Record 104 of 193 in MEDLINE(R) on CD 1998 Part B
TITLE: Effects of premilitary and military trauma on the development of post-traumatic stress disorder symptoms in female and male active duty soldiers.
AUTHOR: Stretch,-R-H; Knudson,-K-H; Durand,-D
ADDRESS OF AUTHOR: Department of Military Psychiatry, Walter Reed Army Institute of Research, Washington, DC 20307-5100, USA.
SOURCE: Mil-Med. 1998 Jul; 163(7): 466-70
INTERNATIONAL STANDARD SERIAL NUMBER: 0026-4075
LANGUAGE: English
ABSTRACT: We surveyed more than 1,000 female and male active duty soldiers to assess the effect of premilitary and military trauma on their psychological well-being. Questionnaire data were obtained on pertinent demographic information, history of trauma exposure, and symptoms of post-traumatic stress disorder (PTSD). The results indicated significant gender differences in the types of traumatic events experienced, with females reporting more sexual traumas and males reporting more nonsexual traumas. In addition, males reported experiencing more military-related traumas, whereas females reported experiencing more premilitary traumas. The prevalence of PTSD symptoms was 8.6% for females and 5% for males. Recommendations are presented that may help mitigate development of PTSD symptoms in the future.
ACCESSION NUMBER: 98360725
Record 105 of 193 in MEDLINE(R) on CD 1998 Part B
TITLE: Trauma and posttraumatic stress disorder in the community: the 1996 Detroit Area Survey of Trauma.
AUTHOR: Breslau,-N; Kessler,-R-C; Chilcoat,-H-D; Schultz,-L-R; Davis,-G-C; Andreski,-P
ADDRESS OF AUTHOR: Department of Psychiatry, Henry Ford Health System, Detroit, Mich 48202-3450, USA. nbresla1@hfhs.org
SOURCE: Arch-Gen-Psychiatry. 1998 Jul; 55(7): 626-32
INTERNATIONAL STANDARD SERIAL NUMBER: 0003-990X
LANGUAGE: English
ABSTRACT: BACKGROUND: The study estimates the relative importance of specific types of traumas experienced in the community in terms of their prevalence and risk of leading to posttraumatic stress disorder (PTSD). METHODS: A representative sample of 2181 persons in the Detroit area aged 18 to 45 years were interviewed by telephone to assess the lifetime history of traumatic events and PTSD, according to DSM-IV. Posttraumatic stress disorder was assessed with respect to a randomly selected trauma from the list of traumas reported by each respondent, using a modified version of the Diagnostic Interview Schedule, Version IV, and the World Health Organization Composite International Diagnostic Interview. RESULTS: The conditional risk of PTSD following exposure to trauma was 9.2%. The highest risk of PTSD was associated with assaultive violence (20.9%). The trauma most often reported as the precipitating event among persons with PTSD (31% of all PTSD cases) was sudden unexpected death of a loved one, an event experienced by 60% of the sample, and with a moderate risk of PTSD (14.3%). Women were at higher risk of PTSD than men, controlling for type of trauma. CONCLUSIONS: The risk of PTSD associated with a representative sample of traumas is less than previously estimated. Previous studies have overestimated the conditional risk of PTSD by focusing on the worst events the respondents had ever experienced. Although recent research has focused on combat, rape, and other assaultive violence as causes of PTSD, sudden unexpected death of a loved one is a far more important cause of PTSD in the community, accounting for nearly one third of PTSD cases.
ACCESSION NUMBER: 98335774
Record 106 of 193 in MEDLINE(R) on CD 1998 Part B
TITLE: Effectiveness of anxiety management training in the treatment of posttraumatic stress disorder: a preliminary report.
AUTHOR: Pantalon,-M-V; Motta,-R-W
ADDRESS OF AUTHOR: Yale University School of Medicine, New Haven, CT 06519, USA.
SOURCE: J-Behav-Ther-Exp-Psychiatry. 1998 Mar; 29(1): 21-9
INTERNATIONAL STANDARD SERIAL NUMBER: 0005-7916
LANGUAGE: English
ABSTRACT: This preliminary study investigated the effectiveness of anxiety management training (AMT), a coping skills treatment similar to systematic desensitization, in comparison to implosive therapy (IT), an exposure-based treatment, for treating six Vietnam combat veterans with posttraumatic stress disorder (PTSD). The Clinician Administered PTSD Interview Scale (CAPS; Blake et al. (1988), The Behaviour Therapist, 18, 187-188) and a self-monitoring measure (Weathers et al., 1991) were used as dependent measures. A single-subject, multiple-baseline, crossover design (ABC/ACB) was employed. A new statistic for such designs (Mueser et al. (1991), Behaviour Modification, 15, 134-155), based on classical test theory, was used to assess treatment effects on intrusive war memories and avoidance of stimuli reminiscent of war. Within-subject results indicated that AMT and IT were similarly effective in reducing the frequency and intensity of intrusions and avoidance. This preliminary report therefore suggests that it may be productive to investigate multidimensional approaches (combining coping skills, exposure-based, and other approaches) to the treatment of combat-related PTSD as Foa et al. (1991), Journal of Consulting and Clinical Psychology, 59, 715-723 and Nishith et al. (1995), Behaviour Therapy, 26, 319-335 have for rape-related PTSD.
ACCESSION NUMBER: 98291292
Record 107 of 193 in MEDLINE(R) on CD 1998 Part B
TITLE: Abuse-related posttraumatic stress disorder and alterations of the hypothalamic-pituitary-adrenal axis in women with chronic pelvic pain.
AUTHOR: Heim,-C; Ehlert,-U; Hanker,-J-P; Hellhammer,-D-H
ADDRESS OF AUTHOR: Center for Psychobiological and Psychosomatic Research, University of Trier, Germany.
SOURCE: Psychosom-Med. 1998 May-Jun; 60(3): 309-18
INTERNATIONAL STANDARD SERIAL NUMBER: 0033-3174
LANGUAGE: English
ABSTRACT: OBJECTIVE: Although numerous organic conditions may cause chronic pelvic pain (CPP), diagnostic laparoscopy reveals a normal pelvis in many patients with CPP. However, psychological studies yield a high frequency of psychopathology and increased prevalences of chronic stress and traumatic life events, ie, sexual and physical abuse, in women with CPP, suggesting a relationship between posttraumatic stress disorder (PTSD) and CPP. As chronic stress and PTSD have been associated with specific alterations of the hypothalamic-pituitary-adrenal (HPA) axis, we explored stress history, psychopathology and HPA axis alterations in women with CPP. METHOD: We recruited 16 patients with CPP and 14 painfree, infertile controls from a general hospital where diagnostic laparoscopy was performed. Psychological assessment included standardized interviews on clinical symptoms, abuse experiences and major life events as well as psychometric testing for PTSD-like symptoms and depression. Endocrinological evaluation involved determinations of diurnal salivary cortisol levels and hormonal responses to a corticotropin-releasing factor (CRF) stimulation test (100 microg human CRF) and a low-dose dexamethasone suppression test (0.5 mg). RESULTS: We observed increased prevalences of abuse experiences and PTSD in women with CPP as well as a higher total number of major life events, whereas the mean extent of depression was within the normal range. With respect to endocrine measures, women with CPP demonstrated normal to low diurnal salivary cortisol levels, normal plasma-adrenocorticotropin (ACTH), but reduced salivary cortisol levels in the CRF stimulation test, and an enhanced suppression of salivary cortisol by dexamethasone. CONCLUSION: Women with CPP demonstrate HPA axis alterations, that partly parallel and partly contrast neuroendocrine correlates of PTSD, but show marked similarity to findings in patients with other stress-related bodily disorders. These findings suggest that a lack of protective properties of cortisol may be of relevance for the development of bodily disorders in chronically stressed or traumatized individuals.
