Record 78 of 193 in MEDLINE(R) on CD 1999 Part B
TITLE: Posttraumatic stress disorder in abused and neglected children grown up.
AUTHOR: Widom,-C-S
ADDRESS OF AUTHOR: School of Criminal Justice, University at Albany, NY 12222, USA.
SOURCE: Am-J-Psychiatry. 1999 Aug; 156(8): 1223-9
INTERNATIONAL STANDARD SERIAL NUMBER: 0002-953X
LANGUAGE: English
ABSTRACT: OBJECTIVE: The purpose of this study was to describe the extent to which childhood abuse and neglect increase a person's risk for subsequent posttraumatic stress disorder (PTSD) and to determine whether the relationship to PTSD persists despite controls for family, individual, and lifestyle characteristics associated with both childhood victimization and PTSD. METHOD: Victims of substantiated child abuse and neglect from 1967 to 1971 in a Midwestern metropolitan county area were matched on the basis of age, race, sex, and approximate family socioeconomic class with a group of nonabused and nonneglected children and followed prospectively into young adulthood. Subjects (N = 1,196) were located and administered a 2-hour interview that included the National Institute of Mental Health Diagnostic Interview Schedule to assess PTSD. RESULTS: Childhood victimization was associated with increased risk for lifetime and current PTSD. Slightly more than a third of the childhood victims of sexual abuse (37.5%), 32.7% of those physically abused, and 30.6% of victims of childhood neglect met DSM-III-R criteria for lifetime PTSD. The relationship between childhood victimization and number of PTSD symptoms persisted despite the introduction of covariates associated with risk for both. CONCLUSIONS: Victims of child abuse (sexual and physical) and neglect are at increased risk for developing PTSD, but childhood victimization is not a sufficient condition. Family, individual, and lifestyle variables also place individuals at risk and contribute to the symptoms of PTSD.
ACCESSION NUMBER: 99378758
Record 79 of 193 in MEDLINE(R) on CD 1999 Part B
TITLE: Factors related to the reporting of childhood rape.
AUTHOR: Hanson,-R-F; Resnick,-H-S; Saunders,-B-E; Kilpatrick,-D-G; Best,-C
ADDRESS OF AUTHOR: National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston 29425, USA.
SOURCE: Child-Abuse-Negl. 1999 Jun; 23(6): 559-69
INTERNATIONAL STANDARD SERIAL NUMBER: 0145-2134
LANGUAGE: English
ABSTRACT: OBJECTIVE: The aim of this study was to examine whether there would be differences in reported versus unreported cases of childhood rape on incident characteristics including life threat, physical injury, identity of the perpetrator, frequency of assault(s), and rates of posttraumatic stress disorder or major depression. METHOD: In a telephone interview, a national probability sample of 4,008 (weighted) adult women was screened for a history of completed rape in childhood. Respondents were also assessed for DSM-III-R diagnoses of major depressive episode and/or posttraumatic stress disorder (PTSD). Three hundred forty-one (8.5%) of these women were victims of at least one rape prior to the age of 18, for a total of 437 completed rapes. Of these 437 rape incidents, 52 (11.9%) were reported to the police or other authorities. RESULTS: Significant differences were obtained between reported versus nonreported cases on incident characteristics, including life threat, physical injury, identity of the perpetrator. Reported cases were more likely to involve life threat and/or physical injury, and were more likely to have been committed by a stranger than nonreported cases. No significant differences between reported and nonreported cases were found concerning whether the rape involved a single incident versus series of events, or rates of PTSD or major depression. CONCLUSIONS: Findings suggest that different characteristics are associated with reported versus unreported cases of childhood rape. Since few cases of childhood rape are actually reported to the authorities, it appears that we may be missing valuable information. Implications for research and clinical intervention are discussed.
ACCESSION NUMBER: 99318397
Record 80 of 193 in MEDLINE(R) on CD 1999 Part B
TITLE: Sexually and physically abused foster care children and posttraumatic stress disorder.
AUTHOR: Dubner,-A-E; Motta,-R-W
ADDRESS OF AUTHOR: Department of Psychology, Hofstra University, Hempstead, New York 11549, USA.
SOURCE: J-Consult-Clin-Psychol. 1999 Jun; 67(3): 367-73
INTERNATIONAL STANDARD SERIAL NUMBER: 0022-006X
LANGUAGE: English
ABSTRACT: Considerable debate exists regarding the possible relationship between child abuse and posttraumatic stress disorder (PTSD). In this study, 3 groups of foster care children were compared. The groups included 50 sexually abused, 50 physically abused, and 50 nonabused foster care children. Participants completed the Child Post-Traumatic Stress Reaction Index, the Childhood PTSD Interview, and the Modified Stroop Procedure (MSP), which included sexual abuse and nonsexual abuse stimuli. The MSP has not been previously used in child abuse research. Results indicated that sexually and physically abused children demonstrated PTSD at a high level. The MSP discriminated between the sexually abused children with PTSD and those without PTSD. Responses to the MSP sexual abuse stimuli resulted in significantly longer color-naming times than responses to nonsexual abuse stimuli. Preadolescents demonstrated more severe PTSD than early adolescent children.
ACCESSION NUMBER: 99297446
Record 81 of 193 in MEDLINE(R) on CD 1999 Part B
TITLE: Physiologic reactivity to startling tones in women with posttraumatic stress disorder.
