Biomedical subjects

Edward J Hickling

Publications and source records attributed to Edward J Hickling.

14 recordsLinked to original sources

PubMed2006

Heart rate of motor vehicle accident survivors in the emergency department, peritraumatic psychological reactions, ASD, and PTSD severity: a 6-month prospective study.

This small-scale study investigates the relationships between the heart rate of motor vehicle accident survivors presenting in the emergency department (ED) and acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) symptom severity. It also examines the relationships between the survivor's heart rate in the ED and peritraumatic dissociation and peritraumatic distress reported 2 weeks posttrauma. Fifty motor vehicle accident (MVA) survivors were assessed 2 weeks, 1 (N = 42), 3 (N = 37), and 6 months (N = 37) post-MVA. The heart rate in the ED predicted self-reported ASD symptom severity and clinician-rated PTSD symptom severity at 6 months but not at 1 or 3 months. Survivors' heart rate in the ED was significantly correlated with peritraumatic dissociation but not peritraumatic distress. These findings support the role of elevated ED heart rate as a predictor of both ASD and chronic PTSD symptom severity and may help to clarify the discrepant findings of previous research.

Accidents, Traffic↗

PubMed2005

Psychophysiological assessment of youthful motor vehicle accident survivors.

Twenty-one children and adolescents (age range 8-17, mean 12.7 years) who had been in motor vehicle accidents (MVAs), and 14 non-MVA controls matched for age and gender, underwent a psychophysiological assessment in which heart rate, systolic and diastolic blood pressure, and skin conductance were measured during baseline and two stressor phases: mental arithmetic and listening to and imagining a MVA like their own. The eight youth who currently met criteria for PTSD or sub-syndromal PTSD significantly reported more subjective distress to the MVA audiotape than the 13 MVA non-PTSD youth or the 14 non-MVA controls. All groups responded physiologically to the mental arithmetic. However, in contrast to expectations, there were no differential physiological responses among the groups to the stimuli reminiscent of the trauma. Possible explanations are explored.

Accidents, Traffic↗

PubMed2004

Studies of the vicarious traumatization of college students by the September 11th attacks: effects of proximity, exposure and connectedness.

From mid-October 2001 through the end of November 2001, we collected fairly large sets of questionnaires from undergraduates at three public universities (Albany, NY, n = 507, Augusta, GA, n = 336, Fargo, ND, n = 526 ) to assess rate of acute stress disorder (ASD) and level of ASD symptoms following the September 11th attacks, rate of current posttraumatic stress disorder (PTSD) and level of PTSD symptoms, and current level of depressive symptoms resulting from the September 11th attacks. We also gathered information on exposure to media coverage of the attacks, connectedness to the World Trade Center (WTC) and personnel there, and degree of engagement in reparative acts such as giving blood, attending vigils. We found higher levels of ASD, ASD symptoms, PTSD and PTSD symptoms as a function of geographical proximity to New York City (and within the Albany site, proximity of students' homes) and gender. Exposure (hours of TV watched) was a predictor in some instances as was connectedness to WTC victims. ASD symptoms were the strongest predictor of subsequent PTSD symptoms. Path models accounted for over 60% of the variance in PTSD symptoms.

Acute Disease↗

PubMed2004

Two studies of psychiatric morbidity among motor vehicle accident survivors 1 year after the crash.

We assessed the psychiatric co-morbidity associated with chronic posttraumatic stress disorder (PTSD) (1-2 years) secondary to personal injury motor vehicle accidents (MVAs) in two studies. In Study 1, we compared the results of SCID assessments for 75 treatment-seeking MVA survivors (51 with PTSD and 24 with symptoms but no PTSD). In Study 2, we compared similar results among 132 MVA survivors who had been followed prospectively for 12+ months after their accidents (19 with PTSD, 32 who had PTSD but who had remitted, and 81 who never met criteria for PTSD). We found comparable levels of current co-morbid major depression (53%), any mood disorder (62-68%), generalized anxiety disorder (26%) and any anxiety disorder (42%) for both groups of participants with chronic PTSD. These rates of co-morbidity were higher than those found in non-PTSD comparison groups with similar MVA histories.

Accidents, Traffic↗

PubMed2004

One- and two-year prospective follow-up of cognitive behavior therapy or supportive psychotherapy.

We followed up over 90% of 57 motor vehicle accident survivors, who completed a controlled comparison of cognitive behavioral therapy (CBT) to supportive psychotherapy (SUPPORT). One-year results showed a continued significant advantage on categorical diagnosis (PTSD or not) and structured interview measures (CAPS) for CBT over SUPPORT. Other measures generally showed the same results. At two years, we were able to follow-up only 75% of one-year completers. Although there continued to be arithmetic differences favoring CBT over SUPPORT, with these attenuated samples only differences on PTSD Checklist and Impact of Event Scale scores and in overall categorical diagnoses were significant. There was very modest improvement from end of treatment to the two-year follow-up.

