Record 140 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Hippocampal volume in women victimized by childhood sexual abuse.
AUTHOR: Stein,-M-B; Koverola,-C; Hanna,-C; Torchia,-M-G; McClarty,-B
ADDRESS OF AUTHOR: Department of Psychiatry, University of Manitoba, Winnipeg, Canada.
SOURCE: Psychol-Med. 1997 Jul; 27(4): 951-9
INTERNATIONAL STANDARD SERIAL NUMBER: 0033-2917
LANGUAGE: English
ABSTRACT: BACKGROUND: Several prior studies have found reduced hippocampal volume in victims of psychological trauma with post-traumatic stress disorder (PTSD). We were interested to determine if this finding was evident in women who were victimized by severe sexual abuse in childhood. METHODS: In this study, hippocampal volume was measured using quantitative magnetic resonance imaging (MRI) in 21 women who reported being severely sexually abused in childhood and 21 socio-demographically similar women without abuse histories. RESULTS: Women who reported sexual victimization in childhood had significantly reduced (5% smaller) left-sided hippocampal volume compared to the non-victimized women. Hippocampal volume was also smaller on the right side, but this failed to reach statistical significance. Left-sided hippocampal volume correlated highly (rs = -0.73) with dissociative symptom severity, but not with indices of explicit memory functioning. CONCLUSIONS: These findings, which are generally consistent with prior reports of reduced hippocampal volume in combat veterans with PTSD, suggest that diminished hippocampal size may be either a consequence of trauma exposure or a risk factor for the development of psychiatric complications following trauma exposure. The observed relationship between symptom severity and hippocampal volume suggests that mesial temporal lobe dysfunction may directly mediate certain aspects of PTSD and dissociative disorder symptomatology.
ACCESSION NUMBER: 97378875
Record 141 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Posttraumatic stress disorder, self- and interpersonal dysfunction among sexually retraumatized women.
AUTHOR: Cloitre,-M; Scarvalone,-P; Difede,-J-A
ADDRESS OF AUTHOR: Department of Psychiatry, New York Hospital-Cornell Medical Center, New York 10021, USA.
SOURCE: J-Trauma-Stress. 1997 Jul; 10(3): 437-52
INTERNATIONAL STANDARD SERIAL NUMBER: 0894-9867
LANGUAGE: English
ABSTRACT: This study assessed self and interpersonal dysfunction as well as posttraumatic stress disorder (PTSD) among three groups of women: women sexually assaulted in both childhood and adulthood, women sexually assaulted only in adulthood and women who were never assaulted. Rates of PTSD were high and equivalent in the two assault groups. However, retraumatized women were more likely to be alexithymic, show dissociation scores indicating risk for dissociative disorders, and to have attempted suicide compared to the other two groups, who did not differ from each other. Additionally, only the retraumatized women experienced clinically significant levels of interpersonal problems. The findings suggest that formulations more inclusive than PTSD are required to capture the psychological difficulties experienced by this population. Treatment implications are discussed.
ACCESSION NUMBER: 97389469
Record 142 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: An affect-management group for women with posttraumatic stress disorder and histories of childhood sexual abuse.
AUTHOR: Zlotnick,-C; Shea,-T-M; Rosen,-K; Simpson,-E; Mulrenin,-K; Begin,-A; Pearlstein,-T
ADDRESS OF AUTHOR: Butler Hospital, Brown University Department of Psychiatry & Human Behavior, Providence, Rhode Island 02906, USA.
SOURCE: J-Trauma-Stress. 1997 Jul; 10(3): 425-36
INTERNATIONAL STANDARD SERIAL NUMBER: 0894-9867
LANGUAGE: English
ABSTRACT: Systematic research on effective treatment for survivors of childhood sexual abuse with posttraumatic stress disorder (PTSD) is virtually non-existent. The aim of the present study was to compare the effectiveness of an affect-management treatment (AM) group to a wait list control condition for female survivors of childhood sexual abuse with PTSD. Forty-eight female survivors of childhood sexual abuse with PTSD were randomly assigned to either a 15-week affect-management treatment group or to a wait list control condition. All subjects received individual psychotherapy and pharmacotherapy for the duration of the study, and for at least 1-month prior to the study. Controlling for pretreatment scores, subjects who completed the affect-management treatment group (n = 17) reported significantly fewer posttreatment symptoms of PTSD and dissociation than subjects in the wait list control condition (n = 16). Our findings suggest that an affect-management group treatment is beneficial as an adjunct to individual psychotherapy and pharmacotherapy for survivors of childhood sexual abuse with PTSD.
ACCESSION NUMBER: 97389468
Record 143 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Full and partial posttraumatic stress disorder: findings from a community survey.
AUTHOR: Stein,-M-B; Walker,-J-R; Hazen,-A-L; Forde,-D-R
ADDRESS OF AUTHOR: Department of Psychiatry, University of California, San Diego, La Jolla 92093-0985, USA. mstein@ucsd.edu
SOURCE: Am-J-Psychiatry. 1997 Aug; 154(8): 1114-9
INTERNATIONAL STANDARD SERIAL NUMBER: 0002-953X
LANGUAGE: English
ABSTRACT: OBJECTIVE: Full and partial posttraumatic stress disorder (PTSD) following trauma exposure were examined in a community sample in order to determine their prevalence and their relative importance and functional significance. METHOD: A standardized telephone interview with a series of trauma probes and a DSM-IV PTSD checklist was administered to a random sample of 1,002 persons in a midsized Midwestern Canadian city. The authors determined current (i.e., 1-months) prevalence rates of full PTSD, i.e., all DSM-IV criteria, and partial PTSD, i.e., fewer than the required number of DSM-IV criterion C symptoms (avoidance/numbing) or criterion D symptoms (increased arousal). Additional questions about interference with functioning were also posed. RESULTS: The estimated prevalence of full PTSD was 2.7% for women and 1.2% for men. The prevalence of partial PTSD was 3.4% for women and 0.3% for men. Interference with work or school was significantly more pronounced in persons with full PTSD than in those with only partial symptoms, although the latter were significantly more occupationally impaired than traumatized persons without PTSD. CONCLUSIONS: These findings in an epidemiologic sample underscore observations from patient and military groups that many traumatized persons suffer from a subsyndromal form of PTSD. These persons with partial PTSD, although somewhat less impaired than persons with the full syndrome, nonetheless exhibit clinically meaningful levels of functional impairment in association with their symptoms. This subthreshold form of PTSD may be especially prevalent in women. Additional study of partial PTSD is warranted.
ACCESSION NUMBER: 97390541
Record 144 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Objective assessment of peritraumatic dissociation: psychophysiological indicators.
AUTHOR: Griffin,-M-G; Resick,-P-A; Mechanic,-M-B
ADDRESS OF AUTHOR: Department of Psychology, University of Missouri-St. Louis 63121, USA.