ACCESSION NUMBER: 98286882
Record 108 of 193 in MEDLINE(R) on CD 1998 Part B
TITLE: Trauma and posttraumatic stress disorder in severe mental illness.
AUTHOR: Mueser,-K-T; Goodman,-L-B; Trumbetta,-S-L; Rosenberg,-S-D; Osher,-f-C; Vidaver,-R; Auciello,-P; Foy,-D-W
ADDRESS OF AUTHOR: Department of Psychiatry, Dartmouth Medical School, New Hampshire-Dartmouth Psychiatric Research Centre, Concord 03301, USA.
SOURCE: J-Consult-Clin-Psychol. 1998 Jun; 66(3): 493-9
INTERNATIONAL STANDARD SERIAL NUMBER: 0022-006X
LANGUAGE: English
ABSTRACT: This research assessed the lifetime prevalence of traumatic events and current posttraumatic stress disorder (PTSD) in 275 patients with severe mental illness (e.g., schizophrenia and bipolar disorder) receiving public mental health services in Concord and Manchester, New Hampshire, and Baltimore, Maryland. Lifetime exposure to traumatic events was high, with 98% of the sample reporting exposure to at least 1 traumatic event. The rate of PTSD in our sample was 43%, but only 3 of 119 patients with PTSD (2%) had this diagnosis in their charts. PTSD was predicted most strongly by the number of different types of trauma, followed by childhood sexual abuse. The findings suggest that PTSD is a common comorbid disorder in severe mental illness that is frequently overlooked in mental health settings.
ACCESSION NUMBER: 98306857
Record 109 of 193 in MEDLINE(R) on CD 1998 Part B
TITLE: Predictors of cortisol and 3-methoxy-4-hydroxyphenylglycol responses in the acute aftermath of rape.
AUTHOR: Yehuda,-R; Resnick,-H-S; Schmeidler,-J; Yang,-R-K; Pitman,-R-K
ADDRESS OF AUTHOR: Psychiatry Department, Mount Sinai School of Medicine, Bronx VA Medical center, New York 10468, USA.
SOURCE: Biol-Psychiatry. 1998 Jun 1; 43(11): 855-9
INTERNATIONAL STANDARD SERIAL NUMBER: 0006-3223
LANGUAGE: English
ABSTRACT: BACKGROUND: Prospective studies of trauma survivors can provide information about the relationship between rape characteristics and the development of subsequent symptoms. METHODS: The present study examined the relationship of prior assault, rape severity, posttraumatic stress disorder (PTSD) symptoms following rape, and subsequent PTSD diagnosis, to the acute cortisol and 3-methoxy-4-hydroxyphenylglycol (MHPG) response to this traumatic event in 20 women. RESULTS: Women with a history of prior physical or sexual assault showed a significantly attenuated cortisol response to the acute stress of rape compared to women without such a history. MHPG appeared to be associated with injury-related rape characteristics, and symptoms of active avoidance, but not prior history. PTSD status at the 3-month follow-up was predicted by both a prior history of assault and high injury rape, but was not directly predicted by either cortisol or MHPG levels. MHPG and cortisol were not correlated in the sample as a whole, but were correlated among individuals who did not subsequently develop PTSD (p = .04) CONCLUSIONS: The results suggest that different neuroendocrine systems may mediate different components of the response to traumatic stress.
ACCESSION NUMBER: 98274611
Record 110 of 193 in MEDLINE(R) on CD 1998 Part B
TITLE: Duty-related and sexual stress in the etiology of PTSD among women veterans who seek treatment.
AUTHOR: Fontana,-A; Rosenheck,-R
ADDRESS OF AUTHOR: Northeast Program Evaluation Center, Veterans Affairs Connecticut Healthcare System, West Haven 06516, USA.
SOURCE: Psychiatr-Serv. 1998 May; 49(5): 658-62
INTERNATIONAL STANDARD SERIAL NUMBER: 1075-2730
LANGUAGE: English
ABSTRACT: OBJECTIVE: The stressful experiences of women serving in the military have been a focus of increasing concern. A model of the impact of stress related to military duty and stress related to sexual abuse and harassment on the development of posttraumatic stress disorder (PTSD) among female veterans was evaluated. METHODS: Structural equation modeling was applied to data from 327 women treated in a VA clinical program for women with stress disorders. The model was a chronological one and included variables related to the women's premilitary experience, their military service, and their postmilitary experience. RESULTS: Altogether 48 percent of the sample served overseas, and 12 percent were exposed to enemy fire. A total of 63 percent reported experiences of physical sexual harassment during military service, and 43 percent reported rape or attempted rape. Both duty-related and sexual stress were found to contribute separately and significantly to the development of PTSD. Sexual stress was found to be almost four times as influential in the development of PTSD as duty-related stress. Postmilitary social support played a highly significant mediational role between sexual stress during military service and development of PTSD. CONCLUSIONS: Women's exposure to sexual stress in the military is much more prevalent than previously believed. It is particularly toxic for the development of PTSD. Correct assessment is essential to effective treatment.
ACCESSION NUMBER: 98264735
Record 111 of 193 in MEDLINE(R) on CD 1998 Part B
TITLE: PTSD as a mediator between childhood rape and alcohol use in adult women.
AUTHOR: Epstein,-J-N; Saunders,-B-E; Kilpatrick,-D-G; Resnick,-H-S
ADDRESS OF AUTHOR: National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, USA.
SOURCE: Child-Abuse-Negl. 1998 Mar; 22(3): 223-34
INTERNATIONAL STANDARD SERIAL NUMBER: 0145-2134
LANGUAGE: English
ABSTRACT: OBJECTIVE: Though a relationship between childhood sexual abuse and later alcohol use among women has been documented, little is known about the pathways that link these two variables. A tension reduction hypothesis posits that emotional distress precedes substance usage. PTSD symptomatology resulting from childhood sexual abuse is examined as a possible source of emotional distress that may cause subsequent alcohol use. METHOD: A sample of adult women was selected and interviewed on two occasions 1 year apart and childhood rape history, lifetime PTSD symptoms, and lifetime alcohol use were assessed. Path analytic techniques were used to evaluate the mediating role of PTSD symptoms on the relationship between childhood rape and subsequent alcohol use. RESULTS: A history of childhood rape doubled the number of alcohol abuse symptoms that women experienced in adulthood. Path analysis and cross-validation results demonstrated significant pathways connecting childhood rape to PTSD symptoms and PTSD symptoms to alcohol use. CONCLUSIONS: The results of the present study suggest that PTSD symptomatology which develops after childhood rape may be one of many variables that affect alcohol abuse patterns in women who were victims of childhood sexual abuse.
ACCESSION NUMBER: 98251063
Record 112 of 193 in MEDLINE(R) on CD 1998 Part B
TITLE: Relationship between trauma narratives and trauma pathology.
AUTHOR: Amir,-N; Stafford,-J; Freshman,-M-S; Foa,-E-B
ADDRESS OF AUTHOR: Allegheny University of the Health Sciences, Department of Psychiatry, Philadelphia, Pennsylvania 19129, USA.
