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Biomedical subjects

E Cardeña

Publications and source records attributed to E Cardeña.

At least 19 recordsLinked to original sources
PubMed2001

Psychiatric disorders among tortured Bhutanese refugees in Nepal.

BACKGROUND: The impact of torture on the distribution of psychiatric disorders among refugees is unknown. METHODS: We surveyed a population-based sample of 418 tortured and 392 nontortured Bhutanese refugees living in camps in Nepal. Trained interviewers assessed International Classification of Diseases, 10th Revision (ICD-10) disorders through structured diagnostic psychiatric interviews. RESULTS: Except for male sex, history of torture was not associated with demographics. Tortured refugees, compared with nontortured refugees, were more likely to report 12-month ICD-10 posttraumatic stress disorder, persistent somatoform pain disorder, and dissociative (amnesia and conversion) disorders. In addition, tortured refugees were more likely to report lifetime posttraumatic stress disorder, persistent somatoform pain disorder, affective disorder, generalized anxiety disorder, and dissociative (amnesia and conversion) disorders. Tortured women, compared with tortured men, were more likely to report lifetime generalized anxiety disorder, persistent somatoform pain disorder, affective disorder, and dissociative (amnesia and conversion) disorders. CONCLUSIONS: Among Bhutanese refugees, the survivors had higher lifetime and 12-month rates of ICD-10 psychiatric disorder. Men were more likely to report torture, but tortured women were more likely to report certain disorders. The results indicate the increased need for attention to the mental health of refugees, specifically posttraumatic stress disorder, persistent somatoform pain disorder, and dissociative (amnesia and conversion) disorders among those reporting torture.

Adult↗
PubMed2001

An examination of the diagnostic validity of dissociative identity disorder.

We review the empirical evidence for the validity of the Dissociative Identity Disorder (DID) diagnosis, the vast majority of which has come from research conducted within the last 10 years. After reviewing three different guidelines to establish diagnostic validity, we conclude that considerable converging evidence supports the inclusion of DID in the current Diagnostic and Statistical Manual for Mental Disorders. For instance, DID appears to meet all of the guidelines for inclusion and none of the exclusion guidelines; proposed by Blashfield et al. [Comprehensive Psychiatry 31 (1990) 15-19], and it is one of the few disorders currently supported by taxometric research. However, we also discuss possible problems with the current diagnostic criteria and offer recommendations, based on recent research, for possible revisions to these criteria.

Adult↗
PubMed2001

Trauma and loss as determinants of medically unexplained epidemic illness in a Bhutanese refugee camp.

BACKGROUND: We sought to identify personal factors that placed people at risk during an epidemic of medically unexplained illness in a Bhutanese refugee camp in southeastern Nepal. METHODS: We conducted a case-control study, involving 68 cases and 66 controls. Caseness was defined as experiencing at least one attack of medically unexplained fainting or dizziness during the time of the epidemic. We performed hierarchical logistic regression analysis to identify significant predictors of case status. RESULTS: In terms of Western psychiatric constructs, the illness involved somatoform symptoms of both acute anxiety and dissociation. Sixty per cent reported visual and 28% reported auditory hallucinatory experiences. Cases and controls were similar on all demographic variables, school performance, number of attacks witnessed and psychopathology before the onset of the epidemic. Recent loss, early loss, childhood trauma and pulse-rate were predictors of case status. CONCLUSION: We identified trauma, early loss and, especially, recent loss as predictors of attacks during medically unexplained epidemic illness in a Bhutanese refugee community.

Adolescent↗
PubMed2001

Rapid self-hypnosis: a new self-hypnosis method and its comparison with the Hypnotic Induction Profile (HIP).

Despite its clinical importance, there are few systematic studies on the application of self-hypnosis. Rapid Self-Hypnosis (RSH) was created to provide a new procedure that is easy, comfortable, fosters alertness, and can be done covertly in everyday life. We present it as an alternative to the self-hypnosis version of the Hypnosis Induction Profile (HIP). Using a crossover design, we found in an experimental session that the RSH and the HIP produced comparable objective and subjective scores in the Barber Suggestibility Scale (BSS). However, as compared with the HIP, participants rated RSH as significantly more coherent, pleasant, faster and easier to learn, more likely to be used in everyday life and go unnoticed by others, less bothersome to use, and more likely to be used in private. Additional research should clarify whether these differences are reliable and have clinical significance. Our results suggest that RSH will be a valuable addition to the clinician's arsenal.