AUTHOR: Metzger,-L-J; Orr,-S-P; Berry,-N-J; Ahern,-C-E; Lasko,-N-B; Pitman,-R-K
ADDRESS OF AUTHOR: Veterans Affairs Research Service, Manchester, New Hampshire 03103, USA.
SOURCE: J-Abnorm-Psychol. 1999 May; 108(2): 347-52
INTERNATIONAL STANDARD SERIAL NUMBER: 0021-843X
LANGUAGE: English
ABSTRACT: Autonomic and eyeblink reactivity to startling tones were investigated in women with histories of childhood sexual abuse (CSA). Twenty-one women with current posttraumatic stress disorder (PTSD), 23 with lifetime but not current PTSD, and 13 women who never had PTSD listened to 15 95-dB, 500-ms, 1000-Hz tones with a 0-ms rise time while heart rate (HR), skin conductance (SC), and orbicularis oculi electromyogram (EMG) responses were measured. Participants in the current and lifetime PTSD groups produced larger HR responses across tones and showed slower absolute habituation of SC response magnitude compared with the never PTSD group. EMG response magnitudes did not differ among groups. Women with CSA-related PTSD showed increased autonomic reactivity and slower habituation to high-intensity tones similar to that observed in primarily male, combat PTSD samples. This suggests that heightened autonomic responsivity to startling stimuli in PTSD is not gender or event specific.
ACCESSION NUMBER: 99297434
Record 82 of 193 in MEDLINE(R) on CD 1999 Part B
TITLE: Reduced sensory gating of the P1 potential in rape victims and combat veterans with posttraumatic stress disorder.
AUTHOR: Skinner,-R-D; Rasco,-L-M; Fitzgerald,-J; Karson,-C-N; Matthew,-M; Williams,-D-K; Garcia-Rill,-E
ADDRESS OF AUTHOR: Department of Anatomy, University of Arkansas for Medical Sciences, Little Rock 72205, USA.
SOURCE: Depress-Anxiety. 1999; 9(3): 122-30
INTERNATIONAL STANDARD SERIAL NUMBER: 1091-4269
LANGUAGE: English
ABSTRACT: The P1 midlatency auditory evoked potential was studied in female rape victims with Posttraumatic Stress Disorder (PTSD) and compared to an age-matched female control group; and in male combat veterans with PTSD and compared to three groups of age-matched male control subjects. Sensory gating of the P1 potential was determined using a paired click stimulus paradigm in which the stimuli were presented at 250, 500 and 1000 msec interstimulus intervals (ISI). Results showed that sensory gating of the P1 potential was significantly decreased at the 250 msec ISI, and that there was a numerical, but not a statistically significant, decrease in sensory gating at the other intervals tested in both male and female PTSD subjects compared to all control groups. Since the P1 potential may be generated, at least in part, by the reticular activating system, dysregulation of sensory processing by elements of this system may be present in PTSD.
ACCESSION NUMBER: 99285138
Record 83 of 193 in MEDLINE(R) on CD 1999 Part B
TITLE: A.E. Bennett Research Award. Developmental traumatology. Part II: Brain development.
AUTHOR: De-Bellis,-M-D; Keshavan,-M-S; Clark,-D-B; Casey,-B-J; Giedd,-J-N; Boring,-A-M; Frustaci,-K; Ryan,-N-D
ADDRESS OF AUTHOR: Developmental Traumatology Laboratory, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, PA 15213, USA.
SOURCE: Biol-Psychiatry. 1999 May 15; 45(10): 1271-84
INTERNATIONAL STANDARD SERIAL NUMBER: 0006-3223
LANGUAGE: English
ABSTRACT: BACKGROUND: Previous investigations suggest that maltreated children with a diagnosis of posttraumatic stress disorder (PTSD) evidence alterations of biological stress systems. Increased levels of catecholaminergic neurotransmitters and steroid hormones during traumatic experiences in childhood could conceivably adversely affect brain development. METHODS: In this study, 44 maltreated children and adolescents with PTSD and 61 matched controls underwent comprehensive psychiatric and neuropsychological assessments and an anatomical magnetic resonance imaging (MRI) brain scan. RESULTS: PTSD subjects had smaller intracranial and cerebral volumes than matched controls. The total midsagittal area of corpus callosum and middle and posterior regions remained smaller; while right, left, and total lateral ventricles were proportionally larger than controls, after adjustment for intracranial volume. Brain volume robustly and positively correlated with age of onset of PTSD trauma and negatively correlated with duration of abuse. Symptoms of intrusive thoughts, avoidance, hyperarousal or dissociation correlated positively with ventricular volume, and negatively with brain volume and total corpus callosum and regional measures. Significant gender by diagnosis effect revealed greater corpus callosum area reduction in maltreated males with PTSD and a trend for greater cerebral volume reduction than maltreated females with PTSD. The predicted decrease in hippocampal volume seen in adult PTSD was not seen in these subjects. CONCLUSIONS: These data suggest that the overwhelming stress of maltreatment experiences in childhood is associated with adverse brain development.
ACCESSION NUMBER: 99278650
Record 84 of 193 in MEDLINE(R) on CD 1999 Part B
TITLE: Phenotype of blood lymphocytes in PTSD suggests chronic immune activation.
