Record 25 of 193 in MEDLINE(R) on CD 2001
TITLE: Trauma-related sleep disturbance and self-reported physical health symptoms in treatment-seeking female rape victims.
AUTHOR: Clum,-G-A; Nishith,-P; Resick,-P-A
ADDRESS OF AUTHOR: Center for Trauma Recovery, University of Missouri-St. Louis, 63121, USA.
SOURCE: J-Nerv-Ment-Dis. 2001 Sep; 189(9): 618-22
INTERNATIONAL STANDARD SERIAL NUMBER: 0022-3018
LANGUAGE: English
ABSTRACT: The purpose of the study was to assess the relationship between trauma-related sleep disturbance and physical health symptoms in treatment-seeking female rape victims. A total of 167 participants were assessed for PTSD symptoms, depression, sleep disturbance, and frequency of self-reported health symptoms. Results demonstrated that trauma-related sleep disturbance predicted unique variance in physical health symptoms after other PTSD and depression symptoms were controlled. The findings suggest that trauma-related sleep disturbance is one potential factor contributing to physical health symptoms in rape victims with PTSD.
ACCESSION NUMBER: 21463720
Record 26 of 193 in MEDLINE(R) on CD 2001
TITLE: A prospective investigation of the role of cognitive factors in persistent posttraumatic stress disorder (PTSD) after physical or sexual assault.
AUTHOR: Dunmore,-E; Clark,-D-M; Ehlers,-A
ADDRESS OF AUTHOR: Department of Psychology, University of Surrey, Guildford, UK. e.dunmore@surrey.ac.uk
SOURCE: Behav-Res-Ther. 2001 Sep; 39(9): 1063-84
INTERNATIONAL STANDARD SERIAL NUMBER: 0005-7967
LANGUAGE: English
ABSTRACT: The effectiveness of psychological treatments for PTSD is likely to be enhanced by improved understanding of the factors involved in maintaining the disorder. Ehlers and Clark [A cognitive model of persistent posttraumatic stem disorder Behav. Res. Ther. 38 (2000) 319-345] recently proposed a cognitive model of maintenance. The current study aimed to investigate several cognitive factors highlighted in Ehlers and Clark's model using a prospective design. Fifty-seven victims of physical or sexual assault participated in the study. Cognitive factors were assessed within 4 months of assault and victims were followed-up 6 and 9 months after the assault. Cognitive variables which significantly predicted PTSD severity at both follow-ups were: cognitive processing style during assault (mental defeat, mental confusion, detachment); appraisal of assault sequelae (appraisal of symptoms, perceived negative responses of others, permanent change); negative beliefs about self and world; and maladaptive control strategies (avoidance/safety seeking). Relationships between early appraisals, control strategies, and processing styles and subsequent PTSD severity remained significant after statistically controlling for gender and perceived assault severity. These findings support the cognitive model of PTSD proposed by Ehlers and Clark and suggest that effective treatment will need to address these cognitive factors.
ACCESSION NUMBER: 21410826
Record 27 of 193 in MEDLINE(R) on CD 2001
TITLE: Women and traumatic events.
AUTHOR: Foa,-E-B; Street,-G-P
ADDRESS OF AUTHOR: Center for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia 19104, USA. foa@mail.med.upenn.edu
SOURCE: J-Clin-Psychiatry. 2001; 62 Suppl 17: 29-34
INTERNATIONAL STANDARD SERIAL NUMBER: 0160-6689
LANGUAGE: English
ABSTRACT: Posttraumatic stress disorder (PTSD) gained the status of a psychiatric disorder in 1980, although the syndrome had already been recognized widely for many years. PTSD is distinguished by alternations between reexperiencing of the traumatic event that triggered the PTSD in the first place and avoidance and numbing. Increased arousal (e.g., exaggerated startle reaction) also forms part of the diagnosis. Although the majority of trauma victims recover spontaneously, more than 30% develop persistent PTSD symptoms, with women being twice as likely as men to suffer PTSD. To date, the most studied psychosocial treatments for PTSD are the cognitive-behavioral interventions. Exposure therapy (systematic exposure to the traumatic memory in a safe environment) has been demonstrated to be quite effective with adult women who were sexually or nonsexually assaulted in adulthood as well as with women who were sexually abused in childhood. Supportive counseling does not appear as effective as exposure therapy, but is better than no therapy.