SOURCE: Am-J-Psychiatry. 1997 Aug; 154(8): 1081-8
INTERNATIONAL STANDARD SERIAL NUMBER: 0002-953X
LANGUAGE: English
ABSTRACT: OBJECTIVE: The aims of this study were to investigate psychophysiological changes associated with peritraumatic dissociation in female victims of recent rape and to assess the relation between these changes and symptoms of posttraumatic stress disorder (PTSD). METHOD: Eighty-five rape victims were examined in a laboratory setting within 2 weeks after the rape, and measures of heart rate, skin conductance, and nonspecific movement were collected. Self-report indexes of reactions to the trauma and interviews to assess PTSD symptoms and peritraumatic dissociation were also completed. On the basis of their scores on the Peritraumatic Dissociation Index, the subjects were classified as having low or high levels of dissociation. RESULTS: Items from the index exhibited good internal consistency, and scores were approximately normally distributed. Individuals in the high peritraumatic dissociation group showed a significantly different pattern of physiological responses from those of the low dissociation group. In general, there was a suppression of autonomic physiological responses in the high dissociation group. This group also contained a larger proportion of subjects (94%) identified as meeting PTSD symptom criteria. Also, among the high dissociation subjects there was a discrepancy between self-reports of distress and objective physiological indicators of distress in the laboratory setting. CONCLUSIONS: The results provide preliminary support for the idea that there is a dissociative subtype of persons with PTSD symptoms who exhibit diminished physiological reactivity. The results also underscore the importance of assessing dissociative symptoms in trauma survivors.
ACCESSION NUMBER: 97390536
Record 145 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Startle reflex abnormalities in women with sexual assault-related posttraumatic stress disorder.
AUTHOR: Morgan,-C-A 3rd; Grillon,-C; Lubin,-H; Southwick,-S-M
ADDRESS OF AUTHOR: Department of Psychiatry, Yale University School of Medicine, New Haven, Conn, USA.
SOURCE: Am-J-Psychiatry. 1997 Aug; 154(8): 1076-80
INTERNATIONAL STANDARD SERIAL NUMBER: 0002-953X
LANGUAGE: English
ABSTRACT: OBJECTIVE: This investigation was designed to assess the acoustic startle response in treatment-seeking women with sexual assault-related posttraumatic stress disorder (PTSD). METHOD: Thirteen patients with sexual assault-related PTSD and 16 healthy female comparison subjects were recruited for participation in the study. Each patient met the full criteria for PTSD according to the Structured Clinical Interview for DSM-III-R. All subjects in the study were right-handed. The acoustic stimuli were bursts of white noise (92 dB and 102 dB) with a nearly instantaneous onset delivered binaurally through headphones. RESULTS: The magnitude of the startle response (eye blink) to the first stimulus was asymmetrically distributed in the PTSD patients but not in the comparison subjects: it was greater for the left eye than the right eye in the PTSD patients only. There was a differential asymmetry of startle response in the two subgroups of patients (recent PTSD and long-standing PTSD): the startle reflex was larger for the left eye than the right in the subgroup with recent PTSD but not in the group with long-standing PTSD. CONCLUSIONS: This study provides the first objective evidence of startle abnormalities in women with PTSD. The significantly greater startle responses for the left eye compared with the right in the PTSD subjects suggest a laterality effect. As suggested by the preclinical model of shock sensitization, it is possible that in a subgroup of individuals with PTSD, trauma may sensitize the startle reflex. This model may hold true in humans and is supported by the findings of greater startle response in the patients with recent-onset PTSD.
ACCESSION NUMBER: 97390535
Record 146 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: A positron emission tomographic study of symptom provocation in PTSD.
AUTHOR: Shin,-L-M; McNally,-R-J; Kosslyn,-S-M; Thompson,-W-L; Rauch,-S-L; Alpert,-N-M; Metzger,-L-J; Lasko,-N-B; Orr,-S-P; Pitman,-R-K
ADDRESS OF AUTHOR: Department of Psychology, Harvard University, Cambridge, Massachusetts 02138, USA. ls@wjh.harvard.edu
SOURCE: Ann-N-Y-Acad-Sci. 1997 Jun 21; 821: 521-3
INTERNATIONAL STANDARD SERIAL NUMBER: 0077-8923
LANGUAGE: English
ACCESSION NUMBER: 97380886
Record 147 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Evidence for diminished P3 amplitudes in PTSD.
AUTHOR: Metzger,-L-J; Orr,-S-P; Lasko,-N-B; Berry,-N-J; Pitman,-R-K
ADDRESS OF AUTHOR: Department of Psychiatry, Harvard Medical School, Boston, Massachusetts 02115, USA.
SOURCE: Ann-N-Y-Acad-Sci. 1997 Jun 21; 821: 499-503
INTERNATIONAL STANDARD SERIAL NUMBER: 0077-8923
LANGUAGE: English
ACCESSION NUMBER: 97380881
Record 148 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Psychophysiologic assessment of PTSD in adult females sexually abused during childhood.
AUTHOR: Orr,-S-P; Lasko,-N-B; Metzger,-L-J; Berry,-N-J; Ahern,-C-E; Pitman,-R-K
ADDRESS OF AUTHOR: Veterans Affairs Research Service, Manchester, New Hampshire 03103, USA.
SOURCE: Ann-N-Y-Acad-Sci. 1997 Jun 21; 821: 491-3
INTERNATIONAL STANDARD SERIAL NUMBER: 0077-8923
LANGUAGE: English
ACCESSION NUMBER: 97380879
Record 149 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Neurological status of combat veterans and adult survivors of sexual abuse PTSD.
AUTHOR: Gurvits,-T-V; Gilbertson,-M-W; Lasko,-N-B; Orr,-S-P; Pitman,-R-K
ADDRESS OF AUTHOR: Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
SOURCE: Ann-N-Y-Acad-Sci. 1997 Jun 21; 821: 468-71
INTERNATIONAL STANDARD SERIAL NUMBER: 0077-8923
LANGUAGE: English
ABSTRACT: We found higher levels of positive soft neurological signs in PTSD participants than in participants who also experienced similar trauma but did not develop PTSD. This finding was replicated in two samples, that is, Vietnam combat veterans and adult female survivors of childhood sexual abuse, despite differences in gender, age, nature of trauma, and period of life when the trauma occurred. Past developmental history of participants and a substance abuse history of first-degree relatives also differentiated PTSD from non-PTSD groups in both combat and sexual abuse samples. Evidence for neurological impairment and compromised developmental history raises the possibility of pretrauma impairment as a risk factor for the development of PTSD.
ACCESSION NUMBER: 97380874
Record 150 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Acute post-rape plasma cortisol, alcohol use, and PTSD symptom profile among recent rape victims.
AUTHOR: Resnick,-H-S; Yehuda,-R; Acierno,-R
ADDRESS OF AUTHOR: National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston 29425-0742, USA. resnickh@musc.edu
SOURCE: Ann-N-Y-Acad-Sci. 1997 Jun 21; 821: 433-6
INTERNATIONAL STANDARD SERIAL NUMBER: 0077-8923
LANGUAGE: English
ACCESSION NUMBER: 97380866
Record 151 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Implicit and explicit memory for trauma-related information in PTSD.
