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Biomedical subjects

D D Blake

Publications and source records attributed to D D Blake.

At least 19 recordsLinked to original sources
PubMed2000

Prevalence of personality disorders among combat veterans with posttraumatic stress disorder.

Many combat veterans with PTSD have co-occurring symptoms of other forms of psychopathology; however, there have been limited studies examining personality disorders among this population. The few extant studies typically have assessed only two or three personality disorders or examined a small sample, resulting in an incomplete picture and scope of comorbidity. This study assessed all DSM-III-R personality disorders in 107 veterans in a specialized, inpatient unit. Using the Structured Clinical Interview for DSM-III-R Personality Disorders, 79.4% of the participants were diagnosed with at least one personality disorder: 29.9% received only one diagnosis, 21.5% had two, 15.9% had three, and 12.1% had four or more. The most frequent single diagnoses were Avoidant (47.2%), Paranoid (46.2%), Obsessive-Compulsive (28.3%), and Antisocial (15.1%) personality disorders.

Cluster Analysis↗
PubMed1998

A scale for assessing sleep hygiene: preliminary data.

No reliable measure exists for assessing the nature and scope of adherence or nonadherence to effective sleep hygiene practices. This report details the creation and empirical validation of the Sleep Hygiene Self-test. 52 combat veterans, patients in a treatment program for PTSD, completed the 30-item self-test prior to and after their participation in 5 wks. of group therapy for sleep hygiene. Analysis indicated good internal consistency and suitability as a pre-posttest measure.

Adult↗
PubMed1997

Hope, coping, and social support in combat-related posttraumatic stress disorder.

Dispositional hope, coping, and perceived social support were assessed among Vietnam combat veterans upon admission to and discharge from inpatient treatment for posttraumatic stress disorder (PTSD). Veterans reported lower dispositional hope than any previously described sample, and hope did not increase at discharge from treatment. At admission, higher hope was correlated with greater perceived social support coming from family (this relationship persisted when controlling for depression and PTSD symptoms). At discharge, higher hope was associated with greater perceived social support coming from family and friends and the use of adaptive coping strategies. Results indicate that hope confers a beneficial effect once veterans undergo treatment for combat-related PTSD, a finding that suggests that hope may be "gone but not lost" for these individuals.

Adaptation, Psychological↗
PubMed1996

Childhood factors and war zone stress in chronic PTSD.

This study assessed the predictive validity of combat factors and selected premilitary variables (i.e., childhood physical abuse, substance abuse in the family of origin, or being raised in a nonadaptive or noncohesive family) on posttraumatic stress disorder (PTSD) group membership. In addition, it assessed the correlation of combat exposure and selected premilitary variables with the severity of PTSD symptomology. Ninety-three male Vietnam combat veterans with PTSD were compared to 82 male Vietnam combat veterans without the disorder. The results of two hierarchical logit analyses identified combat exposure as the best predictor of PTSD group membership. However, physical punishment was also found to significantly predict group membership when entered first in the analyses. Furthermore, multiple regression analyses conducted with the PTSD group alone found that both combat exposure and physical abuse predicted greater PTSD symptomology. These findings suggest that childhood physical abuse as well as military trauma should be addressed in the assessment and treatment of chronic PTSD patients.

Adult↗
PubMed1995

The development of a Clinician-Administered PTSD Scale.

Several interviews are available for assessing PTSD. These interviews vary in merit when compared on stringent psychometric and utility standards. Of all the interviews, the Clinician-Administered PTSD Scale (CAPS-1) appears to satisfy these standards most uniformly. The CAPS-1 is a structured interview for assessing core and associated symptoms of PTSD. It assesses the frequency and intensity of each symptom using standard prompt questions and explicit, behaviorally-anchored rating scales. The CAPS-1 yields both continuous and dichotomous scores for current and lifetime PTSD symptoms. Intended for use by experienced clinicians, it also can be administered by appropriately trained paraprofessionals. Data from a large scale psychometric study of the CAPS-1 have provided impressive evidence of its reliability and validity as a PTSD interview.