AUTHOR: Wilson,-S-N; van-der-Kolk,-B; Burbridge,-J; Fisler,-R; Kradin,-R
ADDRESS OF AUTHOR: Massachusetts General Hospital, Harvard Medical School, Boston, USA.
SOURCE: Psychosomatics. 1999 May-Jun; 40(3): 222-5
INTERNATIONAL STANDARD SERIAL NUMBER: 0033-3182
LANGUAGE: English
ABSTRACT: Patients with posttraumatic stress disorder (PTSD) have a past history of extremely stressful experience and often present with somatic complaints. Peripheral blood lymphocytes (PBL) of patients with PTSD associated with a history of childhood sexual abuse were examined for changes in immune phenotype. The ratio of CD45RO-positive to CD45RA-positive lymphocytes (CD45RO/CD45RA), an index of lymphocyte activation, was higher (P = 0.04) in the PTSD subjects than in the normal subjects. No differences were observed for the number of PBL or the representation of major T, B, or NK lymphocyte subsets. These findings suggest the presence of increased lymphocyte activation in the PBL of patients with PTSD.
ACCESSION NUMBER: 99273080
Record 85 of 193 in MEDLINE(R) on CD 1999 Part B
TITLE: Abnormal mismatch negativity in women with sexual assault-related posttraumatic stress disorder.
AUTHOR: Morgan,-C-A 3rd; Grillon,-C
ADDRESS OF AUTHOR: VA Connecticut Healthcare Systems, West Haven, Connecticut, USA.
SOURCE: Biol-Psychiatry. 1999 Apr 1; 45(7): 827-32
INTERNATIONAL STANDARD SERIAL NUMBER: 0006-3223
LANGUAGE: English
ABSTRACT: BACKGROUND: Disturbances in sensory processing have been hypothesized in individuals with posttraumatic stress disorder (PTSD). The authors investigated this possibility by using mismatch negativity (MMN), an event-related potential (ERP) that reflects the operation of a preconscious cortical detector of stimulus change. METHODS: Thirteen medication-free women with sexual assault-related PTSD were compared with 16 age-matched, healthy comparison women without PTSD. ERPs were elicited by regularly presented "standard" auditory stimuli and by infrequently occurring "deviant" auditory stimuli, which differed slightly in frequency. The MMN was identified in the subtraction waveforms as the difference between ERPs elicited by the deviant and standard stimuli. Group comparisons of P50, N1, P2, and N2 to the standard and to the deviant stimuli, and of the MMN in the subtraction waveform were performed. RESULTS: The amplitude of the MMN was significantly greater in the PTSD compared to the non-PTSD women. MMN was significantly correlated with the total Mississippi PTSD Symptom Scale score in the PTSD group. No significant group differences were noted in P50, N1, or P2 responding. Significant group differences in N2 were due to the increased MMN in PTSD subjects. CONCLUSIONS: The data provide evidence for abnormalities in preconscious auditory sensory memory in PTSD, whereas earlier studies have reported abnormalities in conscious processing. These data suggest an increased sensitivity to stimulus changes in PTSD and implicate the auditory cortex in the pathophysiology of the disorder.
ACCESSION NUMBER: 99218894
Record 86 of 193 in MEDLINE(R) on CD 1999 Part B
TITLE: Posttraumatic stress disorder in hospitalized adolescents: psychiatric comorbidity and clinical correlates.
AUTHOR: Lipschitz,-D-S; Winegar,-R-K; Hartnick,-E; Foote,-B; Southwick,-S-M
ADDRESS OF AUTHOR: Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
SOURCE: J-Am-Acad-Child-Adolesc-Psychiatry. 1999 Apr; 38(4): 385-92
INTERNATIONAL STANDARD SERIAL NUMBER: 0890-8567
LANGUAGE: English
ABSTRACT: OBJECTIVE: To describe the diagnostic comorbidity and clinical correlates of posttraumatic stress disorder (PTSD) in adolescent psychiatric inpatients. METHOD: Seventy-four adolescent inpatients were given a structured diagnostic interview, the revised version of the Diagnostic Interview for Children and Adolescents, and a battery of standard self-report measures to assess general trauma exposure, posttraumatic stress symptoms, suicidal behavior, dissociation, and depression. RESULTS: Ninety-three percent of subjects reported exposure to at least one traumatic event such as being a witness/victim of community violence, witnessing family violence, or being the victim of physical/sexual abuse. Thirty-two percent of subjects met diagnostic criteria for current PTSD, with sexual abuse cited as the most common traumatic stressor in 69% of PTSD cases. Girls were significantly more likely to develop PTSD than boys, although the total number of types of trauma did not differ by gender. Compared with psychiatric controls, male youngsters with PTSD were significantly more likely to have comorbid diagnoses of eating disorders, other anxiety disorders, and somatization disorder. Furthermore, male and female youngsters with PTSD were significantly more likely to have attempted suicide and report greater depressive and dissociative symptoms. CONCLUSION: In clinical populations of hospitalized adolescents exposed to multiple forms of trauma, PTSD is a common, but highly comorbid disorder. Specific multimodal assessments and treatments targeted to both PTSD and its comorbidity profile are warranted.