ACCESSION NUMBER: 21386066
Record 28 of 193 in MEDLINE(R) on CD 2001
TITLE: Patterns of recovery from trauma: the use of intraindividual analysis.
AUTHOR: Gilboa-Schechtman,-E; Foa,-E-B
ADDRESS OF AUTHOR: Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel. gilboae@mail.biu.ac.il
SOURCE: J-Abnorm-Psychol. 2001 Aug; 110(3): 392-400
INTERNATIONAL STANDARD SERIAL NUMBER: 0021-843X
LANGUAGE: English
ABSTRACT: Patterns of recovery from sexual and nonsexual assault were examined. Two studies containing data from female victims of these assaults were analyzed. In Study 1, victims (N = 101) underwent 12 weekly assessments with measures of posttraumatic stress disorder (PTSD), depression, and state anxiety. In Study 2, victims (N = 108) underwent monthly assessments on the same measures. The authors examined the effects of type of trauma and time of peak reaction on long-term recovery using intraindividual analysis of change. In both studies, initial and peak reactions of rape victims were more severe than were those of nonsexual assault victims on all measures of psychopathology. Victims with delayed peak reaction exhibited more severe pathology at the final assessment than did victims with early peak reaction. Results of Study 2 indicated a slower recovery rate from sexual than nonsexual assault; in Study 1 a similar pattern of recovery emerged. The advantages of an individual-focused, longitudinal approach to recovery from a trauma are discussed.
ACCESSION NUMBER: 21392992
Record 29 of 193 in MEDLINE(R) on CD 2001
TITLE: Imagery rehearsal therapy for chronic nightmares in sexual assault survivors with posttraumatic stress disorder: a randomized controlled trial.
AUTHOR: Krakow,-B; Hollifield,-M; Johnston,-L; Koss,-M; Schrader,-R; Warner,-T-D; Tandberg,-D; Lauriello,-J; McBride,-L; Cutchen,-L; Cheng,-D; Emmons,-S; Germain,-A; Melendrez,-D; Sandoval,-D; Prince,-H
ADDRESS OF AUTHOR: Sleep & Human Health Institute, 4775 Indian School Rd NE, Suite 305, Albuquerque, NM 87110, USA. bkrakow@salud.unm.edu
SOURCE: JAMA. 2001 Aug 1; 286(5): 537-45
INTERNATIONAL STANDARD SERIAL NUMBER: 0098-7484
LANGUAGE: English
ABSTRACT: CONTEXT: Chronic nightmares occur frequently in patients with posttraumatic stress disorder (PTSD) but are not usually a primary target of treatment. OBJECTIVE: To determine if treating chronic nightmares with imagery rehearsal therapy (IRT) reduces the frequency of disturbing dreams, improves sleep quality, and decreases PTSD symptom severity. DESIGN, SETTING, AND PARTICIPANTS: Randomized controlled trial conducted from 1995 to 1999 among 168 women in New Mexico; 95% had moderate-to-severe PTSD, 97% had experienced rape or other sexual assault, 77% reported life-threatening sexual assault, and 58% reported repeated exposure to sexual abuse in childhood or adolescence. INTERVENTION: Participants were randomized to receive treatment (n = 88) or to the wait-list control group (n = 80). The treatment group received IRT in 3 sessions; controls received no additional intervention, but continued any ongoing treatment. MAIN OUTCOME MEASURES: Scores on the Nightmare Frequency Questionnaire (NFQ), Pittsburgh Sleep Quality Index (PSQI), PTSD Symptom Scale (PSS), and Clinician-Administered PTSD Scale (CAPS) at 3- and 6-month follow-up. RESULTS: A total of 114 participants completed follow-up at 3 and/or 6 months. Comparing baseline to follow-up (n = 97-114), treatment significantly reduced nights per week with nightmares (Cohen d = 1.24; P<.001) and number of nightmares per week (Cohen d = 0.85; P<.001) on the NFQ and improved sleep (on the PSQI, Cohen d = 0.67; P<.001) and PTSD symptoms (on the PSS, Cohen d = 1.00; P<.001 and on the CAPS, Cohen d = 1.53; P<.001). Control participants showed small, nonsignificant improvements for the same measures (mean Cohen d = 0.21). In a 3-point analysis (n = 66-77), improvements occurred in the treatment group at 3-month follow-up (treatment vs control group, Cohen d = 1.15 vs 0.07 for nights per week with nightmares; 0.95 vs -0.06 for nightmares per week; 0.77 vs 0.31 on the PSQI, and 1.06 vs 0.31 on the PSS) and were sustained without further intervention or contact between 3 and 6 months. An intent-to-treat analysis (n = 168) confirmed significant differences between treatment and control groups for nightmares, sleep, and PTSD (all P<.02) with moderate effect sizes for treatment (mean Cohen d = 0.60) and small effect sizes for controls (mean Cohen d = 0.14). Posttraumatic stress symptoms decreased by at least 1 level of clinical severity in 65% of the treatment group compared with symptoms worsening or not changing in 69% of controls (chi(2)(1) = 12.80; P<.001). CONCLUSIONS: Imagery rehearsal therapy is a brief, well-tolerated treatment that appears to decrease chronic nightmares, improve sleep quality, and decrease PTSD symptom severity.