SOURCE: J-Trauma-Stress. 1998 Apr; 11(2): 385-92
INTERNATIONAL STANDARD SERIAL NUMBER: 0894-9867
LANGUAGE: English
ABSTRACT: In this study we examined the relationship between posttrauma pathology and the level of articulation (complexity) in rape narratives recounted by victims shortly after the assault. Degree of articulation was operationalized as the reading level of the narrative as determined by a computer program. Shortly after the trauma, reading level was correlated with severity of anxiety but not with posttraumatic stress disorder (PTSD) symptoms. Degree of the narrative articulation shortly after the trauma, however, was related to severity of later PTSD. These results are consistent with the hypothesis that the less developed trauma narratives hinder recovery from trauma.
ACCESSION NUMBER: 98227045
Record 113 of 193 in MEDLINE(R) on CD 1998 Part B
TITLE: Screening for psychologically traumatized rape victims.
AUTHOR: Darves-Bornoz,-J-M; Pierre,-F; Lepine,-J-P; Degiovanni,-A; Gaillard,-P
ADDRESS OF AUTHOR: Clinique Psychiatrique Universitaire, CHU Tours, France.
SOURCE: Eur-J-Obstet-Gynecol-Reprod-Biol. 1998 Mar; 77(1): 71-5
INTERNATIONAL STANDARD SERIAL NUMBER: 0301-2115
LANGUAGE: English
ABSTRACT: OBJECTIVE: This study aimed to determine whether the General Health Questionnaire, a simple psychological screening instrument, could be useful to non-specialists in screening for psychologically traumatized rape victims. STUDY DESIGN: 285 rape victims (mean age 22.5, men 8%) attending consecutively a Consultation for Victims of Psychological Trauma at the University Hospital in Tours, France, were assessed through the Structured Interview for Post-Traumatic Stress Disorder (SI-PTSD), and the French 28-item version of the self-rated General Health Questionnaire (GHQ-28). RESULTS: 70% had Post-Traumatic Stress Disorder (PTSD) and 72% a GHQ-28 overthreshold score. The principal component analysis of the GHQ-28 ratings yielded a 4-factor solution: social dysfunction, feeling of foreshortened future type of depression, somatoform complaints and hyperalertness anxiety. GHQ-28 reliability and validity in screening for PTSD were studied through computation of Cronbach's alpha coefficient (0.95), sensitivity (88%) and positive predictive value (86%). CONCCLUSION: Using the GHQ-28 is valid and appropriate for practical use.
ACCESSION NUMBER: 98209574
Record 114 of 193 in MEDLINE(R) on CD 1998 Part B
TITLE: Adult attachment and long-term effects in survivors of incest.
AUTHOR: Alexander,-P-C; Anderson,-C-L; Brand,-B; Schaeffer,-C-M; Grelling,-B-Z; Kretz,-L
ADDRESS OF AUTHOR: Department of Psychology, University of Maryland, College Park, USA.
SOURCE: Child-Abuse-Negl. 1998 Jan; 22(1): 45-61
INTERNATIONAL STANDARD SERIAL NUMBER: 0145-2134
LANGUAGE: English
ABSTRACT: OBJECTIVE: The aim of the study was to test the hypothesis that adult attachment is related to distress and personality disorders in incest survivors. METHOD: Adult female incest survivors recruited from the community participated in a structured interview (Family Attachment Interview; Bartholomew & Horowitz, 1991) and completed measures of current functioning (Impact of Event Scale, SCL-10, Beck Depression Inventory) and personality (MCMI-II). Complete data from 92 cases out of the total sample of 112 were analyzed. RESULTS: Analyses of variance suggested that attachment (as represented by a category) was significantly related to personality structure, with fearful individuals showing more avoidant, self-defeating, and borderline tendencies and preoccupied individuals showing more dependent, self-defeating, and borderline tendencies than secure or dismissing individuals. Results of hierarchical regression analyses suggested that attachment (as represented by four dimensions) was significantly associated with personality structure, depression and distress, and abuse severity with post traumatic stress disorder (PTSD) symptoms (intrusive thoughts and avoidance of memories) and depression. CONCLUSIONS: The findings demonstrated the propensity for insecure attachment among incest survivors. Sexual abuse severity and attachment have significant but distinct effects on longterm outcome; abuse characteristics predict classic PTSD symptoms and attachment insecurity predicts distress, depression, and personality disorders above and beyond any effects of abuse severity.
ACCESSION NUMBER: 98187415
Record 115 of 193 in MEDLINE(R) on CD 1998 Part B
TITLE: The Addiction Severity Index as a screen for trauma and posttraumatic stress disorder.
AUTHOR: Najavits,-L-M; Weiss,-R-D; Reif,-S; Gastfriend,-D-R; Siqueland,-L; Barber,-J-P; Butler,-S-F; Thase,-M; Blaine,-J
ADDRESS OF AUTHOR: Harvard Medical School & McLean Hospital, Belmont, Massachusetts 02178, USA.
SOURCE: J-Stud-Alcohol. 1998 Jan; 59(1): 56-62
INTERNATIONAL STANDARD SERIAL NUMBER: 0096-882X
LANGUAGE: English
ABSTRACT: OBJECTIVE: The Addiction Severity Index (ASI) includes items to assess patients' history of trauma (physical or sexual). The goal of this study was to assess the sensitivity and specificity of those questions in relation to the Trauma History Questionnaire (THQ), a more thorough measure of lifetime trauma and, in addition, to an actual posttraumatic stress disorder (PTSD) diagnosis. METHOD: At the start of treatment cocaine dependent outpatients (N = 110, 65.5% male) were assessed on the ASI, the THQ and a PTSD symptom checklist as part of a multisite clinical trial. RESULTS: Specificity of the ASI questions was higher than sensitivity for both sexual trauma (specificity = .96, sensitivity = .46) and physical trauma (specificity = .71, sensitivity = .50), while for PTSD the sensitivity of the ASI (.91) was higher than its specificity (.43). Other findings indicated that patients were more likely to report trauma on the THQ than on the ASI (which may be due to the self-report format of the THQ); that the ASI was better at assessing sexual than assessing physical trauma; and that the higher the number of ASI trauma items endorsed, the more likely was the PTSD diagnosis. Finally, PTSD patients had greater severity than non-PTSD patients on other ASI items (e.g., psychological severity, need for treatment). CONCLUSIONS: The ASI trauma questions show stronger utility as a screen for PTSD than for trauma. Results of the study are discussed in light of ways to modify the ASI to screen more accurately for trauma, clinical implications, and limitations of the study method.
ACCESSION NUMBER: 98158081
Record 116 of 193 in MEDLINE(R) on CD 1998 Part B
TITLE: Double trauma: a group therapy approach for Vietnam Veterans suffering from war and childhood trauma.
AUTHOR: Goodman,-M; Weiss,-D
ADDRESS OF AUTHOR: Department of Psychiatry, Cornell University Medical Center, USA.
SOURCE: Int-J-Group-Psychother. 1998 Jan; 48(1): 39-54
INTERNATIONAL STANDARD SERIAL NUMBER: 0020-7284
LANGUAGE: English
ABSTRACT: A model of a 9-month exploratory psychotherapy group for male Vietnam War veterans diagnosed with posttraumatic stress disorder (PTSD) who also experienced childhood physical and sexual abuse is presented. Recent literature delineating an association between combat PTSD and earlier childhood abuse is briefly reviewed and forms the basis for a new treatment strategy. A trauma group psychotherapy approach that investigates the connections between war and childhood traumas and their effects on later adult coping and interpersonal relationships is fundamentally different than existing trauma group treatment paradigms that focus primarily on war-related events. A description of the group formation, philosophy, course, and outcome is provided and enriched by clinical material.
ACCESSION NUMBER: 98170508
Record 117 of 193 in MEDLINE(R) on CD 1998 Part B
TITLE: Risk factors for DSM-III-R posttraumatic stress disorder: findings from the National Comorbidity Survey.