AUTHOR: McNally,-R-J
ADDRESS OF AUTHOR: Department of Psychology, Harvard University, Cambridge, Massachusetts 02138, USA.
SOURCE: Ann-N-Y-Acad-Sci. 1997 Jun 21; 821: 219-24
INTERNATIONAL STANDARD SERIAL NUMBER: 0077-8923
LANGUAGE: English
ABSTRACT: Experiments on content-dependent memory abnormalities in PTSD suggest several conclusions. First, PTSD patients exhibit enhanced recall of words related to trauma relative to trauma-exposed persons with the disorder. Recognition tests, however, appear insensitive to these effects. Second, PTSD patients do not exhibit implicit memory biases for trauma cues on implicit memory tasks that are strongly influenced by perceptual (e.g., orthographic) aspects of input. They may, however, exhibit enhanced implicit memory for trauma-related material on conceptually more complex tasks. Third, directed forgetting research suggests that adult survivors of childhood sexual abuse who have PTSD exhibit memory deficits only for neutral and positive material, not for material related to their abuse. Psychiatrically healthy survivors exhibit normal memory performance in this paradigm. Fourth, autobiographical memory research indicates that trauma survivors, especially those with PTSD, are characterized by difficulties retrieving specific memories from their past in response to cue words. These findings are especially dramatic in Vietnam combat veterans whose self-presentational style suggests a fixation to the war and a failure of their autobiography to unfold.
ACCESSION NUMBER: 97380849
Record 152 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Psychophysiologic reactivity to trauma-related imagery in PTSD. Diagnostic and theoretical implications of recent findings.
AUTHOR: Orr,-S-P
ADDRESS OF AUTHOR: Veterans Affairs Research Service, Manchester, New Hampshire 03103, USA.
SOURCE: Ann-N-Y-Acad-Sci. 1997 Jun 21; 821: 114-24
INTERNATIONAL STANDARD SERIAL NUMBER: 0077-8923
LANGUAGE: English
ACCESSION NUMBER: 97380841
Record 153 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Validation of the structured interview for disorders of extreme stress.
AUTHOR: Zlotnick,-C; Pearlstein,-T
ADDRESS OF AUTHOR: Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA.
SOURCE: Compr-Psychiatry. 1997 Jul-Aug; 38(4): 243-7
INTERNATIONAL STANDARD SERIAL NUMBER: 0010-440X
LANGUAGE: English
ABSTRACT: There is a dearth of valid instruments to evaluate the primary sequelae of sexual abuse. The present study examined the construct validity of the subscales of the Structured interview for Disorders of Extreme Stress (SIDES), a measures of the associated features of posttraumatic stress disorder (PTSD). Using a clinical sample of 74 survivors of childhood sexual abuse with PTSD, this study demonstrated that the subscales of the SIDES (alterations in regulation of affect and impulses, alterations in attention or consciousness, alterations in self-perception, and somatization) correlated highly with instruments hypothesized to measure similar constructs. Divergent validity was established for each of four subscales of the SIDES. Findings from this study and other research on the psychometrics of the SIDES indicate that it is a valid measure of the associated features of PTSD in survivors of childhood sexual abuse.
ACCESSION NUMBER: 97346465
Record 154 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: What determines post-traumatic stress disorder symptomatology for survivors of childhood sexual abuse?
AUTHOR: Briggs,-L; Joyce,-P-R
ADDRESS OF AUTHOR: University Department of Psychological Medicine, Christchurch School of Medicine, New Zealand.
SOURCE: Child-Abuse-Negl. 1997 Jun; 21(6): 575-82
INTERNATIONAL STANDARD SERIAL NUMBER: 0145-2134
LANGUAGE: English
ABSTRACT: OBJECTIVE: The aim of this paper was to ascertain which childhood abuse experiences are associated with post-traumatic stress disorder (PTSD) symptomatology for women survivors of childhood sexual abuse (CSA). METHOD: Seventy-three women attending a Family Health Counselling Service's Sexual Abuse Program were invited to participate in a study looking at the effectiveness of sexual abuse counselling. Initially, the women completed a series of self-report questionnaires including a measure of PTSD symptoms, and were interviewed about childhood abuse experiences. RESULTS: PTSD symptoms were associated with higher levels of all psychopathology. However, more interestingly, the severity of PTSD symptoms was also associated with the extent of CSA which involved actual sexual intercourse. This association of repeated abuse involving sexual intercourse with PTSD symptoms was still significant (partial coefficient = .30, p, .000) even when controlling for general level of psychopathology. CONCLUSIONS: One of the long-term effects of child sexual abuse (CSA) is post-traumatic stress disorder (PTSD), and the women who reported multiple abusive episodes which involved sexual intercourse had increased symptoms of PTSD.
ACCESSION NUMBER: 97335479
Record 155 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Prevalence and risk factors for posttraumatic stress disorder among chemically dependent adolescents.
AUTHOR: Deykin,-E-Y; Buka,-S-L
ADDRESS OF AUTHOR: Department of Psychiatry, Harvard Medical School, Boston, USA. Deykin.Eva_Y@Boston.VA.-Gov or Dandeykin@aol.com
SOURCE: Am-J-Psychiatry. 1997 Jun; 154(6): 752-7
INTERNATIONAL STANDARD SERIAL NUMBER: 0002-953X
LANGUAGE: English
ABSTRACT: OBJECTIVE: This study ascertained the prevalence of posttraumatic stress disorder (PTSD) among chemically dependent adolescents and identified factors that influence the risk of PTSD after a qualifying trauma. METHOD: The study group consisted of 297 adolescents aged 15-19 years who met the DSM-III-R criteria for dependence on alcohol or other drugs and who were receiving treatment in seven publicly funded Massachusetts facilities. PTSD and other axis I diagnoses were assessed by the Diagnostic Interview Schedule. Data on risk factors were collected by a specially constructed interview schedule. RESULTS: The lifetime prevalence of PTSD was 29.6% (24.3% for males and 45.3% for females), and the current prevalence was 19.2% (12.2% for males and 40.0% for females). These prevalences reflect a high occurrence of traumatic exposures and a high case rate among those who experienced trauma. The risk of PTSD varied with the nature of the trauma, the number of traumas experienced, psychiatric comorbidity, and familial characteristics. The higher rate of PTSD among females was due to a greater frequency of rape, which carries a high risk of PTSD development, and to a high rate of comorbid conditions. CONCLUSIONS: The lifetime prevalence of PTSD among these chemically dependent adolescents is five times that reported for a community sample of adolescents. This extremely high rate provides new understanding of the etiologic connection between PTSD and chemical dependence and has implications for their treatment.
ACCESSION NUMBER: 97310334
Record 156 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Etiological significance of associations between childhood trauma and borderline personality disorder: conceptual and clinical implications.
