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Biomedical subjects

Brett T Litz

Publications and source records attributed to Brett T Litz.

16 recordsLinked to original sources
PubMed2006

A cross-lagged analysis of the relationship between symptoms of PTSD and retrospective reports of exposure.

As part of a larger longitudinal investigation, 522 U.S. peacekeepers who served in Somalia were administered a comprehensive psychosocial questionnaire. The questionnaire included the PTSD Checklist [PCL; Weathers, F. W., Litz, B. T., Herman, D. S., Huska, J. A., & Keane, T. M. (1993, November). The PTSD Checklist (PCL): reliability, validity, and diagnostic utility. Paper presented at the annual meeting of the International Society for Traumatic Stress Studies, San Antonio, TX], the Mississippi Scale [Keane, T. M., Caddell, J. M., & Taylor, K. L. (1988). Mississippi Scale for combat-related posttraumatic stress disorder: three studies in reliability and validity. Journal of Consulting and Clinical Psychology, 56, 85-90], the War-Zone Exposure Scale [WZES; Litz, B. T., Orsillo, S. M, Freidman, M., Ehlich, P., & Batres, A. (1997). Posttraumatic stress disorder associated with peacekeeping duty in Somalia for US military personnel. American Journal of Psychiatry, 154(2), 178-184], and the Other Stressors Associated with Peacekeeping Scale [Litz, B. T., King, L. A., King, D. W., Orsillo, S. M., & Friedman, M. J. (1997). Warriors as peacekeepers: features of the Somalia experience and PTSD. Journal of Consulting and Clinical Psychology, 65, 1001-1010]. These measures were administered approximately 15 weeks postdeployment and roughly a year and a half later. Using a cross-lagged panel design, PTSD symptom severity was associated with increases in reports of exposure at Time 2. However, this finding was modest and was not specific to the recall of traumatic events.

Adult↗
PubMed2006

Predictors of barriers to mental health treatment for Kosovo and Bosnia peacekeepers: a preliminary report.

In this study, we assessed basic, physical, and mental health needs of peacekeepers; determined barriers to mental health treatment; and examined predictors of barriers to mental health care. Active duty peacekeepers were surveyed before and after their deployment to Kosovo (n = 203) concerning their stress symptoms and attitudes about seeking mental health care after peacekeeping. Sixty-five peacekeepers were evaluated before and after their peacekeeping deployment to Bosnia. Upon returning from their mission, between 5% and 9% of Kosovo and Bosnia peacekeepers reported needing help for anger or hostility, depression, or deployment-related stress. The most frequently endorsed barrier was concern about the personal cost of mental health care. Among Kosovo peacekeepers, pre- and postdeployment post-traumatic stress disorder symptoms were the most robust predictors of mental health treatment barriers. Peacekeepers report a number of treatment needs and barriers that could prevent them from receiving care. The soldiers most in need of services are also those who report the most barriers to care.

Adult↗
PubMed2005

Brief cognitive-behavioral phone-based intervention targeting anxiety about the threat of attack: a pilot study.

A brief, cognitive-behavioral, phone-based intervention was employed with an Israeli sample experiencing anticipatory anxiety about potential war-related attacks. In this quasi-experimental controlled pilot study, the cognitive-behavioral therapy intervention (diaphragmatic breathing and a modified cognitive-restructuring technique) was compared with the standard hotline care administered when worried citizens called a mental health emergency hotline in Israel. Individuals (n=32) were administered anxiety and worry measures pre-intervention, post-intervention, and three days post-intervention. The results indicated that anxiety levels decreased for the experimental and control group immediately post-intervention; however, three days later, the levels of anxiety in the CBT group continued to decline, while anxiety levels in the control group reached pre-intervention levels on two of the three outcome measures. These results suggest that CBT can be effectively delivered by paraprofessionals over the phone, which is cost-effective and efficient. Limitations are considered, and implications for treating individuals coping with the threat of terrorism are discussed.

Analysis of Variance↗
PubMed2005

Extending and applying the demand-control model: the role of soldier's coping on a peacekeeping deployment.

The purpose of this study was to extend the demand-control model (R. A. Karasek, 1979) by examining coping as an additional factor. It was hypothesized that perceived job control only buffered the demand-strain relationship when individuals used active coping and exacerbated the relationship when individuals used passive coping. Soldiers (N=638) were surveyed before and during a 6-month peacekeeping deployment to Kosovo. Results partially confirmed the hypotheses. Even after controlling for general psychological health at predeployment, job control moderated the relationship between demands and psychological health during deployment when soldiers used active coping. No significant 3-way interactions were found for religious coping and passive coping. Implications for demand-control modeling and potential applications of the findings to soldier and leader training are discussed.

Adaptation, Psychological↗
PubMed2005

The worried mind: autonomic and prefrontal activation during worrying.