AUTHOR: Bromet,-E; Sonnega,-A; Kessler,-R-C
ADDRESS OF AUTHOR: Department of Psychiatry and Behavioral Science, School of Medicine, State University of New York, Stony Brook 11794-8790, USA.
SOURCE: Am-J-Epidemiol. 1998 Feb 15; 147(4): 353-61
INTERNATIONAL STANDARD SERIAL NUMBER: 0002-9262
LANGUAGE: English
ABSTRACT: The present study examined the association of childhood risk factors with exposure to traumas and posttraumatic stress disorder (PTSD). PTSD is a unique symptom configuration after exposure to an unusual, extreme event. Data come from the US National Comorbidity Study of 5,877 respondents aged 15-54 years conducted between September 1990 and February 1992. The risk factors examined were preexposure affective, anxiety, and substance use disorders; parental mental and substance use disorders; parental aggression toward the respondent and toward the other parent; and a nonconfiding relationship with the mother during childhood. Analyses were stratified by gender and adjusted for demographic variables and traumatic experiences prior to the index trauma. The occurrence of trauma was associated with many risk factors in women but few in men. Similarly, more risk factors predicted PTSD in women than in men. Overall, when respondents were grouped into broad trauma categories, an increase in the number of risk factors was associated with higher rates of PTSD. However, in analyses of the trauma subsample that adjusted for individual type of trauma (e.g., rape, physical attack), only one risk factor (history of affective disorder) predicted PTSD in women, and two (history of anxiety disorder and parental mental disorder) predicted PTSD in men. The results thus indicate that although these risk factors have an important association with PTSD, they operate largely by predicting trauma exposure rather than by predicting the onset of disorder after exposure.
ACCESSION NUMBER: 98167527
Record 118 of 193 in MEDLINE(R) on CD 1998 Part B
TITLE: Prevalence of PTSD in a community sample of older adolescents.
AUTHOR: Cuffe,-S-P; Addy,-C-L; Garrison,-C-Z; Waller,-J-L; Jackson,-K-L; McKeown,-R-E; Chilappagari,-S
ADDRESS OF AUTHOR: Department of Neuropsychiatry and Behavioral Science, University of South Carolina, Columbia, USA.
SOURCE: J-Am-Acad-Child-Adolesc-Psychiatry. 1998 Feb; 37(2): 147-54
INTERNATIONAL STANDARD SERIAL NUMBER: 0890-8567
LANGUAGE: English
ABSTRACT: OBJECTIVE: To examine prevalence and correlates of trauma and posttraumatic stress disorder (PTSD) symptoms and diagnosis in older adolescents aged 16 through 22 years. METHOD: The second cycle of a longitudinal epidemiological study in the Southeast included a semistructured interview assessing PTSD symptomatology administered to 490 adolescents. RESULTS: Approximately 3% of female subjects and 1% of male subjects satisfied the DSM-IV criteria for PTSD. Females reported more traumatic events than males, and black subjects reported more events than white subjects. Being female (odds ratio = 12.32), experiencing rape or child sexual abuse (odds ratio = 49.37), and witnessing an accident or medical emergency (odds ratio = 85.02) were associated with increased risk of PTSD. CONCLUSIONS: While relatively few adolescents satisfy the criteria for PTSD, most subjects who experienced a traumatic event reported some PTSD symptoms. Specific types of traumatic events were associated with occurrence of PTSD.
ACCESSION NUMBER: 98134179
Record 119 of 193 in MEDLINE(R) on CD 1998 Part B
TITLE: Posttraumatic stress disorder among incarcerated battered women: a comparison of battered women who killed their abusers and those incarcerated for other offenses.
AUTHOR: O'Keefe,-M
ADDRESS OF AUTHOR: University of Southern California, School of Social Work, Los Angeles 90089, USA.
SOURCE: J-Trauma-Stress. 1998 Jan; 11(1): 71-85
INTERNATIONAL STANDARD SERIAL NUMBER: 0894-9867
LANGUAGE: English
ABSTRACT: The present study examined differences in the amount and severity of spousal violence and posttraumatic stress symptoms between incarcerated battered women who killed/seriously assaulted their abusers and battered women incarcerated for other offenses. Additionally, several risk and buffering variables suggested by trauma research were tested to determine their ability to predict present posttraumatic stress disorder (PTSD) symptomatology. Findings revealed that battered women who killed/seriously assaulted their batterers experienced more frequent and severe spousal abuse than those in the comparison group. No significant group differences were found for present PTSD symptom levels. Predictors of present PTSD symptomatology included: childhood sexual abuse, childhood physical abuse, past PTSD symptomatology, length of time elapsed since living with partner and receiving counseling in prison. The implications of the findings are discussed.
ACCESSION NUMBER: 98140304
Record 120 of 193 in MEDLINE(R) on CD 1998 Part B
TITLE: Convergent validity of three posttraumatic symptoms inventories among adult sexual abuse survivors.
AUTHOR: Gold,-J-W; Cardena,-E
ADDRESS OF AUTHOR: Clinical Services, Key Program, Springfield, Massachusetts, USA.
SOURCE: J-Trauma-Stress. 1998 Jan; 11(1): 173-80
INTERNATIONAL STANDARD SERIAL NUMBER: 0894-9867
LANGUAGE: English
ABSTRACT: We examined the convergent validity of three posttraumatic symptoms inventories, the civilian version of the Mississippi Scale for Combat-Related PTSD (CM-PTSD), the Trauma Symptom Checklist-40 (TSC-40), and the Response to Childhood Incest Questionnaire (RCIQ), in a sample of 52 adult sexual abuse survivors. The significant and moderate to strong correlations (r = .6 or higher) among these inventories supported their convergent validity. Comparison with other studies also suggests that these instruments can adequately discriminate clinical from nonclinical populations.
ACCESSION NUMBER: 98140313
Record 121 of 193 in MEDLINE(R) on CD 1998 Part B
TITLE: Learning and memory in rape victims with posttraumatic stress disorder.
AUTHOR: Jenkins,-M-A; Langlais,-P-J; Delis,-D; Cohen,-R
ADDRESS OF AUTHOR: Department of Neurology Research, Department of Veterans' Affairs Medical Center, San Diego, USA. Melissa_Jenkins@brown.edu
SOURCE: Am-J-Psychiatry. 1998 Feb; 155(2): 278-9
INTERNATIONAL STANDARD SERIAL NUMBER: 0002-953X
LANGUAGE: English
ABSTRACT: OBJECTIVE: Studies have shown memory deficits among combat veterans with posttraumatic stress disorder (PTSD); however, high rates of comorbid conditions, including alcoholism, make it difficult to definitively associate these findings with the PTSD diagnosis. In this study the authors examined memory functioning among rape survivors without alcoholism or substance abuse but with PTSD. METHOD: Rape victims with (N = 15) and without (N = 16) PTSD were compared to age- and education-matched nontraumatized comparison subjects (N = 16) on measures of learning and memory. RESULTS: The subjects with PTSD performed significantly worse than the other groups on delayed free recall. The deficits were ameliorated by cueing and recognition testing. CONCLUSIONS: Recall deficits in noncombat PTSD patients strengthen the theory that memory deficits are associated with the PTSD diagnosis. The deficits were mild and were not attributable to comorbid depression, anxiety, or substance abuse.
ACCESSION NUMBER: 98125456
Record 122 of 193 in MEDLINE(R) on CD 1998 Part B
TITLE: Cocaine dependence with and without PTSD among subjects in the National Institute on Drug Abuse Collaborative Cocaine Treatment Study.
