005. pp. 316-324.
Journal URL: http://www.elsevier.com/inca/publications/store/4/7/3/
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0306-4530 (Print)
Digital Object Identifier: 10.1016/j.psyneuen.2004.09.003
Language: English
Keywords: post-traumatic stress disorder; fear conditioning;
social behavior; animal models; intense footshock; situational
reminders; anxiety; corticosterone response; stress responses
Abstract: Post-traumatic stress disorder (PTSD) affects a
vulnerable sub-population of individuals exposed to a traumatic event.
This psychopathology induces long-lasting hypothalamo-pituitary-adrenal
(HPA) axis hypoactivity, hyperarousal and avoidance of trauma-like
situation. PTSD also manifests a high co-morbidity with anxiety
disorders. The aim of the present study was to characterise long-term
biobehavioural alterations in female rats in an animal model of PTSD
consisting in an intense footshock (2 mA, 10s) followed by three weekly
situational reminders. This procedure induced several long-term
alterations: increased anxiety behaviour, reduced time spent in an
'aversive-like' context, altered social behaviour and blunted
corticosterone response to stress. These results demonstrate that
exposure to an intense footshock associated with repeated situational
reminders elicited long-term disturbances which lasted more than 1 month
after the footshock administration. Our findings suggest that this
paradigm could provide a useful animal model of PTSD.
_____
Record: 6
Title: PTSD symptoms predict waking salivary cortisol levels in police
officers.
Author(s): Neylan, Thomas C., Department of Psychiatry, University
of California, San Francisco, CA, US, neylan@itsa.ucsf.edu
Brunet, Alain, Department of Psychiatry, McGill University, Montréal,
PQ, Canada
Pole, Nnamdi, Department of Psychology, University of Michigan, Ann
Arbor, MI, US
Best, Suzanne R., Northern California Institute for Research and
Education, San Francisco, CA, US
Metzler, Thomas J., San Francisco Veterans Administration Medical
Center, San Francisco, CA, US
Yehuda, Rachel, Department of Psychiatry, Mount Sinai School of
Medicine, New York, NY, US
Marmar, Charles R., Department of Psychiatry, University of California,
San Francisco, CA, US
Address: Neylan, Thomas C., PTSD Program, Psychiatry Service, VA
Medical Center, 116P, 4150 Clement Street, San Francisco, CA, US,
neylan@itsa.ucsf.edu
Source: Psychoneuroendocrinology, Vol 30(4), May 2005. pp. 373-381.
Journal URL: http://www.elsevier.com/inca/publications/store/4/7/3/
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0306-4530 (Print)
Digital Object Identifier: 10.1016/j.psyneuen.2004.10.005
Language: English
Keywords: post-traumatic stress disorder; dexamethasone salivary
cortisol levels; police officers; peritraumatic emotional distress
Abstract: This study examines whether pre- or post-dexamethasone
salivary cortisol is related to cumulative critical incident exposure,
peritraumatic responses, or post-traumatic stress disorder (PTSD)
symptom severity. Thirty active duty police officers completed the study
protocol, which included measures of peritraumatic emotional distress,
peritraumatic dissociation, duty-related trauma exposure, and PTSD
symptoms. Salivary cortisol was consolidated into three outcome
variables: (1) pre-dexamethasone free cortisol levels at 1, 30, 45, and
60 min after awakening, (2) post-dexamethasone cortisol levels at the
identical wake times, and (3) percentage of cortisol suppression.
Control variables included age, gender, average daily alcohol use, night
shift work, routine work environment stressors, and salivary
dexamethasone levels. Zero order correlations showed that greater levels
of PTSD symptoms, peritraumatic distress, and peritraumatic dissociation
were associated with lower levels of pre-dexamethasone cortisol levels
on awakening, but were not associated with the other two cortisol
variables. A trend was also noted for older subjects to have lower
pre-dexamethasone cortisol on awakening. When these four predictors were
entered simultaneously in a regression analysis, only age and PTSD
symptom severity significantly predicted pre-dexamethasone awakening
cortisol levels. These results replicate previous research indicating a
relationship between greater PTSD symptoms and lower levels of basal
cortisol on awakening, and extend this finding to a previously unstudied
non-treatment seeking population, urban police.
_____
Record: 7
Title: How Trauma, Recent Stressful Events, and PTSD Affect Functional
Health Status and Health Utilization in HIV-Infected Patients in the
South.
Author(s): Leserman, Jane, Department of Psychiatry, University of
North Carolina, Chapel Hill, NC, US, JLes@med.unc.edu
Whetten, Kathryn, Department of Public Policy and Community and Family
Medicine, Duke University, Durham, NC, US
Lowe, Kristin, Department of Public Policy and Community and Family
Medicine, Duke University, Durham, NC, US
Stangl, Dalene, Institute of Statistics and Decision Sciences, Duke
University, Durham, NC, US
Swartz, Marvin S., Department of Psychiatry, Duke University, Durham,
NC, US
Thielman, Nathan M., Division of Infectious Diseases, Department of
Medicine, Duke University, Durham, NC, US
Address: Leserman, Jane, Department of Psychiatry, University of
North Carolina at Chapel Hill, CB 7160, Medical School Wing C, Room 233,
Chapel Hill, NC, US, JLes@med.unc.edu
Source: Psychosomatic Medicine, Vol 67(3), May-Jun 2005. pp. 500-507.
Journal URL: http://www.psychosomaticmedicine.org/
Publisher: US: Lippincott Williams & Wilkins
Publisher URL: http://www.lww.com/
ISSN: 0033-3174 (Print)
Digital Object Identifier: 10.1097/01.psy.0000160459.78182.d9
Language: English
Keywords: trauma; severe stressful events; posttraumatic stress
disorder; depressive symptoms; physical functioning; health care
utilization; HIV infected patients; Southern rural areas; quality of
life
Abstract: Objective: In addition to biological markers of human
immunodeficiency virus (HIV) disease progression, physical functioning
and utilization of health care may also be important indicators of
health status in HIV-infected patients. There is insufficient
understanding of the psychosocial predictors of health-related physical
functioning and use of health services among those with this chronic
disease. Therefore, the current study examines how trauma, severe
stressful events, posttraumatic stress disorder (PTSD), and depressive
symptoms are related to physical functioning and health utilization in
HIV-infected men and women living in rural areas of the South. Methods:
We consecutively sampled patients from 8 rural HIV clinics in 5 southern
states, obtaining 611 completed interviews. Results: We found that
patients with more lifetime trauma, stressful events, and PTSD symptoms
reported more bodily pain, and poorer physical, role, and cognitive
functioning. Trauma, recent stressful events, and PTSD explained from
12% to 27% of the variance in health-related functioning, over and above
that explained by demographic variables. In addition, patients with more
trauma, including sexual and physical abuse, and PTSD symptoms were at
greater risk for having bed disability, an overnight hospitalization, an
emergency room visit, and four or more HIV outpatient clinic visits in
the previous 9 months. Patients with a history of abuse had about twice
the risk of spending 5 or more days in bed, having an overnight hospital
stay, and visiting the emergency room, compared with those without
abuse. The effects of trauma and stress were not explained by CD4
lymphocyte count or HIV viral load; however, these effects appear to be
largely accounted for by increases in current PTSD symptoms. Conclusion:
These findings highlight the importance of addressing past trauma,
stress, and current PTSD within clinical HIV care.
_____
Record: 8
Title: Associations and Predictors of Posttraumatic Stress Levels
According to Person-Related, Disability-Related, and Trauma-Related
Variables Among Individuals With Spinal Cord Injuries.
Author(s): Martz, Erin, University of Missouri, Columbia, MO, US,
martze@missouri.edu
Address: Martz, Erin, Rehabilitation Counseling Program,
Educational, School, and Counseling Psychology Department, University of
Missouri, 4B Hill Hall, Columbia, MO, US, martze@missouri.edu
Source: Rehabilitation Psychology, Vol 50(2), May 2005. pp. 149-157.
Journal URL: http://www.apa.org/journals/rep.html
Publisher: US: Educational Publishing Foundation
Publisher URL: http://www.apa.org
ISSN: 0090-5550 (Print)
Digital Object Identifier: 10.1037/0090-5550.50.2.149
Language: English
Keywords: posttraumatic stress levels; spinal cord injuries;
person related variables; disability related variables; trauma related
variables
Abstract: Objective: To examine the associations and predictors of
posttraumatic stress among individuals with spinal cord injuries (SCI)
in the framework of a Person x Disability x Traumatic Event model.
Design: An exploratory study involving analyses of variance,
correlations, and a hierarchical multiple regression of a
cross-sectional sample. Participants: Three hundred twelve individuals
with SCI using a veteran or a civilian SCI clinic. Main Outcome
Measures: Purdue Posttraumatic Stress Disorder--Revised scale (PPTSD-R).
Results: Four out of all the examined variables had significant
regression coefficients: spiritual-religious coping, pain level,
severity of SCI, and number of traumatic events. Severity of SCI was a
significant predictor, but data suggested that severity of SCI had a
curvilinear association with both total posttraumatic stress levels and
hyperarousal scores. Conclusion: Treatment of an individual's pain may
reduce posttraumatic stress symptoms. Clinicians also can evaluate for
previous trauma unrelated to the onset of the SCI and can intervene with
the goal of reducing the impact of previous trauma on the individual's
present emotional state and reactions to SCI.
_____
Record: 9
Title: On Hardiness and Other Pathways to Resilience.
Author(s): Maddi, Salvatore R., University of California, Irvine,
CA, US, srmaddi@uci.edu
Address: Maddi, Salvatore R., Hardiness Institute, 4425 Jamboree,
Suite 100, Newport Beach, CA, US, srmaddi@uci.edu
Source: American Psychologist, Vol 60(3), Apr 2005. pp. 261-262.