Adult↗
PubMed2001

Evaluation of post-traumatic stress disorders.

This paper introduces important considerations in the evaluation of psychological reactions to traumatic events. Proper assessment should include consideration of psychometric, cultural, and ethical issues. Mental disorders frequently observed in the aftermath of trauma (acute stress disorder and post-traumatic stress disorder) and stress (adjustment disorders) are defined, and the reader is provided with information on both general and specific resources for their evaluation.

Humans↗
PubMed2000

Psychometric properties of the Stanford Acute Stress Reaction Questionnaire (SASRQ): a valid and reliable measure of acute stress.

A reliable and valid measure is needed for assessing the psychological symptoms experienced in the aftermath of a traumatic event. Previous research suggests that trauma victims typically experience dissociative, anxiety and other symptoms, during or shortly after a traumatic event. Although some of these symptoms may protect the trauma victim from pain, they may also lead to acute stress, posttraumatic stress, or other disorders. The Stanford Acute Stress Reaction Questionnaire (SASRQ) was developed to evaluate anxiety and dissociation symptoms in the aftermath of traumatic events, following DSM-IV criteria for acute stress disorder. We present data from multiple datasets and analyses supporting the reliability and construct, convergent, discriminant, and predictive validity of the SASRQ.

Acute Disease↗
PubMed2000

Hypnosis in the treatment of trauma: a promising, but not fully supported, efficacious intervention.

Hypnotic techniques for the treatment of posttraumatic conditions were often used by the clinical pioneers of the end of the 19th century and by military therapists treating soldiers during the 20th century's conflagrations. More recently, hypnosis has also been used with survivors of sexual assault, accidents, and other traumas, and with various groups, including children and ethnic minorities. Nonetheless, there have been almost no systematic studies on the efficacy of hypnosis for posttraumatic disorders. This state of affairs is especially disappointing considering that: hypnosis can be easily integrated into therapies that are commonly used with traumatized clients; a number of PTSD individuals have shown high hypnotizability in various studies; hypnosis can be used for symptoms associated with PTSD; and hypnosis may help modulate and integrate memories of trauma. Hypnotic techniques may indeed be efficacious for posttraumatic conditions, but systematic group or single-case studies need to be conducted before reaching that conclusion.

Humans↗
PubMed2000

Hypnosis as an empirically supported clinical intervention: the state of the evidence and a look to the future.

Drawing on the literature reviews of this special issue of the International Journal of Clinical and Experimental Hypnosis (2000), this article summarizes the evidence for the effectiveness of hypnosis as an empirically supported clinical intervention. As a whole, the clinical research to date generally substantiates the claim that hypnotic procedures can ameliorate some psychological and medical conditions, as judged against the Chambless and Hollon methodological guidelines. In many cases, these clinical procedures can also be quite cost-effective. It is probable that with some key empirical refinement a number of other hypnosis treatment protocols will have sufficient empirical documentation to be considered "well-established." However, it is noted that the Chambless and Hollon guidelines are not particularly well-suited for assessing hypnosis' impact when used adjunctly with other interventions. The article concludes with recommendations regarding the efficacy questions that need to be more fully addressed empirically and offers methodological guidelines for researchers and practitioners.

Anxiety↗
PubMed1999

Preference between two methods of active-alert hypnosis: not all techniques are created equal.

In a cross-over design (N = 80), we compared the differential liking and preference for two hypnotic techniques involving physical activity: active-alert and waking-alert (or alert-hand) procedures. Participants expressed significantly higher liking and preference for the waking-alert as compared to the active-alert procedure. The latter technique, which also had significantly lower suggestibility scores(Cardeña et al., 1998) was also associated with a significantly higher attrition rate (23%). These significant differences may be explained by the greater physical effort and difficulty associated with the active-alert technique. It seems that the waking-alert method extends the advantages of active hypnosis (e.g., alertness, enhanced self-mastery) to individuals who may dislike or are unable to cope with the greater demands required by the active-alert procedure.

Adult↗
PubMed1998

Convergent validity of three posttraumatic symptoms inventories among adult sexual abuse survivors.

We examined the convergent validity of three posttraumatic symptoms inventories, the civilian version of the Mississippi Scale for Combat-Related PTSD (CM-PTSD), the Trauma Symptom Checklist-40 (TSC-40), and the Response to Childhood Incest Questionnaire (RCIQ), in a sample of 52 adult sexual abuse survivors. The significant and moderate to strong correlations (r = .6 or higher) among these inventories supported their convergent validity. Comparison with other studies also suggests that these instruments can adequately discriminate clinical from nonclinical populations.