AUTHOR: Sabo,-A-N
ADDRESS OF AUTHOR: Department of Psychiatry and Behavioral Sciences, Berkshire Medical Center, Pittsfield, MA 01201, USA.
SOURCE: J-Personal-Disord. 1997 Spring; 11(1): 50-70
INTERNATIONAL STANDARD SERIAL NUMBER: 0885-579X
LANGUAGE: English
ABSTRACT: Numerous studies over the past decade have pointed to the frequent occurrence of trauma and neglect in the childhood experience of patients with Borderline Personality Disorder (BPD). Advancing research on Posttraumatic Stress Disorder (PTSD) and Dissociative Disorders offers further insight into understanding shared clinical phenomena with BPD. Drawing upon attachment theory, models of learned helplessness, and early primate deprivation, empirical, theoretical and clinical data are integrated to conceptualize the role of trauma and neglect in the etiology of BPD.
ACCESSION NUMBER: 97264434
Record 157 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Sexual abuse history of women treated in a psychiatric outpatient clinic.
AUTHOR: Lombardo,-S; Pohl,-R
ADDRESS OF AUTHOR: Wayne State University of Detroit, MI, USA.
SOURCE: Psychiatr-Serv. 1997 Apr; 48(4): 534-6
INTERNATIONAL STANDARD SERIAL NUMBER: 1075-2730
LANGUAGE: English
ABSTRACT: The prevalence of sexual abuse and its association with specific axis I diagnoses among 38 women patients in a psychiatric outpatient clinic were examined. Sexual abuse history was recorded in a face-to-face interview, severity of the abuse was rated on a 3-point scale, and the Structured Clinical Interview for DSM-III-R and a posttraumatic stress disorder (PTSD) scale were administered. Twenty-seven of the 38 patients (71 percent) had experienced sexual abuse. Anxiety disorders and affective disorders were the most frequent axis I disorders among the sexually abused patients. No significant relationship was found between abuse and severity of PTSD scores.
ACCESSION NUMBER: 97246130
Record 158 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Internalizing and externalizing characteristics of sexually and/or physically abused children.
AUTHOR: Dykman,-R-A; McPherson,-B; Ackerman,-P-T; Newton,-J-E; Mooney,-D-M; Wherry,-J; Chaffin,-M
ADDRESS OF AUTHOR: Center for Applied Research & Evaluation (C.A.R.E.) Department of Pediatrics, Arkansas Children's Hospital, Little Rock 72202, USA.
SOURCE: Integr-Physiol-Behav-Sci. 1997 Jan-Mar; 32(1): 62-74
INTERNATIONAL STANDARD SERIAL NUMBER: 1053-881X
LANGUAGE: English
ABSTRACT: This study evaluates the behavioral consequences of childhood abuse (sexual, physical, or both), with particular focus on prevalence of posttraumatic stress disorder (PTSD). Three abuse type groups and nonabused controls were contrasted on behavioral rating scales and on structured psychiatric interview data. The participants (109 abused children and 16 normal control children) were recruited from Arkansas Children's Hospital and local agencies for abused children. As expected, proportionately more females than males were sexually abused. Overall, males were rated as more disturbed than females. Type of abuse did not consistently influence behavioral ratings. Externalizing scores were significantly higher than internalizing scores in all abused groups. PTSD was diagnosed in 50% of the abused children, with a higher rate for boys who had been sexually abused as opposed to physically abused only (58% versus 13%). The most frequent comorbid condition with PTSD was Separation Anxiety. Sexually abused boys were hospitalized for psychiatric treatment at a higher rate than were other abused children.
ACCESSION NUMBER: 97259816
Record 159 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: An event-related brain potential investigation of PTSD and PTSD symptoms in abused children.
AUTHOR: McPherson,-W-B; Newton,-J-E; Ackerman,-P; Oglesby,-D-M; Dykman,-R-A
ADDRESS OF AUTHOR: Center for Applied Research and Evaluation, Arkansas Children's Hospital Little Rock 72202, USA.
SOURCE: Integr-Physiol-Behav-Sci. 1997 Jan-Mar; 32(1): 31-42
INTERNATIONAL STANDARD SERIAL NUMBER: 1053-881X
LANGUAGE: English
ABSTRACT: We tested 186 children ranging in age from 6 years, 10 months to 13 years, 7 months; 174 suffered either physical and/or sexual abuse, and 12 were nonabused children. Abused subjects were grouped in four different ways. The primary grouping was based on whether subjects satisfied the DSM III-R criteria for posttraumatic stress disorder (PTSD). Secondary groupings were based upon the three symptom clusters used to make the PTSD diagnosis (arousal, avoidance, and reexperiencing). In each of these groupings three separate subgroups were formed with approximately 25 percent in the high and low symptom count subgroups and the remaining 50 percent in the middle symptom count subgroup. Subjects listened to four different intensity levels (65, 80, 95, and 102 dB) of a 1 KHz tone, pseudo-randomly ordered, while event-related brain potentials (ERPs) were recorded. Two separate blocks were used, one with short intervals (4 +/- 1 sec) between tones and the other with longer intervals (17 +/- 2 sec). PTSD subjects presented a greater P2-N2 ERP intensity gradient (i.e., a larger increase in the P2-N2 ERP component as tone intensity increased) than did abused subjects without PTSD. Abused subjects with the highest number of reexperiencing symptoms showed a similar P2-N2 augmenting effect when compared to those with the lowest number of reexperiencing symptoms. Subjects with the highest number of arousal symptoms showed a shallower intensity gradient for the N1-P2 ERP component than did those with fewer arousal symptoms. The results are discussed in relation to previous results reported on adults with PTSD and in terms of CNS processing of stimulus intensity information.
ACCESSION NUMBER: 97259813
Record 160 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Posttraumatic stress disorder in adult female survivors of childhood sexual abuse: a comparison study.
AUTHOR: Rodriguez,-N; Ryan,-S-W; Vande-Kemp,-H; Foy,-D-W
ADDRESS OF AUTHOR: Neuropsychiatric Institute, University of California, Los Angeles, (UCLA), USA.
SOURCE: J-Consult-Clin-Psychol. 1997 Feb; 65(1): 53-9
INTERNATIONAL STANDARD SERIAL NUMBER: 0022-006X
LANGUAGE: English
ABSTRACT: This study compared symptoms of posttraumatic stress disorder (PTSD) in a group of 45 adult women in outpatient treatment for childhood sexual abuse (CSA) and a group of 31 women who reported no CSA. The comparison group consisted of women in outpatient treatment for problems in their committed relationships with male living partners. This research also investigated the traumatic impact of dual abuse (both childhood sexual and physical abuse). Standardized assessment instruments were used to measure PTSD, CSA, and childhood physical abuse (CPA). Results indicated that 86.7% of the CSA group met criteria for current PTSD in accordance with the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised; American Psychiatric Association, 1987), compared with 19.4% of the relationship distress group, providing support for CSA as an etiological agent for PTSD. In addition, 89% of the CSA survivors reported CPA. Multivariate analysis revealed that both CSA and CPA exposure variables accounted for a significant portion of the variance in PTSD symptoms in the CSA group.