To study the psychophysiological correlates of worrying, the authors recorded heart rate, respiratory sinus arrhythmia (RSA), skin conductance level, and alpha electroencephalographic asymmetry in healthy males during baseline, relaxation, worry induction, and anticipation of an impromptu speech task. Compared with baseline, relaxation, and anticipation, worrying was associated with greater heart rate and lower RSA. Worrying was further characterized by higher skin conductance levels compared with baseline but lower levels than during anticipation. Finally, worrying was associated with relatively greater left frontal activity compared with anticipation. Trait public speaking anxiety was positively correlated with left frontal activity during worrying. These results support the notion that worrying is a unique emotional state that is different from fearful anticipation.

Adolescent↗
PubMed2005

Behavioral interventions for recent trauma: empirically informed practice guidelines.

Despite the successes in the treatment of chronic trauma-related distress, little attention has been devoted to developing behavioral interventions to be delivered soon after traumatic exposure in an effort to promote positive posttraumatic adjustment and to minimize the likelihood of enduring psychopathology. As a result, other forms of early intervention have filled this void and have been widely disseminated and applied, despite the lack of compelling evidence attesting to their efficacy. This article reviews the literature bearing on early interventions for trauma, including the encouraging outcomes of recently developed behavioral treatments. Empirically informed practice guidelines for intervening with recently traumatized individuals are presented. Future treatment development efforts will need to address an issue that has been largely neglected in traditional treatment models for traumatized populations-that of traumatic bereavement. Behavioral interventions may be particularly well-equipped to address this source of distress.

Behavior Therapy↗
PubMed2004

Emotional-processing in posttraumatic stress disorder II: startle reflex modulation during picture processing.

This study examined the impact of a trauma-related stressor on subsequent emotional behavior in veterans with (n = 35) and without (n = 24) posttraumatic stress disorder (PTSD). Self-report and physiological responses, including acoustic startle, were recorded during viewing of emotionally evocative photographs at baseline and following exposure to trauma-related and non-trauma-related stressors. The 2 groups exhibited equivalent patterns of emotional response across self-report and physiological measures at baseline. In contrast, following the trauma challenge, participants with PTSD showed a pattern of startle modulation suggestive of greater defensive reactivity and reduced visual perceptual engagement. These findings, along with augmented corrugator EMG reactivity during the same interval, suggest that trauma-related reexperiencing primes subsequent negative emotional responding in individuals with PTSD.

Adaptation, Psychological↗
PubMed2004

A longitudinal analysis of PTSD symptom course: delayed-onset PTSD in Somalia peacekeepers.

Posttraumatic stress disorder (PTSD) typically follows an acute to chronic course. However, some trauma victims do not report significant symptoms until a period of time has elapsed after the event. Although originally dismissed as an artifact of retrospective methodologies, recent prospective studies document apparent instances of delayed-onset PTSD. Little is known currently about factors associated with the delayed onset of PTSD. This study was designed to examine the course of PTSD in a sample of 1,040 U.S. military peacekeepers who served in Somalia. A small but nontrivial subset of participants endorsed clinically significant levels of PTSD after a period of minimal distress, the magnitude of which cannot be ascribed to minor waxing and waning of symptoms. War-zone exposure and perceived meaningfulness of the mission, as rated by soldiers after returning to the United States, predicted symptom course over the next 18 months.

Adult↗
PubMed2004

Psychometric properties of the life events checklist.

The Life Events Checklist (LEC), a measure of exposure to potentially traumatic events, was developed at the National Center for Posttraumatic Stress Disorder (PTSD) concurrently with the Clinician Administered PTSD Scale (CAPS) to facilitate the diagnosis of PTSD. Although the CAPS is recognized as the gold standard in PTSD symptom assessment, the psychometric soundness of the LEC has never been formally evaluated. The studies reported here describe the performance of the LEC in two samples: college undergraduates and combat veterans. The LEC exhibited adequate temporal stability, good convergence with an established measure of trauma history -- the Traumatic Life Events Questionnaire (TLEQ) -- and was comparable to the TLEQ in associations with variables known to be correlated with traumatic exposure in a sample of undergraduates. In a clinical sample of combat veterans, the LEC was significantly correlated, in the predicted directions, with measures of psychological distress and was strongly associated with PTSD symptoms.

Adult↗
PubMed2004

The stressors and demands of peacekeeping in Kosovo: predictors of mental health response.

U.S. soldiers' appraisal and experience of the Kosovo peacekeeping mission is described. Using a prospective design, we evaluated the prevalence, severity, and predictors of several mental health outcomes at redeployment. We found that peacekeepers frequently were exposed to potentially traumatizing and other stressful events while in Kosovo, but on average, their appraisal of those events was moderate. Postdeployment psychopathology was also low--soldiers endorsed more severe mental health difficulties at predeployment, which suggests anticipatory negative affect. After controlling for the impact of predeployment stressors, we examined the contribution of potentially traumatizing events, general overseas military duty stressors, negative aspects of peacekeeping roles, and generic positive military experiences, including morale, to explain variance in four outcomes: post-traumatic stress disorder, depression, hostility and aggression problems, and problems with alcohol abuse. Findings indicate that hostility and drinking may be more chronic problems that emerge during stressful times, whereas depression and post-traumatic stress disorder symptoms may be more apt to fluctuate and are associated with potentially traumatizing experiences during peacekeeping. The implications and limitations of the study are discussed.