AUTHOR: Najavits,-L-M; Gastfriend,-D-R; Barber,-J-P; Reif,-S; Muenz,-L-R; Blaine,-J; Frank,-A; Crits-Christoph,-P; Thase,-M; Weiss,-R-D
ADDRESS OF AUTHOR: Department of Psychiatry, Harvard Medical School, Boston, USA. Lnajavits@aol.com
SOURCE: Am-J-Psychiatry. 1998 Feb; 155(2): 214-9
INTERNATIONAL STANDARD SERIAL NUMBER: 0002-953X
LANGUAGE: English
ABSTRACT: OBJECTIVE: This study examined the prevalence of lifetime traumatic events and current symptoms of posttraumatic stress disorder (PTSD) among treatment-seeking cocaine-dependent outpatients and compared patients with and without PTSD on current substance use, psychopathology, and sociodemographic characteristics. METHOD: The subjects were 122 adult cocaine-dependent outpatients participating in a treatment outcome study of psychosocial therapy. In addition to standard self-report and interview measures of psychopathology and substance use, the subjects completed the Trauma History Questionnaire and the PTSD Checklist before entering treatment. RESULTS: These patients experienced a large number of lifetime traumatic events (mean = 5.7); men experienced more general disasters and crime-related traumas than women, and women experienced more physical and sexual abuse than men. According to self-report measures, 20.5% of the subjects currently met the DSM-III-R criteria for PTSD; the rate of PTSD was 30.2% among women and 15.2% among men. Patients with PTSD had significantly higher rates of co-occurring axis I and axis II disorders, interpersonal problems, medical problems, resistance to treatment, and psychopathology symptoms than patients without PTSD. Psychopathology symptoms represented the most consistent difference between the two groups and provided the best prediction of PTSD status in a logistic regression. However, the groups did not differ significantly in current substance use or sociodemographic characteristics. CONCLUSIONS: These findings underscore the value of screening substance abusers for PTSD, because it can identify a small but substantial number who might require additional treatment. Further studies of the relationship between PTSD and substance abuse appear warranted.
ACCESSION NUMBER: 98125445
Record 123 of 193 in MEDLINE(R) on CD 1998 Part A
TITLE: The process of transforming self in women veterans with post-traumatic stress disorder resulting from sexual abuse.
AUTHOR: Wing,-D-M; Oertle,-J-R; Raine,-S
ADDRESS OF AUTHOR: University of Tulsa, School of Nursing, Oklahoma 74104, USA.
SOURCE: Int-J-Psychiatr-Nurs-Res. 1998 Sep; 4(2): 463-73
INTERNATIONAL STANDARD SERIAL NUMBER: 0968-0624
LANGUAGE: English
ABSTRACT: In recent years increasing attention has been given to the prevalence and impact of military sexual abuse. Symptoms of post-traumatic stress disorder (PTSD), a diagnostic entity originally restricted to those who had experienced wartime trauma, have been observed in women veterans who reported that they were sexually abused during military service. However, little research has been conducted in this area. The purpose of this study was to determine the recovery process in women veterans suffering from PTSD resulting from sexual abuse. Using grounded theory methods, the researchers interviewed 16 women veterans who were in active recovery. Constant comparison data analysis revealed the emerging basic social process of "transforming self." The finding indicate that participants transformed self by progressing through five stages: reacting to triggers; seeking validation; sorting through confusion; becoming intentional; and affirming self. The authors compare these findings to other research on recovery from sexual abuse.
ACCESSION NUMBER: 99375699
Record 124 of 193 in MEDLINE(R) on CD 1998 Part A
TITLE: Post-traumatic stress disorder in Asian refugees.
AUTHOR: Ton-That,-N
ADDRESS OF AUTHOR: NPI, UCLA, Westminster, California 92683, USA.
SOURCE: Psychiatry-Clin-Neurosci. 1998 Dec; 52 Suppl: S377-9
INTERNATIONAL STANDARD SERIAL NUMBER: 1323-1316
LANGUAGE: English
ABSTRACT: This study profiles 127 cases of Vietnamese, Cambodian, Laotian and Chinese refugee outpatients diagnosed with post-traumatic stress disorder (PTSD). Traumatic etiologies included victims of wars such as political refugees, concentration camp prisoners and victims of rape, severe personal losses (property or human lives). These traumata were experienced by our subjects during the period between the end of the Vietnam war in April 1975 and recent times, when they finally arrived in the USA. Clinical symptoms of these subjects reflected many influences of their oriental culture background and are characterized by internalization that needs to be overcome for assessment as well as for therapy. Symptomatic treatment with psychopharmacology and supportive therapy are helpful while cultural approaches have been adopted by many patients to reach the inner self pathology that could be of both mental and organic in nature. These facts need to be taken into consideration in the future description of the PTSD clinical picture. Recommendations are made for future PTSD studies in Vietnam, Cambodia and Laos, and to promote a global movement for prevention of any socio-political situation that may generate PTSD.
ACCESSION NUMBER: 99110490
Record 125 of 193 in MEDLINE(R) on CD 1998 Part A
TITLE: The effects of stress on memory and the hippocampus throughout the life cycle: implications for childhood development and aging.
AUTHOR: Bremner,-J-D; Narayan,-M
ADDRESS OF AUTHOR: Yale University School of Medicine, New Haven, CT, USA. j.bremner@yale.edu
SOURCE: Dev-Psychopathol. 1998 Fall; 10(4): 871-85
INTERNATIONAL STANDARD SERIAL NUMBER: 0954-5794
LANGUAGE: English
ABSTRACT: Studies in animals showing hippocampal atrophy and associated memory deficits in stress and aging have implications for stress and aging in humans. Clinical studies in traumatized human populations with posttraumatic stress disorder (PTSD) have replicated studies in animals, showing reduction in volume of the hippocampus measured with magnetic resonance imaging and associated memory deficits. Trauma at different stages of development (early childhood abuse versus trauma in later life due to combat) may influence the nature of memory deficits and hippocampal atrophy. Studies in aging human subjects are consistent with animal studies, although future research is needed in this area. The similarities between biological findings related to cortisol and the hippocampus in stress and aging in both animal and human studies raises the question of whether PTSD can be seen as a form of accelerated aging. Evidence that stress affects the hippocampus and the capacity for learning has broad implications for public health policy, underlying the need for additional resources in this important area and a reexamination of our understanding of factors influencing academic achievement.
ACCESSION NUMBER: 99101322
Record 126 of 193 in MEDLINE(R) on CD 1998 Part A
TITLE: Criminal victimization, posttraumatic stress disorder, and comorbid psychopathology among a community sample of women.
AUTHOR: Boudreaux,-E; Kilpatrick,-D-G; Resnick,-H-S; Best,-C-L; Saunders,-B-E
ADDRESS OF AUTHOR: National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston 29425-0742, USA.
SOURCE: J-Trauma-Stress. 1998 Oct; 11(4): 665-78
INTERNATIONAL STANDARD SERIAL NUMBER: 0894-9867
LANGUAGE: English
ABSTRACT: This paper provides information on the relation between victimization status, crime factors, posttraumatic stress disorder (PTSD), and several other psychological disorders among a community sample of women. Results indicated that victims of crime were more likely than nonvictims to suffer from PTSD, major depressive episode, agoraphobia, obsessive-compulsive disorder, social phobia, and simple phobia. Furthermore, life threat was associated with increased risk of major depression, agoraphobia, obsessive-compulsive disorder, and social phobia. Completed rape was strongly related to almost every disorder assessed, while robbery and burglary were not related to any disorder. When demographics, victimization status, and crime factors were entered hierarchically into multivariate logistic regressions with PTSD in the final step, associations between victimization status, other crime characteristics (e.g., life threat, injury), and non-PTSD Axis I disorders were greatly reduced. This suggests that PTSD may be an important mediating factor in the victimization-psychopathology relation for many disorders.