ACCESSION NUMBER: 97257064
Record 161 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: School age children's coping with sexual abuse: abuse stresses and symptoms associated with four coping strategies.
AUTHOR: Chaffin,-M; Wherry,-J-N; Dykman,-R
ADDRESS OF AUTHOR: Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, USA.
SOURCE: Child-Abuse-Negl. 1997 Feb; 21(2): 227-40
INTERNATIONAL STANDARD SERIAL NUMBER: 0145-2134
LANGUAGE: English
ABSTRACT: Strategies used by 84 sexually abused children, ages 7 to 12, to cope with their abuse were evaluated, along with child abuse-related symptoms, parent-reported behavioral symptoms, and teacher-reported behavioral symptoms. Principal components analysis of coping yielded four strategies that were labeled avoidant coping, internalized coping, angry coping, and active/social coping. Each coping strategy was found to be associated with a unique set of abuse characteristics, abuse-related social environment, and symptoms. In contrast to findings with adult survivors and adolescents, use of avoidant coping strategies among school-age children was found to be related to fewer behavioral problems, although it was also associated with greater sexual anxieties. Internalized coping was found to be associated with increased guilt and PTSD hyperarousal symptoms. Active/social coping was the only strategy found to be unrelated to symptoms, but neither was it associated with measured benefits. In contrast to some clinical opinion that externalizing blame and venting anger is a helpful strategy, angry coping was found to be associated with a wide range of behavioral and emotional problems as rated by the child's home-room school teacher. Results are discussed in terms of a proposed mediational model.
ACCESSION NUMBER: 97209160
Record 162 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Rape-related psychotraumatic syndromes.
AUTHOR: Darves-Bornoz,-J-M
ADDRESS OF AUTHOR: Clinique Psychiatrique Universitaire, Centre Hospitalier Universitaire de Tours, France.
SOURCE: Eur-J-Obstet-Gynecol-Reprod-Biol. 1997 Jan; 71(1): 59-65
INTERNATIONAL STANDARD SERIAL NUMBER: 0301-2115
LANGUAGE: English
ABSTRACT: OBJECTIVE: This study took place in a forensic center for rape victims. Our aims were: first, to explore the longitudinal course of post-traumatic stress disorder (PTSD) and prevalence of disorders over the 6-month period following rape, then second, to group these disorders into syndromes related to chronic PTSD whilst remaining distinct from it, and third, to establish some predictive factors for chronic PTSD. STUDY DESIGN: 92 rape victims consecutively admitted to the center were regularly interviewed over a 6-month period by a psychiatrist. RESULTS: The paper confirms that rape leads to a high proportion of PTSD. Generally speaking, the psychopathology following rape is severe. PTSD at 6 months is associated with phobic and dissociative disorders. It is further associated with a cluster of symptoms arising after rape that we term borderline-like. Incestuous rape is a predictive factor for PTSD at 6 months. CONCLUSION: In the aftermath of rape several semiologically distinct psychotraumatic syndromes exist.
ACCESSION NUMBER: 97184001
Record 163 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Discriminant validity of the TSC-40 in an outpatient setting.
AUTHOR: Whiffen,-V-E; Benazon,-N-R; Bradshaw,-C
ADDRESS OF AUTHOR: School of Psychology, University of Ottawa, Ontario, Canada.
SOURCE: Child-Abuse-Negl. 1997 Jan; 21(1): 107-15
INTERNATIONAL STANDARD SERIAL NUMBER: 0145-2134
LANGUAGE: English
ABSTRACT: This study examines the discriminant validity of the Trauma Symptom Checklist (TSC-40) in a clinical sample. The TSC-40 was developed as a research instrument for assessing the impact of a history of sexual victimization. Previous validity studies used nonclinical samples of women (Elliott & Briere, 1992; Gold, Milan, Myall, & Johnson, 1994). In the present study, the TSC-40 was administered to 103 men and 79 women requesting services at two outpatient clinics. Information about sexual victimization was collected from the client during intake and from the therapist after the client had received 6 months of therapy. A history of CSA was associated both with high symptom levels across symptom dimensions, and, specifically, with elevation on the trauma subscale of the TSC-40. The findings support the view that, in a clinical setting, CSA is associated both with generalized distress and with PTSD symptoms.
ACCESSION NUMBER: 97175366
Record 164 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Assessment of a new self-rating scale for post-traumatic stress disorder.
AUTHOR: Davidson,-J-R; Book,-S-W; Colket,-J-T; Tupler,-L-A; Roth,-S; David,-D; Hertzberg,-M; Mellman,-T; Beckham,-J-C; Smith,-R-D; Davison,-R-M; Katz,-R; Feldman,-M-E
ADDRESS OF AUTHOR: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.
SOURCE: Psychol-Med. 1997 Jan; 27(1): 153-60
INTERNATIONAL STANDARD SERIAL NUMBER: 0033-2917
LANGUAGE: English
ABSTRACT: BACKGROUND: In post-traumatic stress disorder (PTSD) there is a need for self-rating scales that are sensitive to treatment effects and have been tested in a broad range of trauma survivors. Separate measures of frequency and severity may also provide an advantage. METHODS: Three hundred and fifty-three men and women completed the Davidson Trauma Scale (DTS), a 17-item scale measuring each DSM-IV symptom of PTSD on 5-point frequency and severity scales. These subjects comprised war veterans, survivors of rape or hurricane and a mixed trauma group participating in a clinical trial. Other scales were included as validity checks as follows: Global ratings, SCL-90-R, Eysenck Scale, Impact of Event Scale and Structured Clinical Interview for DSM-III-R. RESULTS: The scale demonstrated good test-retest reliability (r = 0.86), internal consistency (r = 0.99). One main factor emerged for severity and a smaller one for intrusion. In PTSD diagnosed subjects, and the factor structure more closely resembled the traditional grouping of symptoms. Concurrent validity was obtained against the SCID, with a diagnostic accuracy of 83% at a DTS score of 40. Good convergent and divergent validity was obtained. The DTS showed predictive validity against response to treatment, as well as being sensitive to treatment effects. CONCLUSIONS: The DTS showed good reliability and validity, and offers promised as a scale which is particularly suited to assessing symptom severity, treatment outcome and in screening for the likely diagnosis of PTSD.
ACCESSION NUMBER: 97168234
Record 165 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Development of a criteria set and a structured interview for disorders of extreme stress (SIDES).
AUTHOR: Pelcovitz,-D; van-der-Kolk,-B; Roth,-S; Mandel,-F; Kaplan,-S; Resick,-P
ADDRESS OF AUTHOR: Department of Psychiatry, North Shore University Hospital-Cornell University Medical College, Manhassett, New York 11030, USA.