Adult↗
PubMed1998

Effects on suggestibility of a new method of active-alert hypnosis: alert hand.

Research has shown that the active-alert method described by Bányai and Hilgard (1976) produces a similar increase on suggestibility as relaxation-based techniques, but it has some limitations, including the need for a stationary bicycle and a certain level of physical fitness. The authors compared that method with the new "alert hand" method, which emphasizes activity and alertness, but is simpler and less strenuous. In a repeated measures, counterbalanced design (N = 80), the authors found that (a) the alert hand method produced significantly higher objective and subjective suggestibility scores than the active-alert technique, and (b) a high percentage (23%) of volunteers discontinued participation during the active-alert method but not during the alert hand method. The alert hand method extends the benefits of active hypnosis to individuals who may have difficulties with the physical demands required by the active-alert method, and it seems to enhance suggestibility even more.

Adult↗
PubMed1997

Emotional self-regulation therapy: a new and efficacious treatment for smoking.

We describe emotional self-regulation therapy, a recently-developed suggestion technique for the treatment of smoking, and present data attesting to its efficacy. Of the 38 individuals who completed treatment, 82% (47% of the initial sample) stopped smoking altogether and 13% (8% of the initial sample) reduced their smoking. A follow-up at 6 months showed that 66% (38% of the initial sample) of those who had completed the treatment remained abstinent and reported minimal withdrawal symptoms or weight gain. In a no-treatment comparison group, only 8% reduced their smoking or became abstinent.

Adult↗
PubMed1995

When disaster strikes, acute stress disorder may follow.

During and immediately following a traumatic event, people may manifest a pattern of dissociative and anxiety symptoms and other reactions, referred to as Acute Stress Disorder. A review of the empirical literature on psychological reactions to trauma suggest that this pattern of symptoms has often been identified across different kinds of traumatic events. It is likely to constitute a psychological adaptation to a stressful event, limiting painful thoughts and feelings associated with the event and allowing the person to function at least minimally. Continuation of these symptoms, however, may impair the person's quality of life and disrupt social and other functioning. If symptoms last beyond a month following the traumatic event, Post Traumatic Stress Disorder (PTSD) may ensue, continuing for months or even years after the precipitating event. Hence, it is important to be able to identify this pattern of reactions that may be manifested in reaction to trauma, so that appropriate intervention can be provided. Although it was not officially recognized in the 3rd edition Diagnostic and Statistical Manual (DSM-III-R), Acute Stress Disorder is included as a separate diagnosis in the DSM-IV.

Adaptation, Psychological↗
PubMed1993

Dissociative reactions to the San Francisco Bay Area earthquake of 1989.

OBJECTIVE: This study systematically evaluated the psychological reactions of a nonclinical population to the October 1989 earthquake in the San Francisco Bay Area. METHOD: A representative group of about 100 graduate students from two different institutions in the Bay Area volunteered to participate in the study. Within 1 week of the earthquake, the authors administered a checklist of anxiety and dissociative symptoms to the subjects, and 4 months later they conducted a follow-up study with the same checklist. RESULTS: The participants reported significantly greater numbers and frequency of dissociative symptoms, including derealization and depersonalization, distortions of time, and alterations in cognition, memory and somatic sensations, during or shortly after the earthquake than after 4 months. To a lesser degree they also reported significantly more nonsomatic anxiety symptoms and Schneider's first-rank symptoms at the earlier testing time. CONCLUSIONS: These results suggest that among nonclinical populations, extreme distress may significantly increase the prevalence and severity of transient dissociative phenomena and anxiety. They provide further evidence of the role that dissociation plays in the response to trauma and are of considerable clinical and theoretical importance in view of the lifetime prevalence of traumatic experiences in the general population.

Adult↗
PubMed1991

Disintegrated experience: the dissociative disorders revisited.

We present proposed changes to the dissociative disorders section of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders and review the concept of pathological and nonpathological dissociation, including empirical findings on the relations between trauma and dissociative phenomenology and between dissociation and hypnosis. The most important proposals include the creation of two new diagnostic entities, brief reactive dissociative disorder and transient dissociative disturbance, and the readoption of the criterion of amnesia for a multiple personality disorder diagnosis. We conclude that further work on dissociative processes will provide an important link between clinical and experimental approaches to human cognition, emotion, and personality.

Depersonalization↗