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Biomedical subjects

A E Norwood

Publications and source records attributed to A E Norwood.

15 recordsLinked to original sources
PubMed2001

Psychological effects of biological warfare.

We compare and contrast psychological and behavioral reactions to bioterrorism with responses to the use of traditional and chemical weapons by terrorists. We discuss the characteristics of biological agents that make them potent agents of terror. We suggest strategies for preparation and response to bioterrorism. We reviewed the literature on psychological, behavioral, and social responses to terrorism, natural disasters, and infectious disease outbreaks. The first psychiatric intervention is to ensure good medical care for illness. Initial psychosocial interventions also include effective and accurate risk communication, management of misattribution of somatic symptoms, and the creation of a recovery environment that restores effective social roles and returns people to their usual sources of social support. Bioterrorism presents special challenges for our society. Domestic bioterrorism preparedness and response plans should reflect realistic consideration of psychological, behavioral, and societal reactions to this novel weapon.

Behavior↗
PubMed2001

The emotional impact of injury following an international terrorist incident.

BACKGROUND: Terrorism represents a major public health threat throughout the world. Bombings of the United States Embassies in East Africa in 1998 resulted in extensive physical and emotional casualties. METHODS: This study examined posttraumatic stress reactions, worry, and feelings of safety in the workplace in the context of injury in a convenience sample of 21 individuals directly exposed to the bombing in Dar es Salaam, Tanzania. Eight months postbombing, participants completed a self-report instrument examining demographics, exposure, injury, initial reaction, posttraumatic stress, worry, and feelings of safety in the workplace. Descriptive statistics and multiple regression were used to analyze the data. The "Impact of Event Scale-Revised" measured current posttraumatic stress. RESULTS: Report of injury predicted posttraumatic stress, intrusion, and arousal but not avoidance/numbing. Injury and intrusion were significant predictors of ongoing worry. CONCLUSIONS: Even relatively minor injury may be associated with ongoing posttraumatic stress and worry. The participants in the sample were all highly exposed which, along with the small sample size, may have limited the ability to establish other expected relationships.

Adult↗
PubMed2000

Disaster psychiatry: principles and practice.

Increasingly, trauma and disasters are part of everyday life. Psychiatrists can play an important role in assisting individuals and communities to recover. They bring a unique set of skills and experiences that can be invaluable in minimizing morbidity and facilitating recovery. This paper discusses psychological, physiological, behavioral, and community responses encountered in the aftermath of a disaster. A preventive medicine model of understanding disaster response is discussed in which the psychiatrist delineates traumatic stressors and high-risk populations. The importance of psychiatric participation in disaster preparedness is emphasized. Psychiatric interventions targeted at the various longitudinal phases of disaster response are reviewed.

Disaster Planning↗
PubMed2000

Deployment and the probability of spousal aggression by U.S. Army soldiers.

OBJECTIVE: To determine the relationship between length of soldier deployment and self-reports of moderate and severe spousal violence. METHODS: The Conflict Tactics Scale was used to measure self-reports of behaviors exhibited in marital conflict. Surveys were administered to a 15% random sample of 26,835 deployed and nondeployed married active duty U.S. Army men and women in the 50 United States during the period 1990 to 1994. Multinomial logistic regression and ordered probit analysis were used to estimate the probabilities of moderate and severe violence by length of deployment. RESULTS: After controlling for demographic variables, the probability of severe aggression was significantly greater for soldiers who had deployed in the past year compared with soldiers who had not deployed. CONCLUSIONS: Deployment contributes a significant but small increase to the probability of self-reported spousal aggression during a 1-year period. Although deployment is a military operation, similar effects may be observed in certain civilian occupations.

Adult↗
PubMed2000

Spouse abuse recidivism in the U.S. Army by gender and military status.

Recidivism by spouse abusers was investigated using records of offenders in the U.S. Army Central Registry. Recidivism by gender and military status (active-duty or civilian spouse) was compared over a 70-month period. Between fiscal years 1989-1997, 48,330 offenders were identified in initial and recidivist incidents. Recidivism was analyzed by means of a Cox proportional hazard rate model, controlling for age, race, number of dependents, education, and substance abuse. Two different sets of survival curves were obtained: (a) Men were much more likely than women to have a recurrence and (b) within gender, civilians were more likely to have a recurrence than were active-duty military personnel. At 70 months, 30% of the male civilian offenders and 27% of the male active-duty offenders had committed a subsequent spouse abuse incident compared with 20% of the female civilian offenders and 18% of the female active-duty offenders, controlling for other variables.

Adult↗
PubMed1999

Trends in child maltreatment in the US Army, 1975-1997.