ACCESSION NUMBER: 99087044
Record 127 of 193 in MEDLINE(R) on CD 1998 Part A
TITLE: Psychophysiologic assessment of women with posttraumatic stress disorder resulting from childhood sexual abuse.
AUTHOR: Orr,-S-P; Lasko,-N-B; Metzger,-L-J; Berry,-N-J; Ahern,-C-E; Pitman,-R-K
ADDRESS OF AUTHOR: Research Service, Veterans Affairs Medical Center, Manchester, New Hampshire 03103, USA.
SOURCE: J-Consult-Clin-Psychol. 1998 Dec; 66(6): 906-13
INTERNATIONAL STANDARD SERIAL NUMBER: 0022-006X
LANGUAGE: English
ABSTRACT: Heart rate, skin conductance, and left lateral frontalis and corrugator facial electromyogram responses were measured during script-driven imagery of personal childhood sexual abuse (CSA) and other life experiences among women with and without Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev., American Psychiatric Association, 1987)--diagnosed posttraumatic stress disorder (PTSD) resulting from CSA. Women with current PTSD (n = 29) showed larger physiologic responses than those who never had PTSD (n = 18) during personal sexual abuse imagery but not during imagery of stressful, nonabuse-related life experiences. Responses of individuals with lifetime, but not current, PTSD (n = 24) fell between the other groups. An a priori discriminant function, derived from physiologic responses of previously studied individuals, correctly classified 66% of women with current PTSD and 78% of women who never had PTSD.
ACCESSION NUMBER: 99092062
Record 128 of 193 in MEDLINE(R) on CD 1998 Part A
TITLE: Life events and post-traumatic stress: the development of a new measure for children and adolescents.
AUTHOR: Costello,-E-J; Angold,-A; March,-J; Fairbank,-J
ADDRESS OF AUTHOR: Duke University of Medical Center, Department of Psychiatry and Behavioral Sciences, Durham, NC 27710, USA.
SOURCE: Psychol-Med. 1998 Nov; 28(6): 1275-88
INTERNATIONAL STANDARD SERIAL NUMBER: 0033-2917
LANGUAGE: English
ABSTRACT: BACKGROUND: A new interview measure of life events and post-traumatic stress disorder (PTSD) has been developed for children and adolescents aged 9 through 17, for use in both epidemiological and clinical studies. It includes 'high magnitude' events associated with PTSD as well as other 'low magnitude' events. METHOD: The interview is designed as a module of the Child and Adolescent Psychiatric Assessment, an interviewer-based interview conducted with parent and child separately by trained lay interviewers. The module includes: (1) questions about a wide range of events; (2) a screen for key PTSD symptoms (painful recall, avoidance, hypervigilance); and (3) a detailed interview on all PTSD symptoms, including onset, duration, severity and co-morbidity. A test-retest reliability study was conducted with 58 parents and children, who were interviewed twice by different interviewers. RESULTS: Intraclass correlations were 0.72 (child) and 0.83 (parent) for high magnitude events, and 0.62 (child) and 0.58 (parent) for low magnitude events. Kappa coefficients ranged from high for violence and sexual abuse to low for child reports of serious accidents and natural disasters. The reliability of the PTSD screen symptoms was fair to excellent (kappa = 0.40-0.79), and reliability of PTSD symptoms in those who passed the screen was excellent (ICC = 0.94-0.99). Compared with a general population sample (N = 1015), the clinic-referred subjects and their parents were twice as likely to report a traumatic event and, depending on the event, up to 25 times as likely to report symptoms of PTSD. CONCLUSIONS: The results support the reliability and discriminant validity of the measure.
ACCESSION NUMBER: 99071433
Record 129 of 193 in MEDLINE(R) on CD 1998 Part A
TITLE: "Recovered-memory" therapy: profession at a turning point.
AUTHOR: Feigon,-E-A; de-Rivera,-J
ADDRESS OF AUTHOR: Faulkner Hospital, Jamaica Plain, MA, USA.
SOURCE: Compr-Psychiatry. 1998 Nov-Dec; 39(6): 338-44
INTERNATIONAL STANDARD SERIAL NUMBER: 0010-440X
LANGUAGE: English
ABSTRACT: Six hundred Massachusetts-registered psychiatrists were surveyed for their opinions on items plausibly related to the production of false memories of childhood sexual abuse. One hundred fifty-four psychiatrists completed the written questionnaire. A majority of respondents (69%) endorsed the following statement: "The numbers of false accusations of childhood sexual abuse, appearing to emerge from the psychotherapy of adults, constitute a real problem needing public acknowledgment as such by the mental health professions." Nevertheless, a substantial minority endorsed the following practices: 37% endorsed searching for childhood roots of presenting complaints; 36% endorsed validation (expressed belief) of the patient's memories as an essential part of therapy; 36% believed in appropriateness of affect as an indicator of truth in memories; 36% believed in the therapeutic value of abreaction; 26% would refer presumed survivors of abuse to specialists in incest recovery; 18% believed in ritual abuse as an important cause of posttraumatic stress disorder (PTSD) and dissociative disorders; 18% trusted symptom checklists as indicators of sexual abuse histories; and 15% believed that memory is a complete record of the individual's history. Small minorities (6% to 8%) endorsed these practices: using hypnosis to gain access to repressed memories of childhood abuse; patient confrontation of alleged abusers; and recommending the severing of contacts with skeptical family members. A factor analysis was performed, and it was found that self-designated specialists were more likely than nonspecialists to score toward the riskier pole of the four factors extracted.
ACCESSION NUMBER: 99046580
Record 130 of 193 in MEDLINE(R) on CD 1998 Part A
TITLE: Relationship of childhood sexual, physical, and combined sexual and physical abuse to adult victimization and posttraumatic stress disorder.
AUTHOR: Schaaf,-K-K; McCanne,-T-R
ADDRESS OF AUTHOR: Department of Psychology, Northern Illinois University, DeKalb 60115, USA.
SOURCE: Child-Abuse-Negl. 1998 Nov; 22(11): 1119-33
INTERNATIONAL STANDARD SERIAL NUMBER: 0145-2134
LANGUAGE: English
ABSTRACT: OBJECTIVE: Prior research has suggested that women who experience childhood sexual abuse are at increased risk for sexual victimization and Posttraumatic Stress Disorder (PTSD) in adulthood. However, previous studies have paid insufficient attention to the overlap of childhood sexual and physical abuse. In the present study we disentangled the separate and combined effects of childhood sexual and physical abuse by comparing groups of participants who reported contact childhood sexual abuse only (SA), sequelae of childhood physical abuse only (PA), combined childhood sexual and physical abuse (CA), or no child abuse (NA). METHOD: A sample of 475 female college students completed measures of sexual and physical abuse in childhood (before age 15) and adulthood (after age 15), PTSD and trauma symptoms, and demographic variables. Of these participants, 27 were assigned to the SA group, 53 to the PA group, 31 to the CA group, and 211 to the NA group. RESULTS: The highest rate of adult sexual and/or physical victimization was reported by the CA group, followed by the PA group, with lower rates reported by the SA and NA groups. Using adult victimization as a covariate, the analyses revealed that the CA group reported significantly higher rates of PTSD and trauma symptoms compared to the NA group. CONCLUSIONS: The results suggest that prior reports of differences in rates of adult victimization and PTSD between women who experienced childhood sexual abuse and women who did not may be attributable to the inclusion of participants with a history of combined childhood sexual and physical abuse in childhood sexual abuse groups. The importance of separating physical and combined forms of victimization from sexual abuse is discussed.