Journal URL: http://www.apa.org/journals/amp.html
Publisher: US: American Psychological Assn
Publisher URL: http://www.apa.org
ISSN: 0003-066X (Print)
Digital Object Identifier: 10.1037/0003-066X.60.3.261
Language: English
Keywords: emotional experiences; traumatic events; aversive
events; loss; capacity to thrive; recovery; posttraumatic stress
disorder; resilience
Abstract: Comments on George Bonanno's article entitles Loss,
Trauma, and Human Resilience: Have We Underestimated the Human Capacity
to Thrive After Extremely Aversive Events?" (see record 2004-10043-003).
The author of this comment notes that Bonanno's article is a compelling
analysis of several different reactions to extremely aversive events.
With regard to major stressors, such as the death of a loved one or the
experience a life-threatening circumstance, there is, notably, not only
the psychopathological breakdown (e.g., posttraumatic stress disorder
[PTSD] or depressive disorder) that has been emphasized but also the
less recognized resilient response, in which there is little or no loss
of functioning. Whereas the emphasis in the breakdown response is
understandably on treatment that facilitates recovery, the resilient
response may require little but the person's own ongoing efforts in life
to continue effectively. Indeed, Bonanno suggested that the typical
treatment efforts following traumatic events might actually undermine
the resilient person's adjustment efforts. Bonanno's conceptualization
and supportive research evidence advance our understanding of
individuals' reactions to massive stressors. Further, Bonanno (2004)
argued that there are multiple pathways to resilience under stress, and
he identified personality hardiness as one of them. His presentation of
hardiness accurately emphasizes its interrelated attitudes of commitment
(rather than alienation), control (rather than powerlessness), and
challenge (rather than threat) but does not cover how this concept has
evolved over the last 25 years. Coordinating theory, research, and
practice over this period of time, the author has concluded (Maddi,
2002) that hardy attitudes amount to the courage and motivation to face
stressors accurately (rather than to deny or catastrophize them). This
courage and motivation lead to coping by problem solving rather than by
avoiding and to interacting with others by giving and getting assistance
and encouragement rather than by striking out or overprotecting. Thus,
personality hardiness is emerging as a pattern of attitudes and actions
that helps in transforming stressors from potential disasters into
growth opportunities. The author concludes that Bonanno's exciting
position has opened the way for such comparative analytic research
through which researchers can further their current knowledge concerning
how resilience under stress comes about.
_____
Record: 10
Title: Has Resilience to Severe Trauma Been Underestimated?
Author(s): Litz, Brett T., Department of Veterans Affairs Boston
Healthcare System, Boston, MA, US, brettlitz@comcast.com
Address: Litz, Brett T., Department of Veterans Affairs Boston
Healthcare System, 150 South Huntington Avenue, Boston, MA, US,
brettlitz@comcast.com
Source: American Psychologist, Vol 60(3), Apr 2005. pp. 262.
Journal URL: http://www.apa.org/journals/amp.html
Publisher: US: American Psychological Assn
Publisher URL: http://www.apa.org
ISSN: 0003-066X (Print)
Digital Object Identifier: 10.1037/0003-066X.60.3.262a
Language: English
Keywords: emotional experiences; traumatic events; aversive
events; loss; capacity to thrive; recovery; posttraumatic stress
disorder; resilience
Abstract: Comments on George Bonanno's article entitles Loss,
trauma, and human resilience: Have we underestimated the human capacity
to thrive after extremely aversive events? (see record 2004-10043-003).
The author notes that Bonanno articulated a model of loss and
trauma-related resilience cogently and evocatively. In the trauma field,
there is a new focus on risk and resilience factors across the life span
(e.g., King, Vogt, & King, 2004), and the article by Bonanno will serve
as a herald for this new way of thinking about adjustment to trauma and
loss. Because the author believes that the most important function of
Bonanno's article should be to stimulate theory development and research
in this burgeoning area, he raises three issues in service of that goal.
_____
Record: 11
Title: The Human Capacity for Growth Through Adversity.
Author(s): Linley, P. Alex, University of Leicester, Leicester,
United Kingdom, PAL8@le.ac.uk
Joseph, Stephen, University of Warwick, Coventry, United Kingdom,
S.Joseph@warwick.ac.uk
Address: Linley, P. Alex, School of Psychology, University of
Leicester, Leicester, United Kingdom, LE1 7RH, PAL8@le.ac.uk
Source: American Psychologist, Vol 60(3), Apr 2005. pp. 262-264.
Journal URL: http://www.apa.org/journals/amp.html
Publisher: US: American Psychological Assn
Publisher URL: http://www.apa.org
ISSN: 0003-066X (Print)
Digital Object Identifier: 10.1037/0003-066X.60.3.262b
Language: English
Keywords: emotional experiences; traumatic events; aversive
events; loss; capacity to thrive; recovery; posttraumatic stress
disorder; resilience
Abstract: Comments on George Bonanno's article entitled Loss,
trauma, and human resilience: Have we underestimated the human capacity
to thrive after extremely aversive events? (see record 2004-10043-003).
The authors are encouraged by Bonanno's recognition of the human
potential for resilience following adversity and his call for
psychologists to pay greater attention to this capacity rather than
simply focus on psychopathology. This approach parallels recent trends
within psychology toward a more "positive psychology," as championed by
former American Psychological Association President Martin Seligman.
However, it fails to recognize research trends within the traumatic
stress literature, which have increasingly pointed toward the capacity
not just for resilience but also for people to use aversive events as a
springboard for further growth and development. In this comment, the
authors argue that the real paradigm shift needed in dealing with loss
and trauma is not simply to include resilience (i.e., the absence of
psychopathology). Rather, psychologists should seek to develop an
understanding of reactions to adversity that explains the full range of
reactions, from psychopathology, through resilience, to adversarial
growth. Here they review the main points made by Bonanno (2004) within
the context of the adversarial growth literature before presenting a
brief overview of a new theory of adversarial growth that addresses
these salient considerations, explaining the three possible outcomes of
psychopathology, resilience, and adversarial growth following loss and
trauma.
_____
Record: 12
Title: Conceptual Clarifications in the Study of Resilience.
Author(s): Roisman, Glenn I., University of Illinois at
Urbana-Champaign, Champaign, IL, US, roisman@uiuc.edu
Address: Roisman, Glenn I., Department of Psychology, University
of Illinois at Urbana-Champaign, 603 East Daniel Street, Champaign, IL,
US, roisman@uiuc.edu
Source: American Psychologist, Vol 60(3), Apr 2005. pp. 264-265.
Journal URL: http://www.apa.org/journals/amp.html
Publisher: US: American Psychological Assn
Publisher URL: http://www.apa.org
ISSN: 0003-066X (Print)
Digital Object Identifier: 10.1037/0003-066X.60.3.264
Language: English
Keywords: emotional experiences; traumatic events; aversive
events; loss; capacity to thrive; recovery; posttraumatic stress
disorder; resilience
Abstract: Comments on George Bonanno's article entitled Loss,
trauma, and human resilience: Have we underestimated the human capacity
to thrive after extremely aversive events? (see record 2004-10043-003).
The authors note that Bonanno's article on loss, trauma, and human
resilience serves an important function for the field in drawing
attention to the pseudoscientific mythologies that have grown up around
brief normative (loss-related) and nonnormative (traumatic) stressors.
As the author rightly pointed out, traditional assumptions regarding the
absolute necessity of "grief work" in the case of loss and clinical
debriefing following exposure to traumatic events may indeed be
overdrawn (and overprescribed) in light of emerging evidence. Although
there is much to like about Bonanno's analysis, several limitations
inherent in the author's conceptualization of resilience are troubling
in light of the history of developmental research in this area, much of
which is cited in the target article. In essence, Bonanno defined adult
resilience as an individual's capacity to resist maladaptation in the
face of risky experiences (e.g., "stress resistance"). Although this is
one plausible way of conceptualizing resilience, it is by no means an
exclusive definition.
_____
Record: 13
Title: Clarifying and Extending the Construct of Adult Resilience.
Author(s): Bonanno, George A., Teachers College, Columbia
University, New York, NY, US, gab38@columbia.edu
Address: Bonanno, George A., Teachers College, Columbia
University, 525 West 120th Street, Box 218, New York, NY, US,
gab38@columbia.edu
Source: American Psychologist, Vol 60(3), Apr 2005. pp. 265-267.
Journal URL: http://www.apa.org/journals/amp.html
Publisher: US: American Psychological Assn
Publisher URL: http://www.apa.org
ISSN: 0003-066X (Print)
Digital Object Identifier: 10.1037/0003-066X.60.3.265b
Language: English
Keywords: emotional experiences; traumatic events; aversive
events; loss; capacity to thrive; recovery; posttraumatic stress
disorder; resilience
Abstract: In this article the author responds to comments made in
this issue (see records 2005-03019-010; 2005-03019-011; 2005-03019-012;
2005-03019-013; and 2005-03019-014) responding to his original article
entitled Loss, trauma, and human resilience: Have we underestimated the
human capacity to thrive after extremely aversive events? (see record
2004-10043-003). The author notes that in his original article he
focused on three crucial points: Resilience among adults represents a
distinct and empirically separable outcome trajectory from that normally
associated with recovery from trauma; resilience is more prevalent than
generally accepted in either the lay or professional literature; and
there are multiple and sometimes unexpected factors that inform adult
resilience. Owing to the brevity of the article, the author could only
touch briefly on many of the more nuanced and complex issues suggested
by the resilience construct; this left plenty of room for critique.
Fortunately, the comments are generous and insightful and for the most
part compatible with the driving goal of the article. As might be
expected, of course, there were statements peppered throughout the
comments that the author deemed worthy of rebuttal or correction. He
considers four points that seemed to beg most urgently for response.
_____
Record: 14
Title: Natural Resilience and Innate Mental Health.