ACCESSION NUMBER: 21370100
Record 30 of 193 in MEDLINE(R) on CD 2001
TITLE: Determinants of risk behavior for human immunodeficiency virus/acquired immunodeficiency syndrome in people with severe mental illness.
AUTHOR: Rosenberg,-S-D; Trumbetta,-S-L; Mueser,-K-T; Goodman,-L-A; Osher,-F-C; Vidaver,-R-M; Metzger,-D-S
ADDRESS OF AUTHOR: New Hampshire-Dartmouth Psychiatric Research Center, Lebanon, NH 03766, USA.
SOURCE: Compr-Psychiatry. 2001 Jul-Aug; 42(4): 263-71
INTERNATIONAL STANDARD SERIAL NUMBER: 0010-440X
LANGUAGE: English
ABSTRACT: We examined the prevalence and correlates of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) risk behaviors in a large sample of severely mentally ill (SMI) patients. Risk levels were correlated with demographic factors, diagnosis, symptom severity, trauma history, post-traumatic stress disorder (PTSD), substance use disorder (SUD), and sexual orientation. SMI clients from urban and rural settings (N = 275) were assessed regarding HIV/AIDS risk behaviors, and hypothesized risk factors. Patients exhibited substantial levels of risky behavior, particularly sexual risk. Correlates of increased risk included SUD, trauma, male homosexual orientation, younger age, and symptom severity. Structural equation modeling identified SUD and sexual orientation as the primary determinants of both drug and sexual risk behavior. We conclude that specific illness related variables appear to have less impact on risk behavior among people with SMI than previously hypothesized. Substance abuse prevention and treatment may be the most effective means of reducing HIV risk in this population. Copyright 2001 by W.B. Saunders Company
ACCESSION NUMBER: 21349833
Record 31 of 193 in MEDLINE(R) on CD 2001
TITLE: The impact of borderline personality disorder on process group outcome among women with posttraumatic stress disorder related to childhood abuse.
AUTHOR: Cloitre,-M; Koenen,-K-C
ADDRESS OF AUTHOR: Department of Psychiatry, Joan and Sanford Weill Medical College of Cornell University, USA. mcloitre@med.cornell.edu
SOURCE: Int-J-Group-Psychother. 2001 Jul; 51(3): 379-98
INTERNATIONAL STANDARD SERIAL NUMBER: 0020-7284
LANGUAGE: English
ABSTRACT: The outcome of a 12-week interpersonal process group therapy for women with postraumatic Stress Disorder (PTSD) related to childhood sexual abuse with and without borderline personality disorder (BPD) was assessed by comparing three naturally occurring treatment conditions: groups that did not have any members with borderline personality disorder (BPD-) (n = 18), groups in which at least one member carried the diagnosis (BPD+)(n = 16), and a 12-week waitlist (WL) (n = 15). PTSD, anger, depression, and other symptoms were significantly reduced in the BPD- groups. However, the BPD+ and WL conditions did not show any pre- to posttreatment improvements. Furthermore, the BPD+ condition showed a significant worsening on measures of anger. Analyses within the BPD+ condition indicated that women with and without the diagnosis experienced equal posttreatment increases in anger problems. These latter results suggest the presence of an anger "contagion" effect. That is, women without BPD did well in the BPD- groups but showed increased anger similar to the BPD+ women when treated in groups with them. Implications for client-treatment matching considerations in PTSD group therapy are discussed.