Humans↗
PubMed1995

Warzone violence in Vietnam: an examination of premilitary, military, and postmilitary factors in PTSD in-patients.

The impact of childhood victimization and other premilitary factors on warzone abusive violence was examined with 177 Vietnam combat veteran inpatients. Premilitary and military variables were also examined in relationship to postmilitary variables, including violence and PTSD. Statistical analyses showed that none of the premilitary variables predicted warzone violence. High combat exposure did, however, predict warzone abusive violence and PTSD. In addition, participation in warzone violence predicted postmilitary violence to self, spouse, and others. Although high rates of childhood victimization and high levels of combat exposure were found, neither predicted postmilitary violence, criminal activities, drug/alcohol problems, or suicide attempts. Low childhood adjustment ratings and school suspensions predicted adult alcohol abuse and drug abuse, respectively. These findings and their implication for treatment are discussed.

Adult↗
PubMed1995

Psychological impact of the Los Angeles riots on Korean-American victims: implications for treatment.

The psychological impact of the 1992 Los Angeles riots on 202 Korean-American victims who sustained financial loss or physical injury was investigated. Results indicate that the majority of these riot victims underwent severe distressed and experienced symptoms of post-traumatic stress disorder. Related research on trauma survivors is reviewed and implications for treatment are discussed.

Adaptation, Psychological↗
PubMed1992

Post-traumatic stress disorder and coping in veterans who are seeking medical treatment.

The present study examined psychological coping styles and mental health treatment histories in veterans with PTSD. This study also served as a replication and extension of an earlier investigation that assessed the prevalence of PTSD in World War II, Korea, and Vietnam combat veterans who were seeking medical treatment. Thirty-six combat veteran medical patients were compared to 38 war-era controls. Nearly a third of the combat veterans met psychometric criteria for PTSD; none of the controls met these criteria. Both PTSD-positive subjects and mental health treatment seekers showed a significantly greater use of emotion-focused coping. Results also showed that Vietnam combatants were more likely to have received individual mental health treatment. These findings and their treatment implications are discussed.

Adaptation, Psychological↗
PubMed1992

Behavioral consultation with difficult to treat psychiatric patients.

Behavioral procedures have proven efficacious in the ward-wide treatment of psychiatric inpatients. These procedures are often recommended and administrated by behaviorally oriented staff who work as consultants. While numerous published reports show that behavioral consultation is effective for changing patients' targeted behavior, few data show whether it affects recidivism and other general indicators of patients' functioning. The present report describes group and case study data for 7 patients regarding the effects of behavioral consultation on frequency and duration of hospital admissions, distress upon readmission, proportion of time spent at regressive versus autonomous privilege levels, and other molar indices of patients' functioning.

Acting Out↗
PubMed1992

Validity and clinical scale comparisons between the MMPI and MMPI-2 with psychiatric inpatients.

This study was designed to investigate the comparability of the original MMPI (1950) and the MMPI-2 (1989) with a psychiatric patient population. 34 male and 3 female patients, shortly after admission to one of two acute psychiatry units, completed the old and revised versions of the MMPI. Paired t tests indicated but scant differences for raw scores, while many more differences were found among T scores for validity, clinical, and supplemental scales. Analyses, however, showed all scales on the two forms to be highly correlated. Analysis of the high-point and two-point codes across the two administrations also showed relative stability, although the proportion of Scales 2 (Depression) and 8 (Schizophrenia) decreased, while those for Scales 6 (Paranoia) and 7 (Psychasthenia) increased markedly in the MMPI-2 protocols. Examination of each version's discriminability among mood- and thought-disordered subsamples suggested that the MMPI provides slightly better delineation between diagnostic classes. Discriminant function analyses showed that there were essentially no differences between the two forms in the accurate classification of clinical and nonclinical groups. The findings reported here provide support for the MMPI-2; despite modification, the newer form retains the advantages of the original MMPI. Differences found here may be unique to psychiatric patients and their patterns of MMPI/MMPI-2 equivalence and may not generalize to other special populations.