Author(s): Kelley, Thomas M., Wayne State University, Detroit, MI,
US, aa5216@wayne.edu
Address: Kelley, Thomas M., Department of Criminal Justice, Wayne
State University, Detroit, MI, US, aa5216@wayne.edu
Source: American Psychologist, Vol 60(3), Apr 2005. pp. 265.
Journal URL: http://www.apa.org/journals/amp.html
Publisher: US: American Psychological Assn
Publisher URL: http://www.apa.org
ISSN: 0003-066X (Print)
Digital Object Identifier: 10.1037/0003-066X.60.3.265a
Language: English
Keywords: emotional experiences; traumatic events; aversive
events; loss; capacity to thrive; recovery; posttraumatic stress
disorder; resilience; mental health
Abstract: Comments on George Bonanno's article entitled Loss,
trauma, and human resilience: Have we underestimated the human capacity
to thrive after extremely aversive events? (see record 2004-10043-003).
The author notes that Bonanno's article on loss, trauma, and resilience
represents another important step toward pointing psychology in a more
positive and fruitful direction. Bonanno was right; psychologists have
dramatically underestimated the human capacity to thrive after extremely
aversive events. More important, psychologists have also failed to
realize that the human capacity for resilience, highlighted by Bonanno,
is natural and normal, part and parcel of the innate health built into
all human beings. Bonanno concluded from his review of the research on
grieving and posttraumatic stress disorder that resilience to
interpersonal loss and traumatic events is common and represents healthy
adjustment. This conclusion points to the existence of an innate human
psychological immune capacity.
_____
Record: 15
Title: Cognitive therapy for post-traumatic stress disorder:
Development and evaluation.
Author(s): Ehlers, Anke, Department of Psychology, Institute of
Psychiatry, King's College London, London, United Kingdom,
a.ehlers@iop.kcl.ac.uk
Clark, David M., Department of Psychology, Institute of Psychiatry,
King's College London, London, United Kingdom
Hackmann, Ann, Department of Psychiatry, Oxford University, Oxford,
United Kingdom
McManus, Freda, Department of Psychology, Institute of Psychiatry,
King's College London, London, United Kingdom
Fennell, Melanie, Department of Psychiatry, Oxford University, Oxford,
United Kingdom
Address: Ehlers, Anke, Department of Psychology, Institute of
Psychiatry, King's College London, PO77 De Crespigny Park, London,
United Kingdom, SE5 8AF, a.ehlers@iop.kcl.ac.uk
Source: Behaviour Research & Therapy, Vol 43(4), Apr 2005. pp. 413-431.
Journal URL: http://www.elsevier.com/inca/publications/store/2/6/5/
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0005-7967 (Print)
Digital Object Identifier: 10.1016/j.brat.2004.03.006
Language: English
Keywords: cognitive therapy; program development; post traumatic
stress disorder; comorbidity; depression; anxiety; therapy evaluation
Abstract: The paper describes the development of a cognitive
therapy (CT) program for post-traumatic stress disorder (PTSD) that is
based on a recent cognitive model (Behav. Res. Therapy 38 (2000) 319).
In a consecutive case series, 20 PTSD patients treated with CT showed
highly significant improvement in symptoms of PTSD, depression and
anxiety. A subsequent randomized controlled trial compared CT (N = 14)
and a 3-month waitlist condition (WL, N = 14). CT led to large
reductions in PTSD symptoms, disability, depression and anxiety, whereas
the waitlist group did not improve. In both studies, treatment gains
were well maintained at 6- month follow-up. CT was highly acceptable,
with an overall dropout rate of only 3%. The intent-to-treat effect
sizes for the degree of change in PTSD symptoms from pre to
post-treatment were 2.70-2.82 (self-report), and 2.07 (assessor-rated).
The controlled effect sizes for CT versus WL post-treatment scores were
2.25 (self-report) and 2.18 (assessor-rated). As predicted by the
cognitive model, good treatment outcome was related to greater changes
in dysfunctional post-traumatic cognitions. Patient characteristics such
as comorbidity, type of trauma, history of previous trauma, or time
since the traumatic event did not predict treatment response, however,
low educational attainment and low socioeconomic status were related to
better outcome.
_____
Record: 16
Title: Trauma-Related Intrusions and Psychosis: An Information
Processing Account.
Author(s): Steel, Craig, University College London, London, United
Kingdom, c.steel@iop.kcl.ac.uk
Fowler, David, University of East Anglia, Norwich, United Kingdom
Holmes, Emily A., MRC Cognition and Brain Sciences Unit, Cambridge,
United Kingdom
Address: Steel, Craig, Department of Mental Health Sciences,
Royal Free and University College London, Medical School, Holborn Union
Building, Archway Campus, London, United Kingdom, N19 5LW,
c.steel@iop.kcl.ac.uk
Source: Behavioural & Cognitive Psychotherapy, Vol 33(2), Apr 2005. pp.
139-152.
Journal URL: http://uk.cambridge.org/journals/bcp/
Publisher: US: Cambridge Univ Press
Publisher URL: http://www.cup.org
ISSN: 1352-4658 (Print)
Digital Object Identifier: 10.1017/S1352465804001924
Language: English
Keywords: trauma; psychosis; information processing mechanisms;
intrusions; clinical interventions
Abstract: There is active, current speculation about the
relationship between trauma and psychosis. However, little is known
about the information-processing mechanisms underlying the development
of trauma-related intrusions in this area. Our account highlights the
role of contextual integration, i.e. the need for experiential
information to be effectively integrated into a temporal and spatial
context in order to facilitate voluntary recall. Drawing on existing
models of both posttraumatic stress disorder (PTSD) and psychosis
(Brewin, 2001; Ehlers and Clark, 2000; Garety et al., 2001; Morrison,
2001), we propose a contextual integration account of trauma-related
intrusions. It is argued that the strength of contextual integration,
which occurs during encoding, influences the frequency and nature of
subsequent intrusive experiences. Consequently, individual differences
in schizotypal personality traits, which are known to be associated with
levels of contextual integration, are also related to the phenomenology
of trauma-related intrusions. Whilst intrusions can be seen to occur
within a range of disorders, it is argued that contextual integration
may be one key variable in understanding the relationship between an
experienced trauma and any consequent psychiatric symptomatology.
Implications for clinical interventions aimed at trauma-related
psychosis are discussed, along with research aimed at developing the
empirical basis for such interventions.
_____
Record: 17
Title: Corticolimbic Blood Flow in Posttraumatic Stress Disorder During
Script-Driven Imagery.
Author(s): Britton, Jennifer C., Neuroscience Program, University
of Michigan, Ann Arbor, MI, US
Phan, K. Luan, Department of Psychiatry, University of Chicago, Chicago,
IL, US
Taylor, Stephan F., Department of Psychiatry, University of Michigan,
Ann Arbor, MI, US
Fig, Lorraine M., Nuclear Medicine, Ann Arbor VAMC, Ann Arbor, MI, US
Liberzon, Israel, Department of Psychiatry, University of Michigan, Ann
Arbor, MI, US, liberzon@umich.edu
Address: Liberzon, Israel, University Hospital, Psychiatry
Department, 9D, 1500 E Medical Center Drive, Ann Arbor, MI, US,
liberzon@umich.edu
Source: Biological Psychiatry, Vol 57(8), Apr 2005. pp. 832-840.
Journal URL:
http://www.elsevier.com/inca/publications/store/5/0/5/7/5/0/
Publisher: Netherlands: Elsevier Science
Publisher URL: http://elsevier.com
ISSN: 0006-3223 (Print)
Digital Object Identifier: 10.1016/j.biopsych.2004.12.025
Language: English
Keywords: corticolimbic blood flow; posttraumatic stress disorder;
limbic function; neuroimaging; combat veterans
Abstract: Background: Functional neuroimaging experiments
targeting personal recall of emotional events may help elucidate neural
substrates underlying posttraumatic stress disorder (PTSD). Studies
suggest that limbic and paralimbic function might be altered in PTSD, as
compared with trauma-exposed control subjects; however, little is known
about functional changes resulting from traumatic experience itself. The
present study examined both PTSD-specific and trauma-specific regional
cerebral blood flow (rCBF) patterns during script-driven imagery.
Methods: Sixteen combat veterans with PTSD (PP); 15 combat veterans
without PTSD (CC); and 14 healthy, aged-matched noncombat control
subjects (NC) underwent [¹-sup-5O] H-sub-2O positron emission tomography
(PET) scanning during script-driven imagery of emotionally evocative and
neutral autobiographic events. Results: Differential patterns of
activation were detected in amygdala and medial frontal cortex. Past
trauma experience was associated with decreased amygdala activity (i.e.,
less activity than healthy control subjects); however, combat control
subjects deactivated this region (i.e., greater activity to neutral
scripts). All subjects deactivated medial frontal cortex; PTSD patients
had greater rostral anterior cingulate (rACC) deactivation compared with
control groups, who deactivated ventromedial prefrontal cortex (vmPFC).
Conclusions: Trauma-specific patterns may represent potential
compensatory changes to traumatic reminders, while patterns observed
only in the PTSD group may reflect neural substrates specific to PTSD
pathophysiology.
_____
Record: 18
Title: Efficacité d'une intervention de groupe auprès d'hommes agressés
sexuellement dans leur enfance.
Translated Title: Effectiveness of a group intervention for men
sexually molested during childhood.
Author(s): Tourigny, Marc, Département de psychoéducation,
Université de Sherbrooke, Sherbrooke, PQ, Canada
Guillor, Marie-Laure, Université de Montréal, Montréal, PQ, Canada
Morissette, Pauline, Université de Montréal, Montréal, PQ, Canada
Address: Tourigny, Marc, Departement de psychoeducation,
Universite de Sherbrooke, 2500, boulevard de l'Universite, Sherbrooke,
PQ, Canada, J1K 2R1
Source: Canadian Journal of Behavioural Science, Vol 37(2), Apr 2005.
pp. 97-109.