ACCESSION NUMBER: 21341136
Record 32 of 193 in MEDLINE(R) on CD 2001
TITLE: Psychopathology of sexual abuse in young people with intellectual disability.
AUTHOR: Firth,-H; Balogh,-R; Berney,-T; Bretherton,-K; Graham,-S; Whibley,-S
ADDRESS OF AUTHOR: Child Adolescent and Autism Service, Northgate and Prudhoe NHS Trust, Prudhoe Hospital, Prudhoe, Northumberland, UK.
SOURCE: J-Intellect-Disabil-Res. 2001 Jun; 45(Pt 3): 244-52
INTERNATIONAL STANDARD SERIAL NUMBER: 0964-2633
LANGUAGE: English
ABSTRACT: The present study addressed two issues using a sample of child and adolescent victims and perpetrators of sexual abuse: (1) the extent of post-traumatic stress disorder (PTSD) in the sample; and (2) the possible distinction between perpetrators whose motivations were sexually impulsive, and those who were controlling and abuse-reactive. Retrospective case material from 43 cases (21 victims only, and 22 perpetrators, of whom 16 were also victims) provided the data. Post-traumatic symptomatology was not common. Only one case of PTSD was found. Perpetrators could be distinguished by whether they had suffered sexual abuse alone, sexual and physical abuse, or neither. The proposed distinction between perpetrators received support. Sexual abuse directed at younger victims was associated with earlier experience of multiple forms of abuse. The present data does not support the view that post-traumatic symptoms following victimization are a mediator of sexual abuse perpetration. It is argued that an elaboration of the Williams & New developmental model of perpetration better fits the data.
ACCESSION NUMBER: 21316733
Record 33 of 193 in MEDLINE(R) on CD 2001
TITLE: Stability of emotions for traumatic memories in acute and chronic PTSD.
AUTHOR: Zoellner,-L-A; Sacks,-M-B; Foa,-E-B
ADDRESS OF AUTHOR: Center for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia 19104, USA. zoellner@mail.med.upenn.edu
SOURCE: Behav-Res-Ther. 2001 Jun; 39(6): 697-711
INTERNATIONAL STANDARD SERIAL NUMBER: 0005-7967
LANGUAGE: English
ABSTRACT: While memory for central factual information regarding an emotional event is considered to be relatively accurate, memory for emotions seem to be quite inaccurate (Christianson & Safer, 1995). We extended this line of research to examine memory for the emotional intensity surrounding a traumatic event (e.g., memory for the fear and horror of the event). We conducted a series of two studies. In Study 1, we examined memory for the emotional intensity of the traumatic event in recent sexual or non-sexual assault victims with acute PTSD at 2 and 12 weeks following the assault. In Study 2, we compared memory for emotional intensity in sexual and non-sexual assault victims with either acute or chronic PTSD at initial assessment and 12 weeks later. For both studies, participants were asked to recall general emotional intensity, fear intensity, and dissociative intensity of the traumatic event. Results suggested that memory for the fear of the traumatic event did not fluctuate over time. However, memory for the general emotional and dissociative intensity did fluctuate over time, decreasing for individuals with acute PTSD and increasing for individuals with chronic PTSD.
ACCESSION NUMBER: 21293556
Record 34 of 193 in MEDLINE(R) on CD 2001
TITLE: Evaluation of the German version of the PTSD Symptom Scale (PSS).