SOURCE: J-Trauma-Stress. 1997 Jan; 10(1): 3-16
INTERNATIONAL STANDARD SERIAL NUMBER: 0894-9867
LANGUAGE: English
ABSTRACT: Data regarding the development of a structured interview measuring alterations that may accompany extreme stress are presented. A list of 27 criteria often seen in response to extreme trauma and not addressed by DSM-IV criteria for posttraumatic stress disorder (PTSD) were generated based on a systematic review of the literature and a survey of 50 experts. A structured interview for disorders of extreme stress (SIDES) measuring the presence of these criteria was administered to 520 subjects as part of the DSM-IV PTSD field trials. Inter-rater reliability as measured by Kappa coefficients for lifetime Disorders of Extreme Stress was .81. Internal consistency using coefficient alpha ranged from .53 to .96. Results indicate that the SIDES is a useful tool for investigation of response to extremes stress.
ACCESSION NUMBER: 97171445
Record 166 of 193 in MEDLINE(R) on CD 1997 Part B
TITLE: Magnetic resonance imaging-based measurement of hippocampal volume in posttraumatic stress disorder related to childhood physical and sexual abuse--a preliminary report.
AUTHOR: Bremner,-J-D; Randall,-P; Vermetten,-E; Staib,-L; Bronen,-R-A; Mazure,-C; Capelli,-S; McCarthy,-G; Innis,-R-B; Charney,-D-S
ADDRESS OF AUTHOR: Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
SOURCE: Biol-Psychiatry. 1997 Jan 1; 41(1): 23-32
INTERNATIONAL STANDARD SERIAL NUMBER: 0006-3223
LANGUAGE: English
ABSTRACT: We have previously reported smaller hippocampal volume and deficits in short-term memory in patients with combat-related posttraumatic stress disorder (PTSD) relative to comparison subjects. The purpose of this study was to compare hippocampal volume in adult survivors of childhood abuse to matched controls. Magnetic resonance imaging was used to measure volume of the hippocampus in adult survivors of childhood abuse (n = 17) and healthy subjects (n = 17) matched on a case-by-case basis for age, sex, race, handedness, years of education, body size, and years of alcohol abuse. All patients met criteria for PTSD secondary to childhood abuse. PTSD patients had a 12% smaller left hippocampal volume relative to the matched controls (p < .05), without smaller volumes of comparison regions (amygdala, caudate, and temporal lobe). The findings were significant after controlling for alcohol, age, and education, with multiple linear regression. These findings suggest that a decrease in left hippocampal volume is associated with abuse-related PTSD.
ACCESSION NUMBER: 97142770
Record 167 of 193 in MEDLINE(R) on CD 1997 Part A
TITLE: Posttraumatic stress disorder (PTSD), PTSD comorbidity, and childhood abuse among incarcerated women.
AUTHOR: Zlotnick,-C
ADDRESS OF AUTHOR: Butler Hospital/Brown University, Providence, Rhode Island 02906, USA.
SOURCE: J-Nerv-Ment-Dis. 1997 Dec; 185(12): 761-3
INTERNATIONAL STANDARD SERIAL NUMBER: 0022-3018
LANGUAGE: English
ACCESSION NUMBER: 98104217
Record 168 of 193 in MEDLINE(R) on CD 1997 Part A
TITLE: Memory and anxiety disorders.
AUTHOR: Mcnally,-R-J
ADDRESS OF AUTHOR: Department of Psychology, Harvard University, Cambridge, MA 02138, USA. rjm@wjh.harvard.edu
SOURCE: Philos-Trans-R-Soc-Lond-B-Biol-Sci. 1997 Nov 29; 352(1362): 1755-9
INTERNATIONAL STANDARD SERIAL NUMBER: 0962-8436
LANGUAGE: English
ABSTRACT: Experimental psychopathologists have identified varying patterns in memory bias in people with depressive and anxiety disorders. Individuals suffering from depression tend to exhibit explicit memory deficits for positively-valanced material, and sometimes exhibit biases for retrieving negative self-relevant information as well. Most studies, however, provide scant evidence for implicit memory biases in depression. In contrast to depression, anxiety disorders are rarely associated with enhanced explicit memory for threat-related information (with the exception of panic disorder). Evidence for implicit memory biases for threat in these syndromes is mixed. After providing an overview of findings on memory abnormalities in depressive and anxiety disorders, data from several new studies bearing on posttraumatic stress disorder (PTSD) in Vietnam combat veterans and in women with histories of childhood sexual abuse are presented. Involving directed forgetting, implicit memory and autobiographical cueing paradigms, these experiments point to a pattern of abnormalities linked to PTSD rather than to trauma per se.
ACCESSION NUMBER: 98077777
Record 169 of 193 in MEDLINE(R) on CD 1997 Part A
TITLE: Sexual victimization, generalized perception of control, and posttraumatic stress disorder symptom severity.
AUTHOR: Bolstad,-B-R; Zinbarg,-R-E
ADDRESS OF AUTHOR: Department of Psychology, University of Oregon, Eugene 97403-1227, USA.
SOURCE: J-Anxiety-Disord. 1997 Sep-Oct; 11(5): 523-40
INTERNATIONAL STANDARD SERIAL NUMBER: 0887-6185
LANGUAGE: English
ABSTRACT: We examined the relations among various characteristics of sexual victimization, posttraumatic stress disorder (PTSD) symptom severity, and generalized perception of control. Our main focus lay in testing three predictions derived from the animal model of PTSD articulated by Foa, Zinbarg, and Olasov-Rothbaum (1992) based on the effects of uncontrollable and/or unpredictable aversive events. A sample of 117 female undergraduates participated and completed self-report measures of past experience with child sexual abuse, adult sexual victimization, PTSD symptom severity, and locus of control. The results showed that child sexual abuse experienced on multiple occasions was associated with diminished generalized perception of control and that diminished generalized perception of control is associated with greater PTSD symptom severity following adult sexual victimization when experienced on a single occasion or involving force. These results provide partial support for the uncontrollability/unpredictability model of PTSD. Further research is necessary, however, to firmly establish the direction of causality involved in these associations.
ACCESSION NUMBER: 98071162
Record 170 of 193 in MEDLINE(R) on CD 1997 Part A
TITLE: The link between substance abuse and posttraumatic stress disorder in women. A research review.
AUTHOR: Najavits,-L-M; Weiss,-R-D; Shaw,-S-R
ADDRESS OF AUTHOR: McLean Hospital, Belmont, MA 02178-9106, USA. Lnajavits@aol.com
SOURCE: Am-J-Addict. 1997 Fall; 6(4): 273-83
INTERNATIONAL STANDARD SERIAL NUMBER: 1055-0496
LANGUAGE: English
ABSTRACT: Research has documented a high incidence of comorbid post-traumatic stress disorder (PTSD) and substance abuse. Women substance abusers, in particular, show high rates of this dual diagnosis (30% to 59%), most commonly deriving from a history of repetitive childhood physical and/or sexual assault. Rates for men are two to three times lower and typically stem from combat or crime trauma. Patients with both disorders are characterized by high severity on a multitude of psychological and treatment variables and use of the most severe drugs (cocaine and opioids). Treatment research on women is limited but suggests the possibility of retaining patients and achieving positive outcomes.