ACCESSION NUMBER: 99044566
Record 131 of 193 in MEDLINE(R) on CD 1998 Part A
TITLE: Psychopathology in non-clinically referred sexually abused children.
AUTHOR: McLeer,-S-V; Dixon,-J-F; Henry,-D; Ruggiero,-K; Escovitz,-K; Niedda,-T; Scholle,-R
ADDRESS OF AUTHOR: Department of Psychiatry, School of Medicine and Biomedical Sciences, State University of New York, Buffalo, USA.
SOURCE: J-Am-Acad-Child-Adolesc-Psychiatry. 1998 Dec; 37(12): 1326-33
INTERNATIONAL STANDARD SERIAL NUMBER: 0890-8567
LANGUAGE: English
ABSTRACT: OBJECTIVE: To determine the prevalence of psychiatric symptoms and disorders found in non-clinically referred, sexually abused children (nCR-SAC), aged 6 to 16 years, during the 30- to 60-day period after disclosure and termination of abuse. METHOD: Eighty nCR-SAC were compared with clinical and nonclinical groups of nonabused children matched by age, race, and socioeconomic status. Structured and semistructured interviews and standardized rating scales were used for assessment. RESULTS: More posttraumatic stress disorder (PTSD) was found in the nCR-SAC than in the two comparison groups, and symptom severity was intermediate, except for symptoms of posttraumatic stress, trait anxiety, and depression, which were highest in the nCR-SAC. CONCLUSIONS: Sexually abused children are at high risk for PTSD and symptoms of posttraumatic stress, anxiety, and depression in the immediate period after disclosure and termination of abuse. Findings indicate the need for routine and systematic evaluation for these symptoms and PTSD for treatment planning.
ACCESSION NUMBER: 99063972
Record 132 of 193 in MEDLINE(R) on CD 1998 Part A
TITLE: Directed forgetting of trauma cues in adult survivors of childhood sexual abuse with and without posttraumatic stress disorder.
AUTHOR: McNally,-R-J; Metzger,-L-J; Lasko,-N-B; Clancy,-S-A; Pitman,-R-K
ADDRESS OF AUTHOR: Department of Psychology, Harvard University. rjm@wjh.harvard.edu
SOURCE: J-Abnorm-Psychol. 1998 Nov; 107(4): 596-601
INTERNATIONAL STANDARD SERIAL NUMBER: 0021-843X
LANGUAGE: English
ABSTRACT: The authors used a directed-forgetting task to investigate whether psychiatrically impaired adult survivors of childhood sexual abuse exhibit an avoidant encoding style and impaired memory for trauma cues. The authors tested women with abuse histories, either with or without posttraumatic stress disorder (PTSD), and women with neither abuse histories nor PTSD. The women saw intermixed trauma words (e.g., molested), positive words (e.g., confident), and categorized neutral words (e.g., mailbox) on a computer screen and were instructed either to remember or to forget each word. Relative to the other groups, the PTSD group did not exhibit recall deficits for trauma-related to-be-remembered words, nor did they recall fewer trauma-related to-be-forgotten words than other words. Instead, they exhibited recall deficits for positive and neutral words they were supposed to remember. These data are inconsistent with the hypothesis that impaired survivors exhibit avoidant encoding and impaired memory for traumatic information.
ACCESSION NUMBER: 99047939
Record 133 of 193 in MEDLINE(R) on CD 1998 Part A
TITLE: Epidemiological evidence about the relationship between PTSD and alcohol abuse: the nature of the association.
AUTHOR: McFarlane,-A-C
ADDRESS OF AUTHOR: University of Adelaide, Department of Psychiatry, Queen Elizabeth Hospital, Woodville, Australia.
SOURCE: Addict-Behav. 1998 Nov-Dec; 23(6): 813-25
INTERNATIONAL STANDARD SERIAL NUMBER: 0306-4603
LANGUAGE: English
ABSTRACT: This article uses the Bradford Hill criteria for assessing causal associations to examine the nature of the relationship between PTSD and alcohol abuse. A series of studies are presented which examine this relationship. A cross-sectional study of 2,501 subjects in a community sample examined the relationship between at-risk drinking and 11 types of traumatic events. The traumatic events associated with at-risk drinking were involvement in life threatening accidents, witnessing severe injury, rape, being the victim of serious physical assault using the CIDI. In a longitudinal study of 469 firefighters exposed to a natural disaster, PTSD was associated with both an increase and decrease in alcohol consumption and PTSD rather than exposure accounted for the changes in drinking behaviour. In three other populations, psychiatric inpatients, motor accident victims and female prisoners, the association between PTSD and alcohol abuse emphasised the clinical and public health importance of this relationship. The available evidence does nevertheless support the causal nature of this relationship. Other risk factors are necessary to predict alcohol abuse following exposure to traumatic events, although exposure to traumatic events can be caused by alcohol abuse.
ACCESSION NUMBER: 99018526
Record 134 of 193 in MEDLINE(R) on CD 1998 Part A
TITLE: A family study of chronic post-traumatic stress disorder following rape trauma.
AUTHOR: Davidson,-J-R; Tupler,-L-A; Wilson,-W-H; Connor,-K-M
ADDRESS OF AUTHOR: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham NC 27710, USA.
SOURCE: J-Psychiatr-Res. 1998 Sep-Oct; 32(5): 301-9
INTERNATIONAL STANDARD SERIAL NUMBER: 0022-3956
LANGUAGE: English
ABSTRACT: There is evidence that familial factors serve as determinants of risk for post-traumatic stress disorder (PTSD), especially familial anxiety. This study investigates the relationship between chronic PTSD and family psychiatric morbidity. The sample was drawn from 81 female rape survivors with or without lifetime PTSD, 31 major depressive disorder controls, 20 anxiety disorder controls and 39 healthy controls. First-degree family members were directly interviewed (n = 285) and diagnoses assigned of major depressive, anxiety and alcohol or substance use disorder. Information was also available by family history for 639 relatives. In the directly interviewed sample, no consistently increased morbidity risk was observed for anxiety, PTSD, or alcohol/substance abuse in the rape survivor groups, but there was an increase in depression relative to the anxiety in healthy control groups. When comorbid depression in rape survivor probands was taken into account post hoc, an increased risk for depression was noted in family members of PTSD probands with depression, but not in relatives of PTSD probands without lifetime depression. Among rape survivor probands with non-comorbid PTSD, rates by history of familial anxiety and depression were negligible. In a logistic regression analysis, individual vulnerability to depression served as an independent predictor of chronic PTSD, along with specific trauma-related variables. In the family history group, results were consistent with those obtained from the directly interviewed group. Our findings clearly support the view that PTSD following rape is associated with familial vulnerability to major depression, which may thus serve as a risk factor for developing PTSD. The exact nature of this predisposition calls for further inquiry and there is a need to expand this study to include other PTSD populations. PTSD may on occasion represent a form of depression which is induced and/or modified neurobiologically and phenomenologically by extreme stress. Our findings may be a reflection of the sample composition, the current conceptualization of PTSD, or be related to study limitations.
ACCESSION NUMBER: 99005638
Record 135 of 193 in MEDLINE(R) on CD 1998 Part A
TITLE: Reactivation of posttraumatic stress disorder after minor head injury.
AUTHOR: Berthier,-M-L; Kulisevsky,-J; Fernandez-Benitez,-J-A; Gironell,-A
ADDRESS OF AUTHOR: Neurology Service, Clinic University Hospital, University of Malaga, Spain.