ACCESSION NUMBER: 99215322
Record 87 of 193 in MEDLINE(R) on CD 1999 Part B
TITLE: Regional cerebral blood flow during script-driven imagery in childhood sexual abuse-related PTSD: A PET investigation.
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 Psychiatry, Massachusetts General Hospital, Boston, USA. Ishin01@emerald.tufts.edu
SOURCE: Am-J-Psychiatry. 1999 Apr; 156(4): 575-84
INTERNATIONAL STANDARD SERIAL NUMBER: 0002-953X
LANGUAGE: English
ABSTRACT: OBJECTIVE: The purpose of this study was to determine whether anterior limbic and paralimbic regions of the brain are differentially activated during the recollection and imagery of traumatic events in trauma-exposed individuals with and without posttraumatic stress disorder (PTSD). METHOD: Positron emission tomography (PET) was used to measure normalized regional cerebral blood flow (CBF) in 16 women with histories of childhood sexual abuse: eight with current PTSD and eight without current PTSD. In separate script-driven imagery conditions, participants recalled and imagined traumatic and neutral autobiographical events. Psychophysiologic responses and subjective ratings of emotional state were measured for each condition. RESULTS: In the traumatic condition versus the neutral control conditions, both groups exhibited regional CBF increases in orbitofrontal cortex and anterior temporal poles; however, these increases were greater in the PTSD group than in the comparison group. The comparison group exhibited regional CBF increases in insular cortex and anterior cingulate gyrus; increases in anterior cingulate gyrus were greater in the comparison group than in the PTSD group. Regional CBF decreases in bilateral anterior frontal regions were greater in the PTSD group than in the comparison group, and only the PTSD group exhibited regional CBF decreases in left inferior frontal gyrus. CONCLUSIONS: The recollection and imagery of traumatic events versus neutral events was accompanied by regional CBF increases in anterior paralimbic regions of the brain in trauma-exposed individuals with and without PTSD. However, the PTSD group had greater increases in orbitofrontal cortex and anterior temporal pole, whereas the comparison group had greater increases in anterior cingulate gyrus.
ACCESSION NUMBER: 99216744
Record 88 of 193 in MEDLINE(R) on CD 1999 Part B
TITLE: Treating health concerns within the context of childhood sexual assault: a case study.
AUTHOR: Nayak,-M-B; Resnick,-H-S; Holmes,-M-M
ADDRESS OF AUTHOR: Department of Obstetrics/Gynecology, Medical University of South Carolina, Charleston 29401, USA. MNAYAK@HSC.KUNIV.EDU.KW
SOURCE: J-Trauma-Stress. 1999 Jan; 12(1): 101-9
INTERNATIONAL STANDARD SERIAL NUMBER: 0894-9867
LANGUAGE: English
ABSTRACT: A cognitive-behavioral treatment package used to treat physical health concerns and fears in a young adult woman with a history of child sexual assault is described. Treatment targeting health concerns was used as an adjunct to treatment for posttraumatic stress disorder (PTSD). Treatment included psychoeducation, systematic desensitization, and stress-innoculation training. The treatment helped reduce the patient's health concerns, including stomach cramps and fear of medical examinations. Theoretical issues underlying treatment of health concerns as related to PTSD avoidance behavior are discussed.
ACCESSION NUMBER: 99151207
Record 89 of 193 in MEDLINE(R) on CD 1999 Part B
TITLE: The effects of suppressing trauma-related thoughts on women with rape-related posttraumatic stress disorder.
AUTHOR: Shipherd,-J-C; Beck,-J-G
ADDRESS OF AUTHOR: Department of Psychology, State University of New York at Buffalo 14260, USA. shipherd@acsu.buffalo.edu
SOURCE: Behav-Res-Ther. 1999 Feb; 37(2): 99-112
INTERNATIONAL STANDARD SERIAL NUMBER: 0005-7967
LANGUAGE: English
ABSTRACT: A hallmark symptom of posttraumatic stress disorder (PTSD) is the presence of intrusive thoughts that come to mind against an individual's will and are frequently accompanied by considerable distress. This investigation examined the effects of deliberate suppression of rape-related thoughts on female sexual assault survivors, in order to explore this facet of PTSD. Seventeen women with chronic PTSD following a sexual assault were contrasted with nineteen survivors without PTSD, using a thought suppression paradigm (e.g. [Wegner, Schneider, Carter, & White (1987) Paradoxical effects of thought suppression. Journal of Personality and Social Psychology, 53 5-13]). Results indicated that PTSD participants experienced a rebound in the frequency of rape-related thoughts following deliberate suppression, whereas non-PTSD participants did not experience a rebound. Reported level of perceived controllability over rape-related thoughts for the PTSD participants was significantly lower during the suppression phase (as compared with the expression phase) relative to the non-PTSD participants. PTSD participants were significantly more anxious, depressed and distressed throughout the procedure relative to non-PTSD participants, although mood changes did not parallel the rebound effect found with rape-related thoughts in the PTSD group. Results are discussed in light of the role that intrusive thoughts may play in the maintenance of PTSD.
ACCESSION NUMBER: 99144553
Record 90 of 193 in MEDLINE(R) on CD 1999 Part B
TITLE: Perceived abuse and neglect as risk factors for suicidal behavior in adolescent inpatients.