Publisher: Canada: Canadian Psychological Assn
Publisher URL: http://www.cpa.ca
ISSN: 0008-400X (Print)
Language: French
Keywords: group intervention; men; childhood experiences; sexual
molestation; childhood sexual abuse; victims; posttraumatic stress
symptoms; psychological distress; self-esteem; feeling of loneliness
Abstract: The purpose of this research was to evaluate the effects
of a group intervention intended for men victims of childhood sexual
abuse (CSA). A quasi-experimental design was used to compare 23 men who
took part in the group intervention against 13 men who suffered CSA but
who received no service relative to this victimization. Data was
collected through a self-administered questionnaire, which comprised
various sections, including: 1) one on the participants'
sociodemographic and CSA characteristics; 2) a posttraumatic stress
symptoms scale; 3) a psychological distress index; 4) a self-esteem
measure; and 5) a measure of the feeling of loneliness. The results
demonstrate that, compared with the men in the control group, the men
who completed the group intervention improved significantly in terms of
self-esteem and on the subscale measuring CSA-related traumatic
symptoms. No inter-group difference emerged concerning psychological
distress, posttraumatic stress, and feeling of loneliness. Despite
certain methodological limitations (including the non-random
distribution of subjects into groups and the small size of the samples),
the use of a quasi-experimental control-group design and of validated
standardized measures (including one for posttraumatic stress disorder)
lends strength and credence to the study.
_____
Record: 19
Title: Gender and PTSD.
Author(s): Fraser, George
Source: Canadian Journal of Psychiatry, Vol 50(5), Apr 2005. pp. 297.
Journal URL: http://www.cpa-apc.org/Publications/cjpHome.asp
Publisher: Canada: Canadian Psychiatric Assn
Publisher URL: http://www.cpa-apc.org
Reviewed Item: Rachel Kimerling; Paige Ouimette; Jessica Wolfe (Eds.)
(2002). Gender and PTSD; New York: The Guilford Press; 2002. 460 p.
US$66.00.
ISSN: 0706-7437 (Print)
Language: English
Keywords: posttraumatic stress disorder; epidemiology; gender
differences; human development; psychosocial factors; risk; trauma;
cognition; physiology; comorbidity; treatment response
Abstract: Reviews the book "Gender and PTSD" edited by Rachel
Kimerling, Paige Ouimette and Jessica Wolfe (see record 2003-04410-000).
This multiauthored book takes a comprehensive look at the many sex
issues that might explain the increased vulnerability of girls and women
to PTSD. Many readers will likely be surprised by how many issues need
to be considered in the management of male vs female PTSD patients or
clients. Knowledge of these issues will certainly assist PTSD therapists
in being more alert to therapy issues that previously might not have
even been considered. Another interesting area pointed out in this book
is that female sex may result in an underdiagnosis of PTSD. Girls and
women are more likely be diagnosed instead with various other disorders,
including depression and borderline personality disorder. There are many
other pertinent areas discussed, which help explain women's
vulnerability to PTSD. The various authors do point out that much of the
data analyzed and presented is early in its development; more research,
especially research addressing the sex differences in PTSD studies, is
necessary to better examine the sex variations that will guide the
theory and therapy of PTSD in women. This book may be the first to
address gender issues in PTSD and will be a guide to therapists.
_____
Record: 20
Title: Mother-Child Expression of Psychological Distress in War Trauma.
Author(s): Qouta, Samir, Gaza Community Mental Health Program, Gaza
City, Palestine
Punamäki, Raija-Leena, University of Tampere, Helsinki, Finland,
raija-leena.punamaki@uta.fi
Sarraj, Eyad El, Gaza Community Mental Health Program, Gaza City,
Palestine
Address: Punamäki, Raija-Leena, Department of Psychology, 330014
University of Tampere, Helsinki, Finland, raija-leena.punamaki@uta.fi
Source: Clinical Child Psychology & Psychiatry, Vol 10(2), Apr 2005. pp.
135-156.
Publisher: US: Sage Publications
Publisher URL: http://www.sagepublications.com/
ISSN: 1359-1045 (Print)
1461-7021 (Electronic)
Digital Object Identifier: 10.1177/1359104505051208
Language: English
Keywords: war trauma; maternal neuroticism; psychological
distress; mental health; mothers expression; children expression
Abstract: The aims of this study were, first, to examine how
exposure to war trauma, maternal neuroticism and psychological distress
are associated with child psychological distress, and, second, whether
good maternal mental health and low neuroticism can moderate the
negative impact of war trauma on child mental health. Third, we examined
whether mother-child dyads' psychological distress was dependent on who
was the main war trauma victim in the family: the mother, the child or
both. Fourth, we tested whether mother-child dyads express similar or
different symptoms. The sample consists of 121 Palestinian children
(aged 6-16 years; 45% girls and 55% boys), and their mothers (aged 21-55
years) living under conditions of military violence and war in Gaza.
Child psychological distress was measured using the CPTS-RI
(child-reported) and Rutter Parent Questionnaire (mother-reported), and
mothers' mental health was measured using the SCL-90- R. The results
failed to show any moderating effect of good maternal mental health or
low neuroticism in protecting child mental health from negative impact
of war trauma. The main effects showed that the child's young age, war
trauma and poor maternal mental health were associated with children's
internalizing symptoms, and male gender, maternal neuroticism and poor
mental health with children's externalizing symptoms. There were gender
differences in psychological distress depending on whether the mother,
the child or both were the main war trauma victim in the family: girls
showed particularly high psychological distress when their mothers were
exposed to war trauma (family systems model), whereas boys showed high
levels of distress when both they themselves and their mothers were
exposed to war trauma (accumulative impact model). Similarities were
confirmed in dyadic symptom expression: significant associations were
found between mothers' depressive and children's internalizing symptoms,
and between mothers' hostile and children's externalizing symptoms.
_____
Record: 21
Title: School-based Cognitive-Behavioural Therapy Group Intervention
for Refugee Children who have Experienced War-related Trauma.
Author(s): Ehntholt, Kimberly A., Maudsley Hospital, London, United
Kingdom, kim.ehntholt@slam.nhs.uk
Smith, Patrick A., Child Traumatic Stress Clinic, Maudsley Hospital,
London, United Kingdom
Yule, William, Maudsley Hospital (South London and Maudsley NHS Trust),
London, United Kingdom
Address: Ehntholt, Kimberly A., Michael Rutter Centre for
Children and Young People, Maudsley Hospital, De Crespigny Park, London,
United Kingdom, SE5 8AZ, kim.ehntholt@slam.nhs.uk
Source: Clinical Child Psychology & Psychiatry, Vol 10(2), Apr 2005. pp.
235-250.
Publisher: US: Sage Publications
Publisher URL: http://www.sagepublications.com/
ISSN: 1359-1045 (Print)
1461-7021 (Electronic)
Digital Object Identifier: 10.1177/1359104505051214
Language: English
Keywords: school based intervention; cognitive behavioral therapy;
war related trauma; refugee children; traumatic experiences; treatment
evaluation
Abstract: This study evaluated the effectiveness of a school-based
group intervention designed for children who have experienced trauma.
Twenty-six children (aged 11-15 years) who were refugees or
asylum-seekers from war-affected countries participated. The
manual-based intervention consisted of cognitive-behavioural therapy
(CBT) techniques and was implemented within secondary schools. The
treatment group (n = 15) received six sessions of group CBT over a
6-week period, while the control group (n = 11) were placed on a waiting
list for 6 weeks and then invited to enter treatment. Children in the
CBT group showed statistically significant, but clinically modest
improvements following the intervention, with decreases in overall
severity of post-traumatic stress symptoms. Significant improvements
were also found in overall behavioural difficulties and emotional
symptoms. Children in the waiting list control group did not show any
improvements over the same period. However, follow-up data, which were
only available for a small subset of eight children, suggest that gains
in the CBT group were not maintained at 2-month follow-up.
_____
Record: 22
Title: Posttraumatic stress disorder as a reaction to the experience of
psychosis and its sequelae.
Author(s): Centofanti, Antoni T., Department of Psychology and
Disability Studies, RMIT University, Bundoora, VIC, Australia,
Antoni.Centofanti@rmit.edu.au
Smith, David I., Department of Psychology and Disability Studies, RMIT
University, Bundoora, VIC, Australia
Altieri, Trish, Department of Psychology and Disability Studies, RMIT
University, Bundoora, VIC, Australia
Address: Centofanti, Antoni T., Department of Psychology and
Disability Studies, RMIT University, Po Box 71, Bundoora, VIC,
Australia, 3083, Antoni.Centofanti@rmit.edu.au
Source: Clinical Psychologist, Vol 9(1), Apr 2005. pp. 15-23.
Journal URL: http://www.tandf.co.uk/journals/titles/13284207.asp
Publisher: United Kingdom: Taylor & Francis
Publisher URL: http://www.taylorandfrancis.com/
ISSN: 1328-4207 (Print)
1742-9552 (Electronic)
Language: English
Keywords: posttraumatic stress disorder; psychosis; treatment;
traumatic experiences; psychiatric hospitalisation; police conveyance
Abstract: The potentially distressing nature of both the symptoms
of psychosis and its treatment (i.e., hospitalisation) can have a
traumatic impact upon the individual. This pilot study investigates this
relationship in 20 outpatients hospitalised for psychosis within the
past year. All participated in a research interview. Five participants
(25%) met criteria for Post-Psychotic PTSD. Overall trauma levels were
related significantly to the total number of different types of previous
traumatic events experienced, the distress associated with police
conveyance to their most recent psychiatric hospitalisation, and the
total number of experiences related to harm to self/others during their
most recent hospitalisation. The implications of these findings are
discussed.
_____
Record: 23
Title: The Clenching-Grinding Spectrum and Fear Circuitry Disorders:
Clinical Insights from the Neuroscience/Paleoanthropology Interface.