ACCESSION NUMBER: 98061260
Record 171 of 193 in MEDLINE(R) on CD 1997 Part A
TITLE: Predicting PTSD in women with a history of childhood rape.
AUTHOR: Epstein,-J-N; Saunders,-B-E; Kilpatrick,-D-G
ADDRESS OF AUTHOR: National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston 29425-0742, USA.
SOURCE: J-Trauma-Stress. 1997 Oct; 10(4): 573-88
INTERNATIONAL STANDARD SERIAL NUMBER: 0894-9867
LANGUAGE: English
ABSTRACT: The impact of factors that predispose childhood rape victims to develop posttraumatic stress disorder (PTSD) is important in understanding both the impact of childhood rape and the development of PTSD as a psychological disorder. The present study attempted to determine which crime, perpetrator, victim, and aftermath characteristics are related to PTSD status. A national representative sample of women (N = 3,220) were interviewed about their history of rape, trauma-related variables, and PTSD status. Consistent with research on crime victims, life threat and physical injury discriminated PTSD status in a sample of childhood rape victims. In addition, two other domains were related to PTSD development: (1) testification about rape and (2) rape types. The present findings are discussed in relation to previous research.
ACCESSION NUMBER: 98053430
Record 172 of 193 in MEDLINE(R) on CD 1997 Part A
TITLE: Complex PTSD in victims exposed to sexual and physical abuse: results from the DSM-IV Field Trial for Posttraumatic Stress Disorder.
AUTHOR: Roth,-S; Newman,-E; Pelcovitz,-D; van-der-Kolk,-B; Mandel,-F-S
ADDRESS OF AUTHOR: Duke University, Durham, North Carolina 27708, USA.
SOURCE: J-Trauma-Stress. 1997 Oct; 10(4): 539-55
INTERNATIONAL STANDARD SERIAL NUMBER: 0894-9867
LANGUAGE: English
ABSTRACT: Two hundred thirty four participants in the DSM-IV Posttraumatic Stress Disorder (PTSD) Field Trial who reported sexual and/or physical abuse were evaluated. Participants were categorized according to type of abuse (physical, sexual, both), duration of abuse (acute versus chronic), and onset of abuse (early versus late). Separate logistic regression analyses examined the relationship between age of onset, duration, abuse type, and the complex PTSD (CP) lifetime diagnosis for women and men. Sexually abused women, especially those who also experienced physical abuse, had a higher risk of developing CP, although CP symptoms occurred at a high base rate among physically abused women. The theoretical implications and incremental clinical usefulness of targeting CP symptoms with abused populations are discussed.
ACCESSION NUMBER: 98053428
Record 173 of 193 in MEDLINE(R) on CD 1997 Part A
TITLE: Sexual and physical abuse: do they compromise drug treatment outcomes?
AUTHOR: Gil-Rivas,-V; Fiorentine,-R; Anglin,-M-D; Taylor,-E
ADDRESS OF AUTHOR: UCLA Drug Abuse Research Center, University of California-Los Angeles, USA. Vgil@ucla.edu
SOURCE: J-Subst-Abuse-Treat. 1997 Jul-Aug; 14(4): 351-8
INTERNATIONAL STANDARD SERIAL NUMBER: 0740-5472
LANGUAGE: English
ABSTRACT: Histories of sexual and physical abuse are frequently reported by individuals participating in substance abuse treatment, these experiences may be associated with psychopathology and poor drug treatment outcomes. This paper presents the findings from a longitudinal study of 330 subjects participating in 26 outpatient treatment programs. Sexual abuse among women was associated with higher levels of depression, anxiety, suicidal ideation, suicide attempts, and PTSD, while physical abuse was associated with fewer psychological disturbances. For men, sexual abuse was associated only with anxiety. Physical abuse was associated with depression, anxiety, suicidal ideation, and PTSD. However, no significant association was found between sexual and physical abuse, and lower levels of treatment participation or drug use at follow-up. These findings indicate that there is a complex connection between abuse, psychopathology, treatment participation, and relapse. Clinical and research implications of these findings are discussed.
ACCESSION NUMBER: 98034581
Record 174 of 193 in MEDLINE(R) on CD 1997 Part A
TITLE: Symptoms of post-traumatic stress disorder in abused women in a primary care setting.
AUTHOR: Silva,-C; McFarlane,-J; Soeken,-K; Parker,-B; Reel,-S
ADDRESS OF AUTHOR: School of Nursing, University of Texas, Galveston, USA.
SOURCE: J-Womens-Health. 1997 Oct; 6(5): 543-52
INTERNATIONAL STANDARD SERIAL NUMBER: 1059-7115
LANGUAGE: English
ABSTRACT: Abuse is a major source of trauma to women, and post-traumatic stress disorder (PTSD) results from exposure to extreme trauma. To describe the relationship between symptoms of PTSD and severity of abuse, an ethnically stratified cohort of 131 abused women in a primary care setting was interviewed. Symptoms of PTSD, both intrusion (i.e., trouble falling asleep, strong waves of feelings about the abuse) and avoidance (i.e., trying not to think or talk about the abuse, staying away from reminders of the abuse), were significantly (p < 0.01) correlated to severity of abuse, regardless of ethnicity. When asked about childhood physical or sexual abuse, women reporting physical abuse had significantly (p < 0.05) higher intrusion scores, whereas those reporting sexual abuse had significantly (p < 0.004) higher avoidance scores. Sixty-five percent of the women reported dreams, flashbacks, or terror attacks and had significantly (p < 0.001) higher mean results on both intrusion and avoidance. The need to offer abused women information about the connection between severity of abuse and symptoms of PTSD is discussed. We recommend that clinicians ask all abused women about dreams, flashbacks, or terror attacks to assess for further symptoms of PTSD.
ACCESSION NUMBER: 98019825
Record 175 of 193 in MEDLINE(R) on CD 1997 Part A
TITLE: Prevalence and characteristics of trauma and posttraumatic stress disorder in a southwestern American Indian community.