AUTHOR: Lipschitz,-D-S; Winegar,-R-K; Nicolaou,-A-L; Hartnick,-E; Wolfson,-M; Southwick,-S-M
ADDRESS OF AUTHOR: National Center for PTSD, Psychiatry Service (116A), Connecticut Veterans' Affairs Medical Center, West Haven 06516, USA.
SOURCE: J-Nerv-Ment-Dis. 1999 Jan; 187(1): 32-9
INTERNATIONAL STANDARD SERIAL NUMBER: 0022-3018
LANGUAGE: English
ABSTRACT: The aim of this study was to assess relative risk of histories of different types of abuse (sexual, physical, and emotional) and neglect (physical and emotional) for suicidal behavior (attempts, ideation, and self-mutilation) in psychiatrically hospitalized adolescents. Seventy-one adolescent inpatients (34 boys, 37 girls) completed self-report measures of abuse and neglect, current suicidal ideation, and lifetime suicide and self-mutilation attempts. The prevalence of sexual and physical abuse was 37.5% and 43.7%, respectively, with 31.3% and 61% of youngsters reporting emotional and physical neglect. Fifty-one percent of youngsters had made suicide attempts, and 39% had self-mutilated. Suicide attempters were significantly more likely to be female, Latino, to report sexual, physical, and emotional abuse, and to endorse emotional neglect. In multivariate analyses, female gender, sexual abuse, and emotional neglect remained significant predictors of self-mutilation and suicidal ideation. Female gender and sexual abuse remained significant predictors of suicide attempts. These findings suggest that emotional neglect is an important and deleterious component of maltreatment experiences and may be a more powerful predictor of suicidal behavior in hospitalized adolescents than physical abuse, emotional abuse, and physical neglect.
ACCESSION NUMBER: 99135722
Record 91 of 193 in MEDLINE(R) on CD 1999 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
ADDRESS OF AUTHOR: University of Tulsa, School of Nursing, Oklahoma 74104, USA.
SOURCE: Int-J-Psychiatr-Nurs-Res. 1999 Oct; 5(2): 579-88
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 findings 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: 20199025
Record 92 of 193 in MEDLINE(R) on CD 1999 Part A
TITLE: Risk factors for rape, physical assault, and posttraumatic stress disorder in women: examination of differential multivariate relationships.
AUTHOR: Acierno,-R; Resnick,-H; Kilpatrick,-D-G; Saunders,-B; Best,-C-L
ADDRESS OF AUTHOR: National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston 29425-0142, USA. acierno@musc.edu
SOURCE: J-Anxiety-Disord. 1999 Nov-Dec; 13(6): 541-63
INTERNATIONAL STANDARD SERIAL NUMBER: 0887-6185
LANGUAGE: English
ABSTRACT: The National Women's Study, a 2-year, three-wave longitudinal investigation, employed a national probability sample of 3,006 adult women to: (a) identify separate risk factors for rape and physical assault, and (b) identify separate risk factors associated with post-rape posttraumatic stress disorder (PTSD) and post-physical assault PTSD. This investigation differed from previous studies in that it prospectively examined risk factors at the multivariate, as opposed to univariate level. Overall, past victimization, young age, and a diagnosis of active PTSD increased women's risk of being raped. By contrast, past victimization, minority ethnic status, active depression, and drug use were associated with increased risk of being physically assaulted. Risk factors for PTSD following rape included a history of depression, alcohol abuse, or experienced injury during the rape. However, risk factors for PTSD following physical assault included only a history of depression and lower education.
ACCESSION NUMBER: 20151231
Record 93 of 193 in MEDLINE(R) on CD 1999 Part A
TITLE: Interpersonal friction and PTSD in female victims of sexual and nonsexual assault.
AUTHOR: Zoellner,-L-A; Foa,-E-B; Brigidi,-B-D
ADDRESS OF AUTHOR: MCP Hahnemann University, Philadelphia, Pennsylvania 19129, USA. zoellner@auhs.edu
SOURCE: J-Trauma-Stress. 1999 Oct; 12(4): 689-700
INTERNATIONAL STANDARD SERIAL NUMBER: 0894-9867
LANGUAGE: English
ABSTRACT: This study examines the relationship among features of social relationships, both negative and positive, and later posttrauma pathology. Using a prospective design, 142 female victims of sexual or nonsexual assault were assessed at both 2 weeks and 3 months following the assault. We examined self-reported perceptions of how often the participant has been the recipient of socially supportive actions by others and how often the participant has been engaged in interpersonal friction with others. Degree of interpersonal friction shortly after the assault predicted PTSD severity 3 months later. On the contrary, positive social support did not predict later PTSD severity. These results are consistent with previous studies that underscore the association between negative features of social relationships and PTSD.
ACCESSION NUMBER: 20111656
Record 94 of 193 in MEDLINE(R) on CD 1999 Part A
TITLE: Reliability of reports of violent victimization and posttraumatic stress disorder among men and women with serious mental illness.