AUTHOR: Stieglitz,-R-D; Frommberger,-U; Foa,-E-B; Berger,-M
ADDRESS OF AUTHOR: Department of Psychiatry and Psychotherapy, University of Freiburg, Germany. rstieglitz@uhbs.ch
SOURCE: Psychopathology. 2001 May-Jun; 34(3): 128-33
INTERNATIONAL STANDARD SERIAL NUMBER: 0254-4962
LANGUAGE: English
ABSTRACT: The psychometric properties of the PTSD Symptom Scale (PSS) were evaluated in a clinical sample of severely injured in-patients after a traffic accident (n = 123). The PSS contains 17 items which were derived from the DSM-III-R criteria of posttraumatic stress disorder (PTSD). The results indicate that the PSS has satisfactory reliability and validity (internal and external). The results are in correspondence with the results of Foa et al. using a sample of rape and non-sexual-assault patients. Copyright 2001 S. Karger AG, Basel
ACCESSION NUMBER: 21216927
Record 35 of 193 in MEDLINE(R) on CD 2001
TITLE: Post-traumatic stress disorder in extremely poor women: implications for health care clinicians.
AUTHOR: Bassuk,-E-L; Dawson,-R; Perloff,-J; Weinreb,-L
ADDRESS OF AUTHOR: Better Homes Fund, 181 Wells Ave, Newton, MA 02459, USA.
SOURCE: J-Am-Med-Womens-Assoc. 2001 Spring; 56(2): 79-85
INTERNATIONAL STANDARD SERIAL NUMBER: 0098-8421
LANGUAGE: English
ABSTRACT: OBJECTIVES: To identify childhood antecedents for lifetime post-traumatic stress disorder (PTSD) and to determine how this diagnosis relates to health and service use among extremely poor women. METHODS: We conducted a secondary data analysis of 425 women in the Worcester Family Research Project, a case-control longitudinal study of 220 sheltered homeless and 216 extremely poor housed (never homeless) women in Worcester, Massachusetts. RESULTS: We found that extremely poor women with lifetime PTSD were more likely to have grown up in family environments of violence, threat, and anger than those without PTSD. The strongest risk factor for PTSD was childhood sexual abuse with threat. Low-income women with lifetime PTSD had more bodily pain, even when controlling for other health and demographic factors. Women with PTSD experienced more chronic health conditions and had more problematic relationships with their health care providers and perceived more barriers to care. CONCLUSION: Many low-income women have difficulty using medical care appropriately because of childhood histories of physical and sexual abuse, the subsequent development of post-trauma responses, and structural barriers to care. Given these factors, it is critical that health care clinicians routinely screen for histories of violence and PTSD and develop treatment plans that ensure safety, link current symptoms with prior experiences, and provide support as necessary. A team approach coordinated by a case manager may be the best strategy. Without routine screening for PTSD and sensitive treatment, many extremely poor women will receive compromised health care and may even be retraumatized.
ACCESSION NUMBER: 21224744
Record 36 of 193 in MEDLINE(R) on CD 2001
TITLE: Violent traumatic events and drug abuse severity.
AUTHOR: Clark,-H-W; Masson,-C-L; Delucchi,-K-L; Hall,-S-M; Sees,-K-L
ADDRESS OF AUTHOR: Department of Psychiatry, Langley Porter Psychiatric Institute, University of California-San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA. wclark@samhsa.gov
SOURCE: J-Subst-Abuse-Treat. 2001 Mar; 20(2): 121-7
INTERNATIONAL STANDARD SERIAL NUMBER: 0740-5472
LANGUAGE: English
ABSTRACT: We examined the occurrence of violent traumatic events, DSM-III-R diagnosis of posttraumatic stress disorder (PTSD), and PTSD symptoms, and the relationship of these variables to drug abuse severity. One-hundred fifty opioid-dependent drug abusers who were participants in a randomized trial of two methadone treatment interventions were interviewed using the Diagnostic Interview Schedule, the Addiction Severity Index, and the Beck Depression Inventory. Twenty-nine percent met diagnostic criteria for PTSD. With the exception of rape, no gender differences in the prevalence of violent traumatic events were observed. The occurrence of PTSD-related symptoms was associated with greater drug abuse severity after controlling for gender, depression, and lifetime diagnosis of PTSD. The high rate of PTSD among these methadone patients, the nature of the traumatic events to which they are exposed, and subsequent violence-related psychiatric sequelae have important implications for identification and treatment of PTSD among those seeking drug abuse treatment.
ACCESSION NUMBER: 21203765
Record 37 of 193 in MEDLINE(R) on CD 2001
TITLE: SSRI and mirtazapine in PTSD.