AUTHOR: Robin,-R-W; Chester,-B; Rasmussen,-J-K; Jaranson,-J-M; Goldman,-D
ADDRESS OF AUTHOR: Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Rockville, Md. USA. rwrobin@ptialaska.net
SOURCE: Am-J-Psychiatry. 1997 Nov; 154(11): 1582-8
INTERNATIONAL STANDARD SERIAL NUMBER: 0002-953X
LANGUAGE: English
ABSTRACT: OBJECTIVE: High rates of violence and trauma in many American Indian communities have been reported. The authors investigated the relationship between both the frequency and type of traumatic events and the prevalence of posttraumatic stress disorder (PTSD) in a Southwestern American Indian tribe. METHOD: A structured psychiatric interview and the Traumatic Events Booklet were administered to a subset of 247 tribal members from an overall study population of 582. Subjects were recruited from the community on the basis of membership in pedigrees, and not by convenience. DSM-III-R diagnoses were assigned by consensus after the interviews were evaluated blindly by independent raters. RESULTS: The prevalence of lifetime PTSD was 21.9% (N = 54), and 81.4% of the subjects (N = 201) had experienced at least one traumatic event apiece. The most predictive factor for lifetime PTSD among women was the experience of physical assault, and for men the most predictive factors were a history of combat and having experienced more than 10 traumatic events. CONCLUSIONS: In this Southwestern American Indian community, the prevalences of lifetime PTSD and of exposure to a traumatic event were higher than in the general U.S. population. However, the nearly 4:1 ratio of subjects who reported at least one traumatic event to those with PTSD diagnoses is similar to findings from studies of non-Indians. Individuals with a history of multiple traumatic events (66.0%, N = 163) had a significantly higher risk of developing PTSD. Chronic and multiple trauma did not preclude the identification of acute and discrete traumatic events that resulted in PTSD.
ACCESSION NUMBER: 98019381
Record 176 of 193 in MEDLINE(R) on CD 1997 Part A
TITLE: Trauma: prevalence, impairment, service use, and cost.
AUTHOR: Solomon,-S-D; Davidson,-J-R
ADDRESS OF AUTHOR: Office of Behavioral and Social Science Research, National Institutes of Health, Bethesda, MD 20892-9172, USA.
SOURCE: J-Clin-Psychiatry. 1997; 58 Suppl 9: 5-11
INTERNATIONAL STANDARD SERIAL NUMBER: 0160-6689
LANGUAGE: English
ABSTRACT: A review of the literature on the epidemiology of trauma reveals that traumatic events are common: most Americans experience at least one over the course of their lives. According to recent estimates, 5% of men and 10% to 12% of women will suffer from posttraumatic stress disorder (PTSD) sometime in their lives, and for victims of traumas such as rape, the rate may be as high as 60% to 80%. For at least a third of sufferers, PTSD is a persistent condition lasting many years. Over 80% of persons with PTSD suffer from other psychiatric disorders. Many also experience marital, occupational, financial, and health problems. While trauma victims are disproportionate users of the health care system, they are reluctant to seek mental health treatment. Consequences of exposure to trauma are enormously costly, not only to the victims, but also to our health care system and to society as a whole.
ACCESSION NUMBER: 97470028
Record 177 of 193 in MEDLINE(R) on CD 1997 Part A
TITLE: Trauma and women: course, predictors, and treatment.
AUTHOR: Foa,-E-B
ADDRESS OF AUTHOR: Department of Psychiatry, Allegheny University of the Health Sciences, Philadelphia, PA 19129, USA.
SOURCE: J-Clin-Psychiatry. 1997; 58 Suppl 9: 25-8
INTERNATIONAL STANDARD SERIAL NUMBER: 0160-6689
LANGUAGE: English
ABSTRACT: Posttraumatic stress disorder (PTSD) resulting from aggravated assault, rape, or noncrime trauma affects over 4 million women in the United States, according to retrospective studies. Prospective studies reviewed here found that 3 months post assault the prevalence of PTSD was 48% in rape victims and 25% in nonsexual crime victims. Prolonged exposure treatment and stress inoculation training are both effective psychotherapeutic treatments for PTSD. Prolonged exposure involves having the patient relive the traumatic memory and recount the event in detail. This description is audiotaped and the patient is asked to listen to it as part of assigned homework. In vivo exposure to feared objects or situations is also assigned as homework. Stress inoculation training consists of teaching patients a variety of techniques for managing anxiety, including controlled breathing, deep muscle relaxation, thought-stopping, cognitive restructuring, preparation for stressors, covert modeling, and role-play. Both treatments have been proven to be effective alone and in combination in ameliorating chronic PTSD in women after traumatic sexual or nonsexual assault. This efficacy was maintained for 3 months of follow-up.
ACCESSION NUMBER: 97470031
Record 178 of 193 in MEDLINE(R) on CD 1997 Part A
TITLE: Enhanced dexamethasone suppression of plasma cortisol in adult women traumatized by childhood sexual abuse.
AUTHOR: Stein,-M-B; Yehuda,-R; Koverola,-C; Hanna,-C
ADDRESS OF AUTHOR: Department of Psychiatry, University of California, San Diego, USA.
SOURCE: Biol-Psychiatry. 1997 Oct 15; 42(8): 680-6
INTERNATIONAL STANDARD SERIAL NUMBER: 0006-3223
LANGUAGE: English
ABSTRACT: A study was undertaken to determine if female survivors of childhood and/or adolescent sexual abuse (CSA) would exhibit hypothalamic-pituitary-adrenal (HPA) axis abnormalities characteristic of patients with combat-related posttraumatic stress disorder (PTSD)--i.e., enhanced cortisol suppression to low-dose dexamethasone and increased density of lymphocyte glucocorticoid receptors. Nineteen women who reported experiencing severe CSA and 21 nonvictimized women participated in a low-dose (0.5 mg) dexamethasone suppression test and donated blood for measurement of lymphocyte glucocorticoid receptor binding. Women with CSA had significantly enhanced suppression of plasma cortisol in response to 0.5 mg dexamethasone compared to the nonvictimized women. These observations are consistent with findings in male veterans with combat-related PTSD. They suggest that this pattern of HPA axis dysfunction may be a characteristic sequel of psychiatric disorders that occur following a range of traumatic experiences. This HPA axis profile is different than that associated with acute stress or with major depressive disorder.
ACCESSION NUMBER: 97466122
Record 179 of 193 in MEDLINE(R) on CD 1997 Part A
TITLE: A controlled study of eye movement desensitization and reprocessing in the treatment of posttraumatic stress disordered sexual assault victims.
AUTHOR: Rothbaum,-B-O
ADDRESS OF AUTHOR: Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Emory Clinic, Atlanta, GA 30322, USA. brothba@emory.edu
SOURCE: Bull-Menninger-Clin. 1997 Summer; 61(3): 317-34
INTERNATIONAL STANDARD SERIAL NUMBER: 0025-9284
LANGUAGE: English
ABSTRACT: Eye movement desensitization and reprocessing (EMDR) is a new method developed to treat posttraumatic stress disorder (PTSD). This study evaluated the efficacy of EMDR compared to a no-treatment wait-list control in the treatment of PTSD in adult female sexual assault victims. Twenty-one subjects were entered, and 18 completed. Treatment was delivered in four weekly individual sessions. Assessments were conducted pre- and posttreatment and 3 months following treatment termination by an independent assessor kept blind to treatment condition. Measures included standard clinician- and self-administered PTSD and related psychopathology scales. Results indicated that subjects treated with EMDR improved significantly more on PTSD and depression from pre- to posttreatment than control subjects, leading to the conclusion that EMDR was effective in alleviating PTSD in this study.
ACCESSION NUMBER: 97406998