AUTHOR: Goodman,-L-A; Thompson,-K-M; Weinfurt,-K; Corl,-S; Acker,-P; Mueser,-K-T; Rosenberg,-S-D
ADDRESS OF AUTHOR: Counseling Psychology Program, School of Education, Boston College, MA 02467, USA. goodmalc@bc.edu
SOURCE: J-Trauma-Stress. 1999 Oct; 12(4): 587-99
INTERNATIONAL STANDARD SERIAL NUMBER: 0894-9867
LANGUAGE: English
ABSTRACT: Although violent victimization is highly prevalent among men and women with serious mental illness (SMI; e.g., schizophrenia, bipolar disorder), future research in this area may be impeded by controversy concerning the ability of individuals with SMI to report traumatic events reliably. This article presents the results of a study exploring the temporal consistency of reports of childhood sexual abuse, adult sexual abuse, and adult physical abuse, as well as current symptoms of posttraumatic stress disorder (PTSD) among 50 people with SMI. Results show that trauma history and PTSD assessments can, for the most part, yield reliable information essential to further research in this area. The study also demonstrates the importance of using a variety of statistical methods to assess the reliability of self-reports of trauma history.
ACCESSION NUMBER: 20111647
Record 95 of 193 in MEDLINE(R) on CD 1999 Part A
TITLE: Derivation of the SPAN, a brief diagnostic screening test for post-traumatic stress disorder.
AUTHOR: Meltzer-Brody,-S; Churchill,-E; Davidson,-J-R
ADDRESS OF AUTHOR: Department of Psychiatry, Duke University Medical Center, Anxiety and Traumatic Stress Program, Durham, NC 27710, USA.
SOURCE: Psychiatry-Res. 1999 Oct 18; 88(1): 63-70
INTERNATIONAL STANDARD SERIAL NUMBER: 0165-1781
LANGUAGE: English
ABSTRACT: The Davidson Trauma Scale (DTS) is a validated 17-item self-rating scale used in the diagnosis of post-traumatic stress disorder (PTSD), which is sensitive to the effects of treatment. It was felt that a shorter version of the scale might provide a better diagnostic screening tool. Subjects were drawn from a sample of 243 patients obtained from multiple cohorts that included a group of survivors of various forms of trauma, including natural disaster, rape and combat. All subjects had diagnostic assessments for PTSD with a clinical interview and completed the DTS. The data were randomly divided between two subsamples, and frequency and severity scores were calculated for the DTS. A four-item scale, the SPAN (named for its top four items: Startle, Physiological arousal, Anger, and Numbness), was developed. It demonstrated an efficiency of 0.88, sensitivity of 0.84, specificity of 0.91 and positive likelihood ratio of 9.1. In a replication sample, values were slightly lower but still acceptable (efficiency = 0.80). A subgroup of PTSD patients received either fluoxetine or placebo in a clinical trial, and a significant SPAN score improvement was observed on fluoxetine. The SPAN, which correlated significantly with the Impact of Events Scale, the Sheehan Disability Scale, and the Structured Interview of PTSD, was found to have a diagnostic accuracy of 88%.
ACCESSION NUMBER: 20104553
Record 96 of 193 in MEDLINE(R) on CD 1999 Part A
TITLE: Two-year follow-up study of cognitive behavioral therapy for sexually abused children suffering post-traumatic stress symptoms.
AUTHOR: Deblinger,-E; Steer,-R-A; Lippmann,-J
ADDRESS OF AUTHOR: University of Medicine and Dentistry of New Jersey, School of Osteopathic Medicine, Center for Children's Support, Stratford 08084, USA.
SOURCE: Child-Abuse-Negl. 1999 Dec; 23(12): 1371-8
INTERNATIONAL STANDARD SERIAL NUMBER: 0145-2134
LANGUAGE: English
ABSTRACT: OBJECTIVE: The present study sought to determine whether the 12-session pre- to posttest therapeutic gains that had been found by Deblinger, Lippmann. and Steer (1996) for an initial sample of 100 sexually abused children suffering posttraumatic stress disorder (PTSD) symptoms would be sustained 2 years after treatment. METHOD: These sexually abused children, along with their nonoffending mothers, had been randomly assigned to one of three cognitive-behavioral treatment conditions, child only, mother only, or mother and child, or a community comparison condition, and were followed for 3 months, 6 months, 1 year, and 2 years after treatment. RESULTS: A series of repeated MANCOVAs, controlling for the pre-test scores, indicated that for the three measures of psychopathology that had significantly decreased in the original study (i.e., externalizing behavior problems, depression, and PTSD symptoms), these measures at 3 months, 6 months, 1 year, and 2 years were comparable to the posttest scores. CONCLUSIONS: These findings suggest that the pre- to post-treatment improvements held across the 2-year follow-up period. The clinical and research implications of these findings are discussed.
ACCESSION NUMBER: 20090044
Record 97 of 193 in MEDLINE(R) on CD 1999 Part A
TITLE: Risk recognition and trauma-related symptoms among sexually revictimized women.
AUTHOR: Wilson,-A-E; Calhoun,-K-S; Bernat,-J-A
ADDRESS OF AUTHOR: Department of Psychology, University of Georgia, Athens 30602-3013, USA.