Author(s): Bracha, H. Stefan, Veterans Affairs (VA) National Center
for Posttraumatic Stress Disorder, Honolulu, HI, US, H.Bracha@med.va.gov
Ralston, Tyler C., Clinical Bio-Markers of Early Stress Project, US
Williams, Andrew E., Clinical Bio-Markers of Early Stress Project, US
Yamashita, Jennifer M., Clinical Bio-Markers of Early Stress Project, US
Bracha, Adam S., Cornell University, Ithaca, NY, US
Address: Bracha, H. Stefan, National Center for PTSD, Department
of Veterans Affairs, Pacific Islands Health Care System, Spark M.
Matsunaga Medical Center, 1132 Bishop Street, Suite 307, Honolulu, HI,
US, H.Bracha@med.va.gov
Source: CNS Spectrums, Vol 10(4), Apr 2005. pp. 311-318.
Journal URL: http://www.cnsspectrums.com/index.php3
Publisher: US: MBL Communications, Inc
Publisher URL: http://mblcommunications.com
ISSN: 1092-8529 (Print)
Language: English
Keywords: clenching-grinding spectrum; fear circuitry disorders;
neuroscience; paleoanthropology interface; neuropsychiatry
Abstract: This review discusses the clenching-grinding spectrum
from the neuropsychiatric/neuroevolutionary perspective. In
neuropsychiatry, signs of jaw clenching may be a useful objective marker
for detecting or substantiating a self-report of current subjective
emotional distress. Similarly, accelerated tooth wear may be an
objective clinical sign for detecting, or substantiating, long-lasting
anxiety. Clenching-grinding behaviors affect at least 8 percent of the
population. We argue that during the early paleolithic environment of
evolutionary adaptedness, jaw clenching was an adaptive trait because it
rapidly strengthened the masseter and temporalis muscles, enabling a
stronger, deeper and therefore more lethal bite in expectation of
conflict (warfare) with conspecifics. Similarly, sharper incisors
produced by teeth grinding may have served as weaponry during early
human combat. We posit that alleles predisposing to fear-induced
clenching-grinding were evolutionarily conserved in the human clade
(lineage) since they remained adaptive for anatomically and
mitochondrially modern humans (Homo sapiens) well into the
mid-paleolithic. Clenching-grinding, sleep bruxism, myofacial pain,
craniomaxillofacial musculoskeletal pain, temporomandibular disorders,
oro-facial pain, and the fibromyalgia/chronic fatigue spectrum disorders
are linked. A 2003 Cochrane meta-analysis concluded that dental
procedures for the above spectrum disorders are not evidence based.
There is a need for early detection of clenching-grinding in anxiety
disorder clinics and for research into science-based interventions.
Finally, research needs to examine the possible utility of incorporating
physical signs into Diagnostic and Statistical Manual of Mental
Disorders, Fifth Edition posttraumatic stress disorder diagnostic
criteria. One of the diagnostic criterion that may need to undergo a
revision in Diagnostic and Statistical Manual of Mental Disorders, Fifth
Edition is Criterion D (persistent fear-circuitry activation not present
before the trauma). Grinding-induced incisor wear, and clenching-induced
palpable masseter tenderness may be examples of such objective physical
signs of persistent fear-circuitry activation (posttraumatic stress
disorder Criterion D).
_____
Record: 24
Title: Posttraumatische Belastungsstörungen bei somatischen
Erkrankungen.
Translated Title: PTSD in Somatic Disease.
Author(s): Krauseneck, Till, Psychiatrische Klinik und Poliklinik
der Ludwig-Maximilians, Universität München, München, Germany,
Till.Krauseneck@med.uni-muenchen.de
Rothenhäusler, H. -B., Universitätsklinik für Psychiatrie der
Karl-Franzens, Universität Graz, Graz, Germany
Schelling, G., Klinik für Anästhesiologie der Ludwig-Maximilians,
Universität München, München, Germany
Kapfhammer, H. -P., Universitätsklinik für Psychiatrie der
Karl-Franzens, Universität Graz, Graz, Germany
Address: Krauseneck, Till, Psychiatrische Klinik und Poliklinik,
LMU Munchen, Nussbaumstr. 7, 80336, Munchen, Germany,
Till.Krauseneck@med.uni-muenchen.de
Source: Fortschritte der Neurologie, Psychiatrie, Vol 73(4), Apr 2005.
pp. 206-217.
Journal URL: http://www.thieme.de/fdn/index.html
Publisher: Germany: Georg Thieme Verlag KG
Publisher URL: http://www.thieme.de
ISSN: 0720-4299 (Print)
Digital Object Identifier: 10.1055/s-2004-830108
Language: German
Keywords: somatic diseases; posttraumatic stress disorder
Abstract: This review describes the incidence of posttraumatic
stress disorder (PTSD) in physically ill patients. At the beginning,
research in the field of PTSD was primarily focused on war veterans and
victims of bodily assault or rape. Starting in the early 90s, PTSD after
civilian traumas such as motor vehicle accidents was diagnosed
increasingly more often. Recent publications showed that PTSD can also
follow serious somatic diseases. Hence, awareness during anaesthesia,
prolonged ICU treatment (ARDS, septic shock), burns, successful
resuscitation after cardiac arrest, coronary artery bypass surgery,
organ transplantation and cancer were all linked to the development of
PTSD. Prevalence of PTSD in these medical conditions lies around 5-10%,
and it is therefore considered an important comorbidity. Unfortunately,
the diagnosis and treatment of PTSD are not well enough established yet
and thus do receive too little attention in the treatment regime of
somatic illness. Generally, PTSD can occur with every life-threatening
disease, but possibly also with less severe diseases if the patient
experiences intense fear. PTSD symptoms, especially intrusive
recollections, avoidance and hyperarousal can impair the patients'
quality of life more than the primary disease. This seems to be also
true for subsyndromal PTSD. To adequately diagnose and treat patients at
risk of developing PTSD, close collaboration between physicians of all
subspecialties and psychiatrists will be necessary.
_____
Record: 25
Title: Maintenance Therapy With Fluoxetine in Posttraumatic Stress
Disorder: A Placebo-Controlled Discontinuation Study.
Author(s): Davidson, Jonathan R. T., Department of Psychiatry and
Behavioral Sciences, Duke University Medical Center, Durham, NC, US,
Jonathan.Davidson@duke.edu
Connor, Kathryn M., Department of Psychiatry and Behavioral Sciences,
Duke University Medical Center, Durham, NC, US
Hertzberg, Michael A., Durham Veterans Administration Medical Center,
Durham, NC, US
Weisler, Richard H., Private Practice, Raleigh, NC, US
Wilson, William H., Department of Psychiatry and Behavioral Sciences,
Duke University Medical Center, Durham, NC, US
Payne, Victoria M., Department of Psychiatry and Behavioral Sciences,
Duke University Medical Center, Durham, NC, US
Address: Davidson, Jonathan R. T., Anxiety and Traumatic Stress
Program, Department of Psychiatry and Behavioral Sciences, Duke
University Medical Center, Box 3812, Durham, NC, US,
Jonathan.Davidson@duke.edu
Source: Journal of Clinical Psychopharmacology, Vol 25(2), Apr 2005. pp.
166-169.
Journal URL: http://www.psychopharmacology.com/
Publisher: US: Lippincott Williams & Wilkins
Publisher URL: http://www.lww.com/
ISSN: 0271-0749 (Print)
Digital Object Identifier: 10.1097/01.jcp.0000155817.21467.6c
Language: English
Keywords: maintenance therapy; fluoxetine; posttraumatic stress
disorder; drug tolerance
Abstract: The effect of fluoxetine (FLU) in posttraumatic stress
disorder was studied in a one-year trial. Subjects received open-label
treatment for 6 months, followed by double-blind randomized treatment
with FLU or placebo (PBO) for 6 months. Rates of relapse were compared
using the Clinical Global Impressions of Improvement. One hundred
twenty-three subjects entered open-label treatment, of whom 114 returned
at least once. Sixty-two subjects were randomized to receive FLU or PBO,
of whom 57 returned at least once' and were analyzed. The dose of FLU
ranged from 10 to 60 mg/d; at randomization, mean doses were 48.6 and
42.1 mg for FLU and PBO groups. Rates of relapse were 22% for FLU versus
50% for PBO (P=0.02), and time to relapse on FLU was longer than for PBO
(P=0.02, log-rank statistic). The odds ratio for relapse on PBO relative
to FLU was 3.50. No significant differences were found on other
measures. Fluoxetine was well tolerated during double-blind treatment.
_____
Record: 26
Title: Hypomania With Topiramate.
Author(s): Kaplan, Marcia, Department of Psychiatry, University of
Cincinnati, Cincinnati, OH, US, mkaplan@3001.us
Address: Kaplan, Marcia, mkaplan@3001.us
Source: Journal of Clinical Psychopharmacology, Vol 25(2), Apr 2005. pp.
196-197.
Journal URL: http://www.psychopharmacology.com/
Publisher: US: Lippincott Williams & Wilkins
Publisher URL: http://www.lww.com/
ISSN: 0271-0749 (Print)
Digital Object Identifier: 10.1097/01.jcp.0000155828.82456.68
Language: English
Keywords: topiramate; hypomania; mood disorders; drug therapy;
dopamine
Abstract: Presents a letter to the editor on the role of
topiramate in hypomania. Topiramate is a novel antiepileptic drug used
off-label by psychiatrists for treatment of mood disorders,
posttraumatic stress disorder, and weight loss. The author reports on 3
cases of hypomania that developed with the use of topiramate in clinical
outpatient practice. All 3 subjects had some degree of childhood trauma
and long-standing mood disorders. All developed hypomania within the
first few weeks of topiramate treatment in the absence of other changes
in medication, diet, or level of environmental stress. It was found that
emotional stress may cause neurotransmitter elevation or depletion that
leads to episodes of depression or mania. Furthermore, increased
dopamine because of cocaine or amphetamine abuse can induce maniclike
symptoms in those with or without an underlying mood disorder.