AUTHOR: Good,-C; Petersen,-C
SOURCE: J-Am-Acad-Child-Adolesc-Psychiatry. 2001 Mar; 40(3): 263-4
INTERNATIONAL STANDARD SERIAL NUMBER: 0890-8567
LANGUAGE: English
ACCESSION NUMBER: 21182392
Record 38 of 193 in MEDLINE(R) on CD 2001
TITLE: Affect management in group therapy for women with posttraumatic stress disorder and histories of childhood sexual abuse.
AUTHOR: Wolfsdorf,-B-A; Zlotnick,-C
ADDRESS OF AUTHOR: Brown University School of Medicine, USA. wolfsdorf.barbara@boston.va.gov
SOURCE: J-Clin-Psychol. 2001 Feb; 57(2): 169-81
INTERNATIONAL STANDARD SERIAL NUMBER: 0021-9762
LANGUAGE: English
ABSTRACT: Affect dysregulation is pervasive among women with histories of childhood sexual abuse. It is an important aspect of the clinical presentation of posttraumatic stress disorder (PTSD), a disorder that frequently characterizes survivors of childhood abuse. Based on distinctions between approach and avoidance orientations to coping, there is controversy regarding whether initial treatment for trauma survivors should employ an exposure-based approach to increase affect or an affect-management approach to reduce it. In this article, we review theoretical and empirical literature regarding affect dysregulation and its relations with childhood sexual abuse and PTSD. We then describe a new affect-management group for adult survivors of childhood sexual abuse that is based on a stage approach to the treatment of trauma. This group emphasizes skill acquisition, symptom reduction, and patient stabilization. Affect-management strategies such as mindfulness, crisis planning, and challenging distorted thinking are presented to patients. Preliminary research findings support the use of this treatment.
ACCESSION NUMBER: 21156076
Record 39 of 193 in MEDLINE(R) on CD 2001
TITLE: Early sexual abuse and low cortisol.
AUTHOR: King,-J-A; Mandansky,-D; King,-S; Fletcher,-K-E; Brewer,-J
ADDRESS OF AUTHOR: Department of Psychiatry, University of Massachusetts Medical School, Worcester 01655, USA. Jean.King@umassmed.edu
SOURCE: Psychiatry-Clin-Neurosci. 2001 Feb; 55(1): 71-4
INTERNATIONAL STANDARD SERIAL NUMBER: 1323-1316
LANGUAGE: English
ABSTRACT: Post-traumatic stress disorder (PTSD) is a mental health disorder precipitated by a stressful event that produces fear or terror in the individual. Post-traumatic stress disorder studies, particularly in early sexual abuse, have been associated with neuroendocrine dysfunction, most notably the hypothalamic-pituitary-adrenal (HPA) axis. Since the literature on PTSD and neuroendocrine factors in young subjects has been sparse, the present studies were designed to look at the basal functioning of the HPA axis in response to early sexual abuse in girls aged 5 to 7 years. Morning salivary samples were collected for cortisol determination from subjects and controls who were scheduled for a physical exam by their pediatrician. The present study shows that subjects who had been abused within the last couple of months had significantly lower cortisol in comparison to control subjects (age, social economic status and race matched). The data suggest that children may have an impaired HPA axis after early trauma.
ACCESSION NUMBER: 21130591
Record 40 of 193 in MEDLINE(R) on CD 2001
TITLE: A meta-analysis of the published research on the effects of child sexual abuse.