SOURCE: J-Consult-Clin-Psychol. 1999 Oct; 67(5): 705-10
INTERNATIONAL STANDARD SERIAL NUMBER: 0022-006X
LANGUAGE: English
ABSTRACT: This study used experimental methodology to investigate the differential impact of various levels of sexual victimization on women's perceptions of risk and evaluative judgments of sexual assault within a dating interaction. Single- and multiple-incident victims were compared with nonvictims. Results supported the hypothesis that revictimized women would exhibit longer latencies than either single-incident victims or nonvictims in signaling that an audiotaped date rape should be halted. Revictimized women with greater posttraumatic stress disorder (PTSD) symptoms, arousal symptoms in particular, exhibited latencies similar to those of nonvictims, whereas revictimized women with lower levels of PTSD symptoms had significantly longer latencies. Dissociative symptoms were not related to latency. These findings suggest that PTSD-related arousal symptoms may serve a buffering effect, increasing sensitivity to threat cues that portend a sexually coercive interaction.
ACCESSION NUMBER: 20005137
Record 98 of 193 in MEDLINE(R) on CD 1999 Part A
TITLE: Neural correlates of memories of childhood sexual abuse in women with and without posttraumatic stress disorder.
AUTHOR: Bremner,-J-D; Narayan,-M; Staib,-L-H; Southwick,-S-M; McGlashan,-T; Charney,-D-S
ADDRESS OF AUTHOR: Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, Conn., USA.
SOURCE: Am-J-Psychiatry. 1999 Nov; 156(11): 1787-95
INTERNATIONAL STANDARD SERIAL NUMBER: 0002-953X
LANGUAGE: English
ABSTRACT: OBJECTIVE: Childhood sexual abuse is very common in our society, but little is known about the long-term effects of abuse on brain function. The purpose of this study was to measure neural correlates of memories of childhood abuse in sexually abused women with and without the diagnosis of posttraumatic stress disorder (PTSD). METHOD: Twenty-two women with a history of childhood sexual abuse underwent injection of [15O]H2O, followed by positron emission tomography imaging of the brain while they listened to neutral and traumatic (personalized childhood sexual abuse events) scripts. Brain blood flow during exposure to traumatic and neutral scripts was compared for sexually abused women with and without PTSD. RESULTS: Memories of childhood sexual abuse were associated with greater increases in blood flow in portions of anterior prefrontal cortex (superior and middle frontal gyri-areas 6 and 9), posterior cingulate (area 31), and motor cortex in sexually abused women with PTSD than in sexually abused women without PTSD. Abuse memories were associated with alterations in blood flow in medial prefrontal cortex, with decreased blood flow in subcallosal gyrus (area 25), and a failure of activation in anterior cingulate (area 32). There was also decreased blood flow in right hippocampus, fusiform/inferior temporal gyrus, supramarginal gyrus, and visual association cortex in women with PTSD relative to women without PTSD. CONCLUSIONS: These findings implicate dysfunction of medial prefrontal cortex (subcallosal gyrus and anterior cingulate), hippocampus, and visual association cortex in pathological memories of childhood abuse in women with PTSD. Increased activation in posterior cingulate and motor cortex was seen in women with PTSD. Dysfunction in these brain areas may underlie PTSD symptoms provoked by traumatic reminders in subjects with PTSD.
ACCESSION NUMBER: 20019172
Record 99 of 193 in MEDLINE(R) on CD 1999 Part A
TITLE: Response to sexual assault: a relational perspective.
AUTHOR: Regehr,-C; Marziali,-E
ADDRESS OF AUTHOR: Faculty of Social Work, University of Toronto, Ontario, Canada.
SOURCE: J-Nerv-Ment-Dis. 1999 Oct; 187(10): 618-23
INTERNATIONAL STANDARD SERIAL NUMBER: 0022-3018
LANGUAGE: English
ABSTRACT: It has been suggested that although the severity of the stressor is the primary determinant of acute posttraumatic stress disorder (PTSD) symptoms, pre-existing personality patterns may be the primary contributors to the development of chronic PTSD symptomatology. The authors postulate that of the multiple personality factors that influence behavior and response to traumatic events, relational capacity or the ability to sustain interpersonal relationships provides an overarching construct for understanding the contribution of social contextual factors to post-trauma response. The results of this exploratory study support the authors' hypothesis that relational capacity is a significant factor in explaining persistent PTSD symptoms in a sample of adult women who have been raped. Significant correlations were found between measures of relational capacity, the Bell Object Relations Inventory and the Inventory of Interpersonal Problems and measures of distress, the Posttraumatic Symptom Scale, and the Beck Depression Inventory.
ACCESSION NUMBER: 20004313
Record 100 of 193 in MEDLINE(R) on CD 1999 Part A
TITLE: Commonality and specificity of personality disorder profiles in subjects with trauma histories.
AUTHOR: Shea,-M-T; Zlotnick,-C; Weisberg,-R-B
ADDRESS OF AUTHOR: Veterans Affairs Medical Center, Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, RI 02906, USA.