_____
Record: 27
Title: The Additive Benefit of Hypnosis and Cognitive-Behavioral
Therapy in Treating Acute Stress Disorder.
Author(s): Bryant, Richard A., School of Psychology, University of
New South Wales, Sydney, NSW, Australia, r.bryant@unsw.edu.au
Moulds, Michelle L., School of Psychology, University of New South
Wales, Sydney, NSW, Australia
Guthrie, Rachel M., School of Psychology, University of New South Wales,
Sydney, NSW, Australia
Nixon, Reginald D. V., School of Psychology, University of New South
Wales, Sydney, NSW, Australia
Address: Bryant, Richard A., School of Psychology, University of
New South Wales, 2052, Sydney, NSW, Australia, r.bryant@unsw.edu.au
Source: Journal of Consulting and Clinical Psychology, Vol 73(2), Apr
2005. pp. 334-340.
Journal URL: http://www.apa.org/journals/ccp.html
Publisher: US: American Psychological Assn
Publisher URL: http://www.apa.org
ISSN: 0022-006X (Print)
Digital Object Identifier: 10.1037/0022-006X.73.2.334
Language: English
Keywords: cognitive behavioral therapy; acute stress disorder
treatement; hypnosis; civilian trauma survivors
Abstract: This research represents the first controlled treatment
study of hypnosis and cognitive- behavioral therapy (CBT) of acute
stress disorder (ASD). Civilian trauma survivors (N = 87) who met
criteria for ASD were randomly allocated to 6 sessions of CBT, CBT
combined with hypnosis (CBT-hypnosis), or supportive counseling (SC).
CBT comprised exposure, cognitive restructuring, and anxiety management.
CBT-hypnosis comprised the CBT components with each imaginal exposure
preceded by a hypnotic induction and suggestions to engage fully in the
exposure. In terms of treatment completers (n = 69), fewer participants
in the CBT and CBT-hypnosis groups met criteria for posttraumatic stress
disorder at posttreatment and 6-month follow-up than those in the SC
group. CBT-hypnosis resulted in greater reduction in reexperiencing
symptoms at posttreatment than CBT. These findings suggest that hypnosis
may have use in facilitating the treatment effects of CBT for
posttraumatic stress.
_____
Record: 28
Title: Post- Traumatic Stress Disorder (PTSD): What We Have Learned and
What We Still Have Not Found Out.
Author(s): Flouri, Eirini, University of Oxford, Oxford, England
Source: Journal of Interpersonal Violence, Vol 20(4), Apr 2005. pp.
373-379.
Journal URL: http://www.sagepub.com
Publisher: US: Sage Publications
Publisher URL: http://www.sagepublications.com/
ISSN: 0886-2605 (Print)
Digital Object Identifier: 10.1177/0886260504267549
Language: English
Keywords: post-traumatic stress disorder; biomedical model; social
constructionist model; biological correlates; psychological correlates;
etiology
Abstract: This article discusses the biomedical and the social
constructionist models applied to response to trauma, presents the
prevalence and the etiology of post-traumatic stress disorder (PTSD),
and describes its biological and psychological correlates in children
and adults. It concludes that future research might benefit from
investigating factors that may protect people who have been exposed to
an event likely to be traumatic from presenting with PTSD symptoms, and
factors that may affect the longitudinal course of PTSD and treatment
effectiveness.
_____
Record: 29Title: Beyond PTSD: An Evolving Relationship Between Trauma Theory and
Family Violence Research.
Author(s): Becker-Blease, Kathryn A., Crimes Against Children
Research Center, University of New Hampshire, Durham, NH, US
Freyd, Jennifer J., University of Oregon, Eugene, OR, US
Source: Journal of Interpersonal Violence, Vol 20(4), Apr 2005. pp.
403-411.
Journal URL: http://www.sagepub.com
Publisher: US: Sage Publications
Publisher URL: http://www.sagepublications.com/
ISSN: 0886-2605 (Print)
Digital Object Identifier: 10.1177/0886260504269485
Language: English
Keywords: family violence; trauma theory; traumatic experiences;
posttraumatic stress disorder
Abstract: During the past 20 years, we have learned how similarly
harmful are experiences of terror, violence, and abuse, whether they
occur on the combat field or at home. The field of family violence has
gained much from the field of traumatic stress, and collaborations
between these two previously separate fields have yielded important new
answers, as well as new research questions. The field of traumatic
stress is poised to integrate, more fully than in the past, a variety of
aspects of trauma such as social betrayal, as well as outcomes of trauma
such as depression, criminality, and physiological harm that go beyond
posttraumatic stress. The field of family violence has much to offer in
this process. We look forward to improved research designs that will
further our knowledge of how trauma affects aspects of people's lives,
including productivity, relationships, cognition, and emotions, in
negative and positive ways.
_____
Record: 30
Title: Twenty Years of Progress in the Study of Trauma.
Author(s): MacIntosh, Heather B., University of Ottawa, Ottawa, ON,
Canada
Whiffen, Valerie E., University of Ottawa, Ottawa, ON, Canada
Source: Journal of Interpersonal Violence, Vol 20(4), Apr 2005. pp.
488-492.
Journal URL: http://www.sagepub.com
Publisher: US: Sage Publications
Publisher URL: http://www.sagepublications.com/
ISSN: 0886-2605 (Print)
Digital Object Identifier: 10.1177/0886260504267836
Language: English
Keywords: trauma survivors; traumatic memory; posttraumatic stress
disorder; neuroimaging studies
Abstract: In this article, the authors argue that studies
investigating the nature of traumatic memory have made the greatest
contribution to trauma research in the past 20 years. Neuroimaging
studies provide empirical support for the diagnosis of posttraumatic
stress disorder and have important implications for the treatment of
trauma survivors. In the future, the authors hope to see an empirically
derived model of trauma that incorporates both mediating and moderating
factors to predict outcome.
_____
Record: 31
Title: Systemic Traumatic Stress: The Couple Adaptation to Traumatic
Stress Model.
Author(s): Goff, Briana S. Nelson, Marriage and Family Therapy
Program, School of Family Studies and Human Services, Kansas State
University, Manhattan, KS, US, bnelson@ksu.edu
Smith, Douglas B., Marriage and Family Therapy Program, School of Family
Studies and Human Services, Kansas State University, Manhattan, KS, US
Address: Goff, Briana S. Nelson, Marriage and Family Therapy
Program, School of Family Studies and Human Services, Kansas State
University, 322 Justin Hall, Manhattan, KS, US, bnelson@ksu.edu
Source: Journal of Marital & Family Therapy, Vol 31(2), Apr 2005. pp.
145-157.
Publisher: US: American Assn for Marriage & Family Therapy
Publisher URL: http://www.aamft.org
ISSN: 0194-472X (Print)
Language: English
Keywords: traumatic stress; trauma survivors; Couple Adaptation to
Traumatic Stress Model; secondary traumatic stress
Abstract: Research traditionally has focused on the development of
symptoms in those who experienced trauma directly but overlooked the
impact of trauma on the families of victims. In recent years,
researchers and clinicians have begun to examine how individual exposure
to traumatic stress affects the spouses/partners, children, and
professional helpers of trauma survivors. However, empirically
supported, theory-based literature that identifies the mechanisms by
which interpersonal or "secondary trauma" occurs in response to
traumatic events is limited. Here, we present the Couple Adaptation to
Traumatic Stress Model, a systemic model of the development of
interpersonal symptoms in the couple dyad based on empirical literature.
Potential mechanisms and clinical vignettes are included to describe the
systemic processes that occur with trauma couples. Areas for future
research and clinical implications also are identified.
_____
Record: 32
Title: Evaluation of a PTSD psychoeducational program for psychiatric
inpatients.
Author(s): Pratt, Sarah I., New Hampshire-Dartmouth Psychiatric
Research Center, Department of Psychiatry, Dartmouth Medical School,
Concord, NH, US, Sarah.I.Pratt@Dartmouth.edu
Rosenberg, Stanley, New Hampshire-Dartmouth Psychiatric Research Center,
Department of Psychiatry, Dartmouth Medical School, Concord, NH, US
Mueser, Kim T., New Hampshire-Dartmouth Psychiatric Research Center,
Department of Psychiatry, Dartmouth Medical School, Concord, NH, US
Brancato, Joseph, New Hampshire-Dartmouth Psychiatric Research Center,
Department of Psychiatry, Dartmouth Medical School, Concord, NH, US
Salyers, Michelle, New Hampshire-Dartmouth Psychiatric Research Center,
Department of Psychiatry, Dartmouth Medical School, Concord, NH, US
Jankowski, Mary Kay, New Hampshire-Dartmouth Psychiatric Research
Center, Department of Psychiatry, Dartmouth Medical School, Concord, NH,
US
Descamps, Monica, New Hampshire-Dartmouth Psychiatric Research Center,
Department of Psychiatry, Dartmouth Medical School, Concord, NH, US
Address: Pratt, Sarah I., New Hampshire-Dartmouth Psychiatric
Research Center, Main Building, 105 Pleasant Street, Concord, NH, US,
Sarah.I.Pratt@Dartmouth.edu
Source: Journal of Mental Health (UK), Vol 14(2), Apr 2005. pp. 121-127.