Adult↗
PubMed1991

Similarities and differences between MMPI and MMPI-2 applications to the assessment of posttraumatic stress disorder.

The purpose of this study was to address the question: Is the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) comparable to the original MMPI in its applicability to the assessment of posttraumatic stress disorder (PTSD) among Vietnam combat veterans? The question was addressed by administering both the original MMPI and MMPI-2 to 29 subjects classified as meeting Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; DSM-III-R) criteria for PTSD and comparing MMPI and MMPI-2 scores in terms of: degree of association, code-type congruence, diagnostic hit rates (when compared to two other clinical samples, and one normal sample), and congruence of the Keane PTSD Scale (PK). Results reveal highly significant correlations between MMPI and MMPI-2 basic scales for the PTSD sample as well as congruence in 2-point codes comparable to previous studies. The MMPI-2 was found to identify effectively PTSD subjects from the other groups. Results also showed a high degree of association between the MMPI and MMPI-2 in regard to PK scores, although minor differences were found in PK raw scores between the two tests. Overall, the findings suggest a high degree of comparability between the MMPI and MMPI-2 in the assessment of PTSD.

Adult↗
PubMed1990

Increasing group attendance on a psychiatric unit: an alternating treatments design comparison.

Compliance is a critical factor for success in the treatment of chronic psychiatric patients. Major reasons for therapeutic failure are that patients discontinue their medications, fail to keep therapist appointments, or do not participate in recommended psychosocial activities. An alternating treatments design was employed to assess the use of verbal instructions and feedback to promote group attendance on a psychiatric unit. Results showed these methods served to significantly increase group attendance but had no significant effect on patient satisfaction. These results are discussed with regard to cost-efficient methods for promoting treatment compliance with psychiatric inpatients.

Adult↗
PubMed1980

Relationship of lesion size to survival in patients with stage IB squamous cell carcinoma of the cervix uteri treated by radiation therapy.

Forty-five patients with Stage IB squamous cell carcinoma of the cervix uteri were treated with radiation therapy alone. The five year actuarial survival rate of the 22 patients in group 1 in whom the tumor was less than 4 centimeters in diameter was 95 per cent, which was significantly higher than the 67 per cent survival rate in the 23 patients in group 2 with bulky lesions greater than or equal to 4 centimeters in diameter, p less than 0.05. These results of radiation therapy are consistent with surgical results recently reported and indicate that patients with bulky lesions, especially those tumors greater than or equal to 4 centimeters in size, comprise a high risk subset within the Stage IB classification. A new classification is proposed in which bulky lesions are designated Stage IC, advanced overt, so that such high risk patients might be identified and more efficacious treatment regimens might be developed.

Carcinoma, Squamous Cell↗
PubMed1978

The control of chronic lymphocytic leukemia with mediastinal irradiation.

Forty patients with chronic lymphocytic leukemia have been treated with mediastinal irradiation. A full remission was achieved in 18 (45 per cent) patients, a partial response in eight (20 per cent), "WBC control" in eight (20 per cent) and no response in 6 (15 per cent). Although mediastinal irradiation benefited all stages of disease, earlier stages of disease correlated with more complete and longer response to mediastinal irradiation. Toxicity was mild and transient and included leukopenia in five patients (12 per cent), thrombocytopenia in eight patients (20 per cent), mild esophagitis in 12 patients (30 per cent) and pneumonitis in four patients (10 per cent). There were no toxic deaths and mediastinal irradiation did not adversely effect survival. Treatment was readily given on an ambulatory basis and completed within four weeks. In five of 11 patients, abnormal immunoglobulins became normal. Eleven patients had abnormal lymphocyte transformation with PHA, five had marked improvement and three had partial improvements following mediastinal irradiation. This improvement appeared to correlate with response and survival but further study is necessary to confirm this relationship. Although most patients required additional therapy within two years, eight patients have required no further therapy for periods of twenty-eight months to thirteen years.

Chlorambucil↗