SOURCE: J-Personal-Disord. 1999 Fall; 13(3): 199-210
INTERNATIONAL STANDARD SERIAL NUMBER: 0885-579X
LANGUAGE: English
ABSTRACT: Recently, attention has been drawn to a range of disturbances in personality functioning that commonly characterize individuals with a history of severe or prolonged trauma. Many of these features overlap with criteria for some of the Axis II personality disorders. The current study investigated the similarity of personality disorder features in different samples of patients with trauma histories, and specificity of such features compared to other psychiatric samples. Profiles of Axis II features, based on relative frequencies of individual disorder "diagnoses" derived from a common measure (Personality Diagnostic Questionnaire-Revised), were compared in three trauma samples: male Vietnam combat veterans with PTSD, female inpatients with a history of childhood sexual abuse, and female outpatients with a history of childhood sexual abuse. The PDQ-R derived profiles in each of the three trauma samples were then compared with similar PDQ-R derived profiles in published reports of psychiatric samples selected for other diagnoses. Each of the three Spearman rank correlations among the three trauma samples were significant, ranging from .72 to .94. There was a clear pattern of higher correlations within the trauma samples (average correlation of .81) than between the trauma and nontrauma samples (average correlations of .11, .36, and .25 between the nontrauma samples and the combat sample, inpatient sexual abuse sample, and outpatient sexual abuse sample, respectively). The findings suggest that a pattern of personality disorder features may be distinctly associated with individuals with trauma histories, at least of the type examined here. Future studies using more clinically valid measures of personality features and including other types of trauma samples are needed to determine the generalizability of the current findings. Also needed are studies with longitudinal designs to address questions of causal pathways that may underlie such associations.
ACCESSION NUMBER: 99426322
Record 101 of 193 in MEDLINE(R) on CD 1999 Part A
TITLE: Prevention of post-rape psychopathology: preliminary findings of a controlled acute rape treatment study.
AUTHOR: Resnick,-H; Acierno,-R; Holmes,-M; Kilpatrick,-D-G; Jager,-N
ADDRESS OF AUTHOR: Medical University of South Carolina, National Crime Victims Research and Treatment Center, Charleston 29425-0742, USA.
SOURCE: J-Anxiety-Disord. 1999 Jul-Aug; 13(4): 359-70
INTERNATIONAL STANDARD SERIAL NUMBER: 0887-6185
LANGUAGE: English
ABSTRACT: Violent sexual assault such as rape typically results in extremely high levels of acute distress. The intensity of these acute psychological reactions may play a role in later recovery, with higher levels of immediate distress associated with poorer outcome. Unfortunately, post-rape forensic evidence collection procedures may serve to increase, rather than reduce initial distress, potentially exacerbating future psychopathology. To address these concerns, an acute time-frame hospital-based video intervention was developed to: (a) minimize anxiety during forensic rape exams, and (b) prevent post-rape posttraumatic stress disorder (PTSD), panic, and anxiety. Preliminary data indicated that (1) psychological distress at the time of the exam was strongly related to PTSD symptomatology 6 weeks post-rape, and (2) the video intervention successfully reduced distress during forensic exams.
ACCESSION NUMBER: 99431432
Record 102 of 193 in MEDLINE(R) on CD 1999 Part A
TITLE: Post-traumatic stress disorder in female survivors of rape attending a genitourinary medicine clinic: a pilot study.
AUTHOR: Petrak,-J-A; Campbell,-E-A
ADDRESS OF AUTHOR: Ambrose King Centre, Royal London Hospital, Whitechapel, UK. ambrose.king@dial.pipex.com
SOURCE: Int-J-STD-AIDS. 1999 Aug; 10(8): 531-5
INTERNATIONAL STANDARD SERIAL NUMBER: 0956-4624
LANGUAGE: English
ABSTRACT: This study describes psychological symptomatology including post-traumatic stress disorder (PTSD) in 19 women attending a specialist sexual assault service within a genitourinary medicine (GUM) clinic. Women were interviewed within one year post-rape (mean = 12 weeks) using standardized questionnaires for PTSD and other psychological symptomatology. Seventeen (89.5%) of 19 women met full criteria for a diagnosis of PTSD. Anxiety predominated amongst other psychological symptomatology. Suicidal ideation was reported by 8 women and one made a suicide attempt following the rape. Although it is acknowledged this is a small, select sample, the high level of psychological trauma found suggests that genitourinary medicine clinics providing for sexual assault require access to mental health professionals.
ACCESSION NUMBER: 99397704
Record 103 of 193 in MEDLINE(R) on CD 1999 Part A
TITLE: Memory functioning in adult women traumatized by childhood sexual abuse.
AUTHOR: Stein,-M-B; Hanna,-C; Vaerum,-V; Koverola,-C
ADDRESS OF AUTHOR: Department of Psychiatry, University of California, San Diego 92093-0985, USA.
SOURCE: J-Trauma-Stress. 1999 Jul; 12(3): 527-34
INTERNATIONAL STANDARD SERIAL NUMBER: 0894-9867
LANGUAGE: English
ABSTRACT: Memory impairment has been reported in some studies of patients with combat-related posttraumatic stress disorder (PTSD) and in rape victims with PTSD. The authors tested whether explicit memory impairment was evident in adult women who were traumatized by severe sexual abuse in childhood. The California Verbal Learning Test (Delis, Kramer, Kaplan, & Ober, 1987) and the Benton Visual Retention Task (Benton, 1974), were administered to 22 female adult survivors of childhood sexual trauma and to 20 demographically and educationally similar nonvictimized women. No evidence was found of explicit memory impairment in the abuse survivors. Furthermore, neither PTSD severity, dissociative symptom severity, nor extent of preexisting amnesia for childhood trauma contributed to the variance in memory functioning. Additional studies are needed to determine the extent to which impaired explicit memory functioning is a common feature of posttraumatic stress syndromes.