Journal URL: http://www.tandf.co.uk/journals/carfax/09638237.html
Publisher: United Kingdom: Taylor & Francis
Publisher URL: http://www.taylorandfrancis.com/
ISSN: 0963-8237 (Print)
1360-0867 (Electronic)
Language: English
Keywords: psychoeducational program; psychiatric inpatients;
posttraumatic stress disorder
Abstract: Background: Persons with severe mental illness are at
high risk for trauma and posttraumatic stress disorder (PTSD), but
trauma-focused interventions are rarely delivered. Aim: The purpose of
this study was to evaluate the feasibility of providing a
psychoeducational program for individuals with SMI and PTSD in a
psychiatric hospital, and to assess gains in knowledge and satisfaction
with the program. Method: Seventy inpatient participants who met
criteria for PTSD attended three sessions of a psychoeducational program
using a group format of video and discussion. The participants completed
a "knowledge of PTSD" questionnaire before and after the education
programme. Results: Participants demonstrated significant increases in
knowledge about trauma and PTSD, and reported high levels of
satisfaction with the program. Conclusion: Findings support the use of
this intervention as a first step in increasing knowledge about PTSD and
stimulating motivation to seek future treatment.
_____
Record: 33
Title: Differences in Posttraumatic Stress Disorder Symptoms between
Elderly Non-Hispanic Whites and African Americans.
Author(s): Mainous, Arch G. III, Medical University of South
Carolina, Department of Family Medicine, Charleston, SC, US,
mainouag@musc.edu
Smith, Daniel W., Medical University of South Carolina, Department of
Psychiatry, National Crime Victims Research and Treatment Center,
Charleston, SC, US
Acierno, Ron, Medical University of South Carolina, Department of
Psychiatry, National Crime Victims Research and Treatment Center,
Charleston, SC, US
Geesey, Mark E., Medical University of South Carolina, Department of
Family Medicine, Charleston, SC, US
Address: Mainous, Arch G. III, Medical University of South
Carolina, Department of Family Medicine, 295 Calhoun St., PO Box 20192,
Charleston, SC, US, mainouag@musc.edu
Source: Journal of the National Medical Association, Vol 97(4), Apr
2005. pp. 546-549.
Publisher: US: National Medical Assn
Publisher URL: http://www.nmanet.org/
ISSN: 0027-9684 (Print)
Language: English
Keywords: posttraumatic stress disorder symptoms; Whites; African
Americans; coping strategies; trauma; symptom differences
Abstract: This study was a secondary analysis of two similar data
sets to examine potential differences in PTSD symptoms between elderly
whites and African Americans (n=90). Without regard to trauma type,
there were no differences between the races in the distribution of PTSD
diagnosis or specific symptom constellations (e.g., re-experiencing,
avoidance, or arousal). No significant differences were yielded for
individuals who experienced a physical trauma. However, In cases of
nonphysical trauma, elderly whites were significantly more likely than
elderly African Americans to report hyperarousal symptoms, these results
suggest the need to better understand coping strategies used by whites
and African Americans in the face of trauma.
_____
Record: 34
Title: Embedded Journalists in the Iraq War: Are They at Greater
Psychological Risk?
Author(s): Feinstein, Anthony, Department of Psychiatry, Sunnybrook
and Women's College Health Sciences Centre, Toronto, ON, Canada,
antfeinstein@aol.com
Nicolson, Dawn, Department of Psychiatry, Sunnybrook and Women's College
Health Sciences Centre, Toronto, ON, Canada
Address: Feinstein, Anthony, Department of Psychiatry, Sunnybrook
and Women's College Health Sciences Centre, 2075 Bayview Avenue,
Toronto, ON, Canada, M4N 3M5, antfeinstein@aol.com
Source: Journal of Traumatic Stress, Vol 18(2), Apr 2005. pp. 129-132.
Journal URL: http://www.wkap.nl/journalhome.htm/0894-9867
Publisher: US: John Wiley & Sons
Publisher URL: http://www.wiley.com/WileyCDA/
ISSN: 0894-9867 (Print)
Digital Object Identifier: 10.1002/jts.20020
Language: English
Keywords: embedded journalists; Iraq War; psychological distress;
vulnerability
Abstract: The current war in Iraq saw an alliance between the
media and the military, a process called embedded journalism. The aim of
this study was to explore whether this process affected the journalists'
vulnerability to psychological distress. Eighty-five of 100 journalists
approached agreed to participate; 38 (44.7%) were embedded. There were
no differences between embedded and unilateral (nonembedded) journalists
on demographic measures or in their exposure to traumatic events.
Similarly, the two groups did not differ on indices of posttraumatic
stress disorder, depression, psychological distress, and substance use.
Based on General Health Questionnaire scores, one third of all
journalists were psychologically distressed. There is no evidence from
the recent war in Iraq suggesting that embedded journalists are at
increased risk for psychological problems.
_____
Record: 35
Title: The Role of Loss of Meaning in the Pursuit of Treatment for
Posttraumatic Stress Disorder.
Author(s): Fontana, Alan, Northeast Program Evaluation Center, VA
National Center for PTSD, Connecticut Healthcare System, West Haven, CT,
US, Alan.Fontana@med.va.gov
Rosenheck, Robert, Northeast Program Evaluation Center, VA National
Center for PTSD, Connecticut Healthcare System, West Haven, CT, US
Address: Fontana, Alan, Northeast Program Evaluation Center, 182,
950 Campbell Avenue, West Haven, CT, US, Alan.Fontana@med.va.gov
Source: Journal of Traumatic Stress, Vol 18(2), Apr 2005. pp. 133-136.
Journal URL: http://www.wkap.nl/journalhome.htm/0894-9867
Publisher: US: John Wiley & Sons
Publisher URL: http://www.wiley.com/WileyCDA/
ISSN: 0894-9867 (Print)
Digital Object Identifier: 10.1002/jts.20014
Language: English
Keywords: meaning in life; posttraumatic stress disorder;
treatment; traumatic events; help seeking; veterans; clergy; mental
health professionals
Abstract: Clinical observation and theory suggest that people who
have difficulty coping with their exposure to traumatic events often
experience a loss of meaning to their lives. This article examines the
contribution of loss of meaning to seeking help from clergy and/or
mental health providers. Results support the hypotheses that veterans
who have suffered a greater loss of meaning are more likely to seek help
from clergy and from VA mental health professionals. We suggest that
veterans who seek help from clergy are particularly desirous of
achieving a restoration of meaning that is specific to their loss, and
that this quest sustains a continued pursuit of mental health treatment,
especially among those who seek help from the VA.
_____
Record: 36
Title: Correlation Between Traumatic Events and Posttraumatic Stress
Disorder Among North Korean Defectors in South Korea.
Author(s): Jeon, WooTaek, Department of Psychiarry, College of
Medicine, Yonsei University, Seoul, Korea, wtjeon@yumc.yonsei.ac.kr
Hong, ChangHyung, Research Institute of Aging Science, Yonsei
University, Seoul, Korea
Lee, ChangHo, Department of Psychiarry, College of Medicine, Yonsei
University, Seoul, Korea
Kim, Dong Kee, Department of Biostatistics, College of Medicine, Yonsei
University, Seoul, Korea
Han, Mooyoung, Department of Biostatistics, College of Medicine, Yonsei
University, Seoul, Korea
Min, SungKil, Department of Psychiarry, College of Medicine, Yonsei
University, Seoul, Korea
Address: Jeon, WooTaek, Department of Psychiatry, College of
Medicine, Yonsei University, CPO Box 8044, Seoul, Korea,
wtjeon@yumc.yonsei.ac.kr
Source: Journal of Traumatic Stress, Vol 18(2), Apr 2005. pp. 147-154.
Journal URL: http://www.wkap.nl/journalhome.htm/0894-9867
Publisher: US: John Wiley & Sons
Publisher URL: http://www.wiley.com/WileyCDA/
ISSN: 0894-9867 (Print)
Digital Object Identifier: 10.1002/jts.20017
Language: English
Keywords: traumatic events; posttraumatic stress disorder; North
Korean defectors; South Korea; physical trauma; family related trauma
Abstract: The number of North Korean defectors entering South
Korea has been increasing rapidly since 1994. Two hundred North Korean
defectors in South Korea were studied to identify their experiences of
traumatic events in North Korea and during defection, and the
correlation with Posttraumatic Stress Disorder (PTSD). Researchers
conducted face-to-face interviews and assisted defectors in performing a
self-report assessment of this survey. The study questionnaire consisted
of demographic characteristics, the Traumatic Experiences Scale for
North Korean Defectors, and the PTSD part of the Structured Clinical
Interview for DSM-III-R Korean version. Prevalence rate of PTSD in
defectors was 29.5%, with a higher rate for women. In factor analysis,
the 25 items of traumatic events experienced in North Korea were divided
into three factors: Physical Trauma, Political-Ideological Trauma, and
Family-Related Trauma. In addition, the 19 items of traumatic events
during defection were grouped into four factors: Physical Trauma,
Detection and Capture-Related Trauma, Family-Related Trauma, and
Betrayal-Related Trauma. In multifactorial logistic regression analysis,
Family-Related Trauma in North Korea had a significant odds ratio.
_____
Record: 37
Title: Treatment of Residual Insomnia After CBT for PTSD: Case Studies.
Author(s): DeViva, Jason C., Dartmouth Medical School, Lebanon, NH,
US, jason.deviva2@med.va.gov
Zayfert, Claudia, Dartmouth Medical School, Lebanon, NH, US
Pigeon, Wilfred R., Dartmouth Medical School, Lebanon, NH, US
Mellman, Thomas A., Dartmouth Medical School, Lebanon, NH, US
Address: DeViva, Jason C., Veterans Affairs Maryland Health Care
System Baltimore, 10 North Greene Street, Baltimore, MD, US,
jason.deviva2@med.va.gov
Source: Journal of Traumatic Stress, Vol 18(2), Apr 2005. pp. 155-159.