SOURCE: Depress-Anxiety. 1998; 8(1): 43-7
INTERNATIONAL STANDARD SERIAL NUMBER: 1091-4269
LANGUAGE: English
ABSTRACT: This report describes the reactivation of a posttraumatic stress disorder (PTSD) after a minor head injury in two young women who had recovered from extreme stress caused by sexual abuse during adolescence. Intrusive thoughts, images, dreams, and phobic avoidance bear a direct relationship to the specific circumstances of both head injury and sexual abuse, and were associated with obsessive-compulsive symptoms, generalized anxiety with panic, and depression. These findings suggest that in some individuals minor head injuries may induce not only extreme stress reactions, but also cause the reactivation of symptoms related to previous traumatic experiences.
ACCESSION NUMBER: 98423554
Record 136 of 193 in MEDLINE(R) on CD 1998 Part A
TITLE: Prevalence of post traumatic stress disorder and other psychiatric diagnoses in three groups of abused children (sexual, physical, and both).
AUTHOR: Ackerman,-P-T; Newton,-J-E; McPherson,-W-B; Jones,-J-G; Dykman,-R-A
ADDRESS OF AUTHOR: Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, USA.
SOURCE: Child-Abuse-Negl. 1998 Aug; 22(8): 759-74
INTERNATIONAL STANDARD SERIAL NUMBER: 0145-2134
LANGUAGE: English
ABSTRACT: OBJECTIVE: The purpose of this study was to compare the prevalence of Post Traumatic Stress Disorder and other diagnoses in three groups of abused children, sexual only (N = 127), physical only (N = 43), and BOTH (N = 34). METHOD: The children, aged 7 to 13 years, were referred to the project from several sources at Arkansas Children's Hospital and from associated local agencies. The victims and caregivers were separately administered the Diagnostic Interview for Children and Adolescents, Revised Version (DICA). Additionally, caregivers and classroom teachers completed the Child Behavior Checklist (CBCL). Characteristics of the abuse were obtained from an investigative questionnaire. RESULTS: Both victims and caregivers endorsed high rates of disorders, with caregivers generally giving higher rates than children and boys having more externalizing diagnoses than girls. Children in the BOTH group had more diagnoses overall. Concordance between victims and caregivers was modest. PTSD was significantly comorbid with most affective disorders. On the CBCL, caregivers rated girls less disturbed than boys and the sexually abused only group less disturbed than the other groups. Teachers rated the boys more adversely than girls but did not see differences by abuse group. A younger age of onset of sexual abuse and coercion to maintain secrecy predicted a higher number of total diagnoses. Also, children who were physically abused by males had more diagnoses than those physically abused by females. CONCLUSIONS: Children who have been both physically/sexually abused appear to be at highest risk of psychiatric disturbance. PTSD, though common (circa one-third of victims), is generally comorbid with other affective disorders.
ACCESSION NUMBER: 98383348
Record 137 of 193 in MEDLINE(R) on CD 1998 Part A
TITLE: Predicting response to exposure treatment in PTSD: the role of mental defeat and alienation.
AUTHOR: Ehlers,-A; Clark,-D-M; Dunmore,-E; Jaycox,-L; Meadows,-E; Foa,-E-B
ADDRESS OF AUTHOR: Department of Psychiatry, University of Oxford, U.K. ANKE.EHLERS@PSYCHIATRY.OX.AC.UK
SOURCE: J-Trauma-Stress. 1998 Jul; 11(3): 457-71
INTERNATIONAL STANDARD SERIAL NUMBER: 0894-9867
LANGUAGE: English
ABSTRACT: Not all patients with posttraumatic stress disorder benefit from exposure treatment. The present paper describes two cognitive dimensions that are related to inferior response to exposure in rape victims. First, individuals whose memories during relieving of the trauma reflected mental defeat or the absence of mental planning showed little improvement. Second, inferior outcome was correlated with an overall feeling of alienation or permanent change following the trauma. These results are based on blind ratings of transcripts of exposure treatment sessions from 10 women with good outcome and 10 women with inferior outcome. Patients in the two groups were matched for initial symptom severity and were comparable in many aspects of the assault. Patients who experienced mental defeat, alienation, or permanent change may require cognitive restructuring in addition to exposure.
ACCESSION NUMBER: 98354644
Record 138 of 193 in MEDLINE(R) on CD 1998 Part A
TITLE: "Seeking safety": outcome of a new cognitive-behavioral psychotherapy for women with posttraumatic stress disorder and substance dependence.
AUTHOR: Najavits,-L-M; Weiss,-R-D; Shaw,-S-R; Muenz,-L-R
ADDRESS OF AUTHOR: Harvard Medical School, Boston, Massachusetts 02138, USA. LisaNajavits@hms.harvard.edu
SOURCE: J-Trauma-Stress. 1998 Jul; 11(3): 437-56
INTERNATIONAL STANDARD SERIAL NUMBER: 0894-9867
LANGUAGE: English
ABSTRACT: Women with current posttraumatic stress disorder (PTSD) comprise 30-59% of substance abuse treatment samples and experience a more severe course than women with either disorder alone. As yet, no effective treatment for this population has been identified. This paper reports outcome results on 17 women who completed a new manual-based 24-session cognitive behavioral group therapy protocol treatment, based on assessments at pretreatment, during treatment, posttreatment, and at 3-month follow-up. Results showed significant improvements in substance use, trauma-related symptoms, suicide risk, suicidal thoughts, social adjustment, family functioning, problem solving, depression, cognitions about substance use, and didactic knowledge related to the treatment. Patients' treatment attendance, alliance, and satisfaction were also very strong. Treatment completers were more impaired than dropouts, yet more engaged in the treatment. Overall, our data suggest that women with PTSD and substance abuse can be helped when provided with a treatment designed for them. All results are clearly tentative, however, due to the lack of a control group, multiple comparisons, and absence of assessment of dropouts.
ACCESSION NUMBER: 98354643
Record 139 of 193 in MEDLINE(R) on CD 1998 Part A
TITLE: Prostitution, violence, and posttraumatic stress disorder.
AUTHOR: Farley,-M; Barkan,-H
ADDRESS OF AUTHOR: Prostitution Research and Education, Women's Centers, San Francisco, CA 94116-0254, USA.
SOURCE: Women-Health. 1998; 27(3): 37-49
INTERNATIONAL STANDARD SERIAL NUMBER: 0363-0242
LANGUAGE: English
ABSTRACT: One hundred and thirty people working as prostitutes in San Francisco were interviewed regarding the extent of violence in their lives and symptoms of posttraumatic stress disorder (PTSD). Fifty-seven percent reported that they had been sexually assaulted as children and 49% reported that they had been physically assaulted as children. As adults in prostitution, 82% had been physically assaulted; 83% had been threatened with a weapon; 68% had been raped while working as prostitutes; and 84% reported current or past homelessness. We differentiated the types of lifetime violence as childhood sexual assault; childhood physical abuse; rape in prostitution; and other (non-rape) physical assault in prostitution. PTSD severity was significantly associated with the total number of types of lifetime violence (r = .21, p = .02); with childhood physical abuse (t = 2.97, p = .004); rape in adult prostitution (Student's t = 2.77, p = .01); and the total number of times raped in prostitution (Kruskal-Wallace chi square = 13.51, p = .01). Of the 130 people interviewed, 68% met DSM III-R criteria for a diagnosis of PTSD. Eighty-eight percent of these respondents stated that they wanted to leave prostitution, and described what they needed in order to escape.
ACCESSION NUMBER: 98363792