Adult↗
PubMed2003

Social anxiety, depression, and PTSD in Vietnam veterans.

Many Vietnam veterans with PTSD report a high level of social anxiety and avoidance. Many traumatized individuals also suffer from symptoms of depression, which is often associated with significant problems in social functioning. In order to explore the relationship between social anxiety, depression, and PTSD, we recruited a group of Vietnam veterans with PTSD (n = 27), veterans with other mental disorders (n = 20), and veterans with no mental disorders (n = 35). Participants were administered diagnostic interviews and some of the most commonly used social anxiety instruments. Although the groups did not differ in their rates of social phobia, veterans with PTSD scored highest in most social anxiety measures. Veterans with PTSD were also more likely to be clinically depressed than veterans without PTSD at the time of the assessment. When controlling for the level of depression, the three groups no longer differed in any of the social anxiety measures. Furthermore, level of depression was the best predictor for group membership. These findings suggest that social anxiety in Vietnam combat veterans with PTSD is closely associated with mood disturbance, social withdrawal, and isolation associated with depression.

Combat Disorders↗
PubMed2003

Emotional experiencing in women with posttraumatic stress disorder: congruence between facial expressivity and self-report.

The congruence between facial expressivity and self-report of emotion was examined among 11 women with sexual assault-related PTSD and 8 women without PTSD, under both a neutral and a sexual assault prime condition. The PTSD group demonstrated some incongruities in emotional responding. Although the PTSD group was as facially expressive as the control group, they reported more arousal to the emotional stimuli. Further, an inverse relationship between negative facial expressivity and self-report to negative stimuli was found for some variables for the PTSD group only, such that the less expressions they showed facially, the more negative they reported feeling. However, the overall pattern of results suggests fewer significant relationships between expression and experience than predicted.

Adult↗
PubMed2003

The relationship between self-disclosure and symptoms of posttraumatic stress disorder in peacekeepers deployed to Somalia.

The challenges of peacekeeping place individuals at risk for the development of significant psychological distress (e.g., B. T. Litz, S. Orsillo, M. Freidman, P. Ehlich, & A. Batres, 1997). Self-disclosure has been shown to ameliorate psychological distress following exposure to potentially traumatic events (J. W. Pennebaker & K. D. Harber, 1993). Sharing, or self-disclosure of deployment-related experiences, was the focus of this study and was hypothesized to be associated with adaptation. As part of a larger investigation, 426 U.S. military personnel who served as peacekeepers in Somalia were administered a comprehensive psychosocial questionnaire that included measures of exposure to negative and potentially traumatic experiences, reception at homecoming, self-disclosure, and PTSD symptom severity. The results indicate that adjustment to peacekeeping is significantly related to self-disclosure, especially to supportive significant others.

Adaptation, Psychological↗
PubMed2002

Emotional numbing in posttraumatic stress disorder: current and future research directions.

OBJECTIVE: Despite being understudied and poorly understood relative to the chronic fear, anxiety and other aversive emotional states that occur in the immediate aftermath of trauma, emotional numbing has become a core defining feature of posttraumatic stress disorder (PTSD). METHOD: This paper seeks to briefly review the literature bearing on these seemingly disparate emotional responses to trauma as well as theoretical accounts of emotional numbing that have been proffered to date. We then offer an alternative theory of post-traumatic emotional functioning and review empirical support for this model. RESULT: The experience of trauma produces very intense emotions such as overwhelming fear, horror, and anxiety, and these reactions can linger for a lifetime. Many trauma survivors also report restrictions in their emotional experience - a phenomenon most commonly referred to as emotional numbing. In contrast to previous accounts of posttraumatic emotional functioning our model posits that individuals with PTSD have difficulty expressing positive emotions as a result of re-experiencing states. We further argue that patients with PTSD are capable of experiencing and expressing the full range of emotions that were available pretraumatically. CONCLUSION: Our model holds that individuals with PTSD are not, in fact, 'emotionally numb' as a result of traumatic experience. Rather, PTSD is associated with hyperresponsivity to negatively valenced emotional stimuli. Consequently, patients with PTSD require more intense positive stimulation to access the full complement of appetitive or pleasant emotional behaviour.

Adult↗
PubMedDate not supplied

Acute psychological impact of disaster and large-scale tauma: limitations of traditional interventions and future practice recommendations.

Nearly everyone will experience emotional and psychological distress in the immediate aftermath of a disaster or other large-scale traumatic event. Although extremely upsetting and disruptive, the reaction is understood best as a human response to inordinate adversity, which in the majority of cases remits over time without formal intervention. Nevertheless, some people experience sustained difficulties. To prevent chronic post-traumatic difficulties, mental health professionals provide early interventions soon after traumatic exposure. These interventions typically take the form of single-session debriefings, which have been applied routinely following disasters. The research bearing on these traditional forms of early crisis interventions has shown that, although well-received by victims, there is no empirical support for their continued use. However, promising evidence-based, early interventions have been developed, which are highlighted. Finally, traumatic bereavement and complicated grief in survivors of disasters, an area largely neglected in the field, is discussed.

Bereavement↗