OBJECTIVE: To examine trends by year in reports of victims of child maltreatment in the US Army Central Registry (ACR) during the period 1975-97. We report the rates/1,000 children of Army families of initial substantiated cases from 1988-97 and the number of cases of maltreatment as a percentage of total victims for each year from 1975-97. Army data are compared to published reports from military service child abuse registries. METHODS: Numbers of cases of child maltreatment for each year were obtained from the ACR for major, minor, and total physical abuse, sexual abuse, emotional abuse, and neglect. Population figures for numbers of children were obtained from the Defense Manpower Data Center. RESULTS: The rates/1,000 for neglect have decreased by 24% from 1991-97, although the decrease has not been steady. The rates/1,000 of minor physical abuse declined 28% from 1993-97. The rates/1,000 of major physical abuse were basically unchanged from 1988-96, although the highest rate was recorded in 1997. The rates/1,000 of sexual abuse were also basically unchanged with the exception of increases in 1992-94 after which time the rates/1,000 returned to the pre-1992 levels. The rates/1,000 of emotional abuse cases more than doubled from 1988-97. CONCLUSIONS: While minor physical abuse and neglect have shown decreases over the past decade, major physical abuse has remained virtually unchanged and sexual and emotional abuse have shown fluctuations. All these forms of maltreatment are challenges to the Army Family Advocacy Program.

Child↗
PubMed1999

Reports of spouse abuse in the U.S. Army Central Registry (1989-1997).

OBJECTIVE: To report the distributions and characteristics of spouse abuse victims and offenders in the U.S. Army Central Registry from 1989 to 1997. METHOD: Case and population data were tabulated using SAS procedures. RESULTS: There were 61,827 initial substantiated cases, 5,772 subsequent incidents, and 3,921 reopened cases. Victim rates varied between 8 and 10.5 per 1,000 married persons. About 82% of victims and offenders were between the ages of 18 and 31 years. The racial distribution of married active duty white and black victims and offenders was greatly different from that of the married active duty population. The proportion of female victims increased from initial (67%) to subsequent (71%) to reopened cases (75%). CONCLUSIONS: U.S. military populations provide unique opportunities to study family violence because of the socioeconomic "floor" under service members and their families. Comparisons between military and civil populations on precipitating circumstances, case assessment and definition, and treatment efficacy would be fruitful areas for research.

Adolescent↗
PubMed1997

The threat of biological weapons. Prophylaxis and mitigation of psychological and social consequences.

The microbial world is mysterious, threatening, and frightening to most people. The stressors associated with a biological terrorist attack could create high numbers of acute and potentially chronic psychiatric casualties who must be recognized, diagnosed, and treated to facilitate triage and medical care. Media communications, planning for quarantine and decontamination, and the role of community leaders are important to the mitigation of psychological consequences. Physicians will need to accurately diagnose anxiety, depression, bereavement, and organic brain syndromes to provide treatment, reassurance, and the relief of pain.

Biological Warfare↗
PubMed1997

Psychiatric morbidity in medical and surgical patients evacuated from the Persian Gulf War.

Acute treatment records of all medical and surgical patients evacuated to Walter Reed Army Medical Center in Washington, D.C., from the Persian Gulf theater (N = 161) were examined to better understand the relationship of injury to psychiatric symptoms. A total of 110 (68 percent) sustained a traumatic injury. They were significantly more likely to have an axis I disorder or psychiatric symptoms of concern than participants in the Persian Gulf War who did not sustain traumatic injuries but who were evacuated for medical conditions. The results indicate that traumatically injured veterans are at greater risk of psychiatric symptoms than veterans who are not injured and that they should be referred for psychiatric evaluation.

Adolescent↗
PubMed1997

Health effects of the stressors of extreme environments on military women.

This article examines the health effects of generic and unique stressors on military women's health. It is an outgrowth of work performed under the Defense Women's Health Research Program and participation in the Forum on the Health of Women in the Military held at the Uniformed Services University of the Health Sciences on June 17 to 19, 1996. We review gender differences in the effects of stress on health. We comment on some of the methodological challenges in researching gender effects. We hypothesize about some of the ways in which military women may be more vulnerable to specific stressors and/or use different coping strategies than their male counterparts. Finally, we make recommendations about military training and future research.

Adaptation, Psychological↗
PubMedDate not supplied

Psychiatric dimensions of disaster: patient care, community consultation, and preventive medicine.

The majority of persons exposed to a disaster do well and have only mild, transitory symptoms. However, some individuals develop psychiatric illness postdisaster. Such illnesses include those that are secondary to physical injury and sickenss as well as specific trauma-related psychiatric disorders such as acute stress disorder. The extent of the psychiatric morbidity and mortality that develops in individuals in the community depends on the type of disaster, the degree of injury sustained, the amount of life threat, and the duration of community disruption. In this paper we examine the posttraumatic responses of direct concern to psychiatrists working in a community exposed to a disaster. We review the epidemiology of posttraumatic responses, the interface of psychiatry and traumatic stress, the psychiatric disorders associated with trauma, and psychiatric consultation to the disaster community. Overall, psychiatric intervention after a disaster is based on the principles of preventive medicine and includes community consultation and outreach programs with the goals of identifying high-risk groups, promoting community recovery, and minimizing social disruption.

Adult↗