Journal URL: http://www.wkap.nl/journalhome.htm/0894-9867
Publisher: US: John Wiley & Sons
Publisher URL: http://www.wiley.com/WileyCDA/
ISSN: 0894-9867 (Print)
Digital Object Identifier: 10.1002/jts.20015
Language: English
Keywords: residual insomnia; cognitive behavior therapy;
posttraumatic stress disorder
Abstract: Insomnia is one of the most common symptoms of
posttraumatic stress disorder (PTSD). Evidence suggests that insomnia
may persist for many PTSD patients after other symptoms have responded
to cognitive-behavioral therapy (CBT). The present article reports the
effects of administering a five-session cognitive-behavioral insomnia
treatment to 5 patients who responded to CBT for PTSD yet continued to
report insomnia. Insomnia treatment was associated with improvements on
subjective sleep measures (Pittsburgh Sleep Quality Index, Insomnia
Severity Index, and Beliefs and Attitudes about Sleep Scale) and
self-monitored sleep efficiency and related measures in 4 of 5 cases.
Results highlight issues specific to treating insomnia in trauma
populations and future directions for examining treatment of insomnia
associated with PTSD.
_____
Record: 38
Title: Prediction of Numbing and Effortful Avoidance in Female Rape
Survivors With Chronic PTSD.
Author(s): Feuer, Catherine A., Center for Trauma Recovery,
University of Missouri, St. Louis, MO, US
Nishith, Pallavi, Center for Trauma Recovery, University of Missouri,
St. Louis, MO, US
Resick, Patricia, Center for Trauma Recovery, University of Missouri,
St. Louis, MO, US, Resick@med.va.gov
Address: Resick, Patricia, Center for Trauma Recovery, University
of Missouri, Weinman Building-LL, 8001 Natural Bridge Road, St. Louis,
MO, US, Resick@med.va.gov
Source: Journal of Traumatic Stress, Vol 18(2), Apr 2005. pp. 165-170.
Journal URL: http://www.wkap.nl/journalhome.htm/0894-9867
Publisher: US: John Wiley & Sons
Publisher URL: http://www.wiley.com/WileyCDA/
ISSN: 0894-9867 (Print)
Digital Object Identifier: 10.1002/jts.20000
Language: English
Keywords: numbing; arousal; intrusion; avoidance; female rape
survivors; chronic posttraumatic stress disorder
Abstract: The purpose of the present study was to investigate the
relationships among numbing, arousal, intrusion, and avoidance in a
sample of 272 female rape survivors. Multiple regression analyses were
conducted to test a theoretical model, which posits that hyperarousal
and numbing are functionally related mechanisms and intrusions and
avoidance are functionally related. Results supported the hypothesis
that arousal explained the majority of the variance in numbing beyond
that explained by avoidance and intrusion. In addition, intrusive
symptoms explained the majority of the variance in effortful avoidance
beyond that explained by numbing and arousal. The findings suggest that
numbing and effortful avoidance may be separate mechanisms associated
with symptoms of arousal and intrusion, respectively.
_____
Record: 39
Title: Role of Peer Support and Emotional Expression on Posttraumatic
Stress Disorder in Student Paramedics.
Author(s): Lowery, Kim, School of Psychology, Deakin University,
Burwood, VIC, Australia
Stokes, Mark A., School of Psychology, Deakin University, Burwood, VIC,
Australia, stokes@deakin.edu.au
Address: Stokes, Mark A., School of Psychology, Deakin
University, Burwood Highway, Burwood, VIC, Australia, 3125,
stokes@deakin.edu.au
Source: Journal of Traumatic Stress, Vol 18(2), Apr 2005. pp. 171-179.
Journal URL: http://www.wkap.nl/journalhome.htm/0894-9867
Publisher: US: John Wiley & Sons
Publisher URL: http://www.wiley.com/WileyCDA/
ISSN: 0894-9867 (Print)
Digital Object Identifier: 10.1002/jts.20016
Language: English
Keywords: peer support; emotional expression; posttraumatic stress
disorder; social support; trauma related symptomatology; student
paramedics; reverse-buffering hypothesis
Abstract: This exploratory study contrasted and tested the
predictive value of the reverse buffering hypothesis of social support
and the information processing model of posttraumatic stress disorder
(PTSD) in an investigation of trauma-related symptomatology (TRS) in a
single sample of 42 student paramedics. Participants completed several
anonymous self-report measures of PTSD symptomatology, peer social
support, and attitude toward emotional expression. Regression-based path
analyses did not support either theory of PTSD in this population. A
path model of PTSD in student paramedics was subsequently developed,
indicating that a direct relationship exists between duty-related trauma
exposure, dysfunctional peer social support, and students' negative
attitudes toward emotional expression. This new model accounted for 30%
of the variance in student paramedics' TRS.
_____
Record: 40
Title: Neural basis of fear conditioning induced by video clip:
Positron emission tomography study.
Author(s): Doronbekov, Talant K., Division of Psychiatry and
Behavioral Proteomics, Department of Post-Genomics and Diseases, Course
of Advanced Medicine, Osaka, Japan
Tokunaga, Hiromasa, Division of Psychiatry and Behavioral Proteomics,
Department of Post-Genomics and Diseases, Course of Advanced Medicine,
Osaka, Japan, tokunaga@psy.med.osaka-u.ac.jp
Ikejiri, Yoshitaka, Division of Psychiatry and Behavioral Proteomics,
Department of Post-Genomics and Diseases, Course of Advanced Medicine,
Osaka, Japan
Kazui, Hiroaki, Division of Psychiatry and Behavioral Proteomics,
Department of Post-Genomics and Diseases, Course of Advanced Medicine,
Osaka, Japan
Hatta, Naoki, Division of Psychiatry and Behavioral Proteomics,
Department of Post-Genomics and Diseases, Course of Advanced Medicine,
Osaka, Japan
Masaki, Yoshihiro, Division of Psychiatry and Behavioral Proteomics,
Department of Post-Genomics and Diseases, Course of Advanced Medicine,
Osaka, Japan
Ogino, Atsushi, Division of Psychiatry and Behavioral Proteomics,
Department of Post-Genomics and Diseases, Course of Advanced Medicine,
Osaka, Japan
Miyoshi, Noriko, Division of Psychiatry and Behavioral Proteomics,
Department of Post-Genomics and Diseases, Course of Advanced Medicine,
Osaka, Japan
Oku, Naohiko, Division of Tracer Kinetics (Nuclear Medicine), Osaka
University Graduate School of Medicine, Osaka, Japan
Nishikawa, Takashi, Division of Psychiatry and Behavioral Proteomics,
Department of Post-Genomics and Diseases, Course of Advanced Medicine,
Osaka, Japan
Takeda, Masatoshi, Division of Psychiatry and Behavioral Proteomics,
Department of Post-Genomics and Diseases, Course of Advanced Medicine,
Osaka, Japan
Address: Tokunaga, Hiromasa, Division of Psychiatry and
Behavioral Proteomics, Department of Post-Genomics and Diseases, Course
of Advanced Medicine, Osaka University Graduate School of Medicine,
2-2-D3, Yamadaoka, Suita, Osaka, Japan, 565-0871,
tokunaga@psy.med.osaka-u.ac.jp
Source: Psychiatry & Clinical Neurosciences, Vol 59(2), Apr 2005. pp.
155-162.
Journal URL:
http://www.blackwell-science.com/~cgilib/jnlpage.asp?Journal=xpcn&File=x
pcn
Publisher: United Kingdom: Blackwell Publishing
Publisher URL: http://www.blackwellpublishing.com
ISSN: 1323-1316 (Print)
1440-1819 (Electronic)
Digital Object Identifier: 10.1111/j.1440-1819.2005.01351.x
Language: English
Keywords: fear conditioning; posttraumatic stress disorder;
traumatic event
Abstract: In patients with post-traumatic stress disorder (PTSD),
re-experiencing the trauma is often induced by external cues in the
environment. The cues, which were emotionally neutral for the patients
before the traumatic event, become fearful ones after the event. This
phenomenon is considered to be associated with fear conditioning. The
paradigm was set up so that the emotionality changes in the patients
with PTSD would be reproduced, and the regional cerebral blood flow
(rCBF) measured with positron emission tomography (PET) was compared
during exposure to the same stimuli before and after acquisition of fear
conditioning. Ten healthy male subjects were asked to look at some
emotionally neutral photos, then to watch a video with fearful content
that also contained images similar to that presented in the photos, and
afterwards to look at the photos again. Five of the 10 subjects felt
that the object in the photos was more fearful after watching the video
than before, and they were considered to have acquired fear
conditioning. In those five subjects, the rCBF in the right amygdala and
the left posterior cingulate gyrus after acquisition of fear
conditioning significantly increased relative to the rCBF before
conditioning. Thus, these regions seem to have a critical role in fear
conditioning.
_____
Record: 41
Title: Stress, Trauma, and Substance Use: An Overview.
Author(s): Bride, Brian E., University of Georgia, Athens, GA, US
MacMaster, Samuel A., University of Tennessee, Knoxville, TN, US
Source: Stress, Trauma and Crisis: An International Journal, Vol 8(2-3),
Apr-Sep 2005. pp. 75-78.
Journal URL: http://www.tandf.co.uk/journals/titles/15434613.asp
Publisher: United Kingdom: Taylor & Francis
Publisher URL: http://www.taylorandfrancis.com/
ISSN: 1543-4613 (Print)
1543-4591 (Electronic)
Language: English
Keywords: stress; trauma; substance use
Abstract: This special issue of Stress, Trauma, and Crisis: An
International Journal (Vol 8[2-3]) focuses on the interaction between
stress, trauma, and substance use. In soliciting manuscripts for this
special issue, we cast a deliberately wide net. It would have been
relatively easy to compile eight manuscripts that addressed the topic
through a myopic lens, such as by focusing only on the assessment and
treatment of comorbid posttraumatic stress disorder and substance use
disorders. But we left it up to the authors to determine how to address
the issue of the interaction between stress, trauma, and substance use
and where to place the emphasis. This special issue is an addition to
the literature that depicts both the breadth of the relatio
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