AUTHOR: Paolucci,-E-O; Genuis,-M-L; Violato,-C
ADDRESS OF AUTHOR: National Foundation for Family Research and Education, Calgary, Canada. eoddone@acs.ucalgary.ca
SOURCE: J-Psychol. 2001 Jan; 135(1): 17-36
INTERNATIONAL STANDARD SERIAL NUMBER: 0022-3980
LANGUAGE: English
ABSTRACT: A meta-analysis of the published research on the effects of child sexual abuse (CSA) was undertaken for 6 outcomes: posttraumatic stress disorder (PTSD), depression, suicide, sexual promiscuity, victim-perpetrator cycle, and poor academic performance. Thirty-seven studies published between 1981 and 1995 involving 25,367 people were included. Many of the studies were published in 1994 (24; 65%), and most were done in the United States (22; 59%). All six dependent variables were coded, and effect sizes (d) were computed for each outcome. Average unweighted and weighted ds for each of the respective outcome variables were .50 and .40 for PTSD, .63 and .44 for depression, .64 and .44 for suicide, .59 and .29 for sexual promiscuity, .41 and .16 for victim-perpetrator cycle, and .24 and .19 for academic performance. A file drawer analysis indicated that 277 studies with null ds would be required to negate the present findings. The analyses provide clear evidence confirming the link between CSA and subsequent negative short- and long-term effects on development. There were no statistically significant differences on ds when various potentially mediating variables such as gender, socioeconomic status, type of abuse, age when abused, relationship to perpetrator, and number of abuse incidents were assessed. The results of the present meta-analysis support the multifaceted model of traumatization rather than a specific sexual abuse syndrome of CSA.
ACCESSION NUMBER: 21130565
Record 41 of 193 in MEDLINE(R) on CD 2001
TITLE: Factors predicting PTSD, depression, and dissociative severity in female treatment-seeking childhood sexual abuse survivors.
AUTHOR: Johnson,-D-M; Pike,-J-L; Chard,-K-M
ADDRESS OF AUTHOR: Department of Educational and Counseling Psychology, University of Kentucky, Lexington 40506-0017, USA.
SOURCE: Child-Abuse-Negl. 2001 Jan; 25(1): 179-98
INTERNATIONAL STANDARD SERIAL NUMBER: 0145-2134
LANGUAGE: English
ABSTRACT: OBJECTIVE: Two main questions were asked: (1) what abuse characteristics relate to PTSD, depressive, and dissociative severity in adult survivors of child sexual abuse (CSA); and (2) what abuse characteristics influence the severity of dissociation during CSA. METHOD: 89 female CSA survivors' current symptoms of PTSD, depression, and dissociation were assessed with standardized measures. Additionally, abuse characteristics (e.g., age of onset, peritraumatic dissociation) were assessed with a structured interview. RESULTS: Correlational analyses indicated that peritraumatic dissociation was most strongly related to all three types of symptom severity. Additional posthoc correlational analyses revealed that women who experienced penile penetration, believed someone/thing else would be killed, and/or were injured as a result of the abuse exhibited more severe peritraumatic dissociation. Regression analyses indicated that peritraumatic dissociation was the only variable to significantly predict symptom severity across symptom type or disorder. Furthermore, different abuse characteristics predicted adult symptom severity and peritraumatic dissociation. CONCLUSIONS: The relation between peritraumatic dissociation and adult symptomatology was most intriguing and has two main clinical implications: (1) teaching engagement strategies to some CSA survivors in hopes of containing dissociative symptoms immediately following the abuse and (2) the inclusion of exposure-based interventions in the treatment of some adult CSA survivors where indicated.
ACCESSION NUMBER: 21082754
Record 42 of 193 in MEDLINE(R) on CD 2001
TITLE: Treatment of reactivated post-traumatic stress disorder. Imaginal exposure in an older adult with multiple traumas.
AUTHOR: Russo,-S-A; Hersen,-M; Van-Hasselt,-V-B
ADDRESS OF AUTHOR: Nova Southeastern University, USA.
SOURCE: Behav-Modif. 2001 Jan; 25(1): 94-115
INTERNATIONAL STANDARD SERIAL NUMBER: 0145-4455
LANGUAGE: English
ABSTRACT: A single-case analysis was used to assess the effects of imaginal exposure in a 57-year-old woman suffering from current and reactivated post-traumatic stress disorder (PTSD) following a transient ischemic attack. The client's responses to self-reported depression, anxiety, and PTSD symptoms were repeatedly recorded during four phases: (a) initial psychotherapy, (b) imaginal exposure, (c) skill generalization, and (d) fading of treatment. In addition to dramatic reduction in levels of depression and anxiety, results showed a significant improvement in PTSD symptoms relating to recent and remote traumatic experiences. Improvements were maintained approximately 16 months after imaginal exposure ended, despite ongoing external stressors.
ACCESSION NUMBER: 21025962