Accidents, Traffic↗

PubMed2004

Effect of psychological treatment on cognitive bias in motor vehicle accident-related Posttraumatic Stress Disorder.

The modified or "emotional" Stroop paradigm has been frequently employed in previous evaluations of information processing models of Posttraumatic Stress Disorder (PTSD) and other anxiety disorders. These studies have frequently documented an attentional bias to trauma-specific threatening stimuli in PTSD patients. However, the response of the Stroop color-naming interference effect to psychological treatment has yet to be tested in a trauma population. The present study evaluated the effects of three treatment conditions on the Stroop interference effect in motor vehicle accident (MVA) survivors with PTSD. Following treatment, participants were classified as either treatment responders or nonresponders. Participants named the color of three types of stimuli: MVA trauma-specific words, neutral words, and nonwords. Results showed that change in selective color-naming interference for trauma cues was unrelated to treatment response or modality at either posttreatment or follow-up. Findings cast doubt on the clinical utility of the modified Stroop test as a measure of treatment outcome in this population.

Accidents, Traffic↗

PubMed2004

Physiological responsiveness of motor vehicle accident survivors with chronic posttraumatic stress disorder.

This study sought to replicate past research that has shown differences in physiological responsiveness among survivors of motor vehicle accidents (MVAs) with posttraumatic stress disorder (PTSD) and those survivors who do not develop this disorder. Such physiological differences have been found specifically with heart rate (HR) reactivity. This study also attempts to account for differences among those survivors with PTSD who do respond physiologically in laboratory situations and those who do not show a physiological response when presented with audiotaped descriptions of their accidents. Results replicated the significant differences in HR reactivity between diagnostic groups with chronic PTSD versus those with subsyndromal PTSD and non-PTSD. Variables related to the severity of the diagnosis and trauma were found to discriminate between physiological responders and nonresponders with chronic PTSD.

Accidents, Traffic↗

PubMed2003

A controlled evaluation of cognitive behavioural therapy for posttraumatic stress in motor vehicle accident survivors.

Seventy-eight motor vehicle accident survivors with chronic (greater than 6 months) PTSD, or severe sub-syndromal PTSD, completed a randomized controlled comparison of cognitive behavioral therapy (CBT), supportive psychotherapy (SUPPORT), or a Wait List control condition with two detailed assessments. Scores on the CAPS showed significantly greater improvement for those in CBT in comparison to the Wait List and to the SUPPORT conditions. The SUPPORT condition in turn was superior (p=0.012) to the Wait List. Categorical diagnostic data showed the same results. An analysis of CAPS scores including drop-outs (n=98) also showed CBT to be superior to Wait List and to SUPPORT with a trend for SUPPORT to be superior to Wait List. The CBT condition led to significantly greater reductions in co-morbid major depression and GAD than the other two conditions. Results held up well at a 3-month follow-up on the two active treatment conditions.

Accidents, Traffic↗

PubMed2003

Posttraumatic stress disorder and psychosocial functioning within two samples of MVA survivors.

To examine criterion F variables of PTSD, the psychosocial functioning of two samples of motor vehicle accident (MVA) survivors was investigated. Within each sample, comparisons between MVA survivors with and without PTSD were conducted on four psychosocial functioning indices at three time points. In addition, the relationships between specific PTSD symptom clusters and psychosocial functioning indices were examined. The study revealed that, in general, MVA survivors with PTSD evidenced poorer psychosocial functioning than did survivors without PTSD. The emotional numbing symptoms of PTSD emerged as the most consistent predictors of the psychosocial functioning indices. The implications of these findings to the comprehensive treatment of PTSD are discussed.

Accidents, Traffic↗

PubMed2003

Is the emotional Stroop paradigm sensitive to malingering? A between-groups study with professional actors and actual trauma survivors.

Six professional actors, trained by psychologists and acting coaches to feign PTSD, were covertly enrolled into a treatment outcome study for PTSD with the aim of investigating malingering. During pretreatment assessment, individuals completed an emotional Stroop task. Vocal response latencies to different classes of stimuli were examined for sensitivity to malingering. Actor response latencies were compared to those of 6 nonlitigant PTSD patients and 6 nonanxiety controls. The actor/dissimulation group was able to feign an overall slowing of response latency across stimulus types, similar to the PTSD group. However, they were unable to modulate response latency as a function of stimulus content, a pattern that characterized the PTSD group. The use of information-processing paradigms to detect dissimulation is discussed.

Adolescent↗

PubMed2003

Of "crashes" and "accidents," a comment on Stewart and Lord.

A. E. Stewart and J. H. Lord (2002) call for abandoning the term motor vehicle accident and substituting motor vehicle crash on definitional and patient care grounds. We disagree on definitional grounds and because of the absence of empirical data from accident survivors to support their contentions.

Accidents, Traffic↗

PubMed2002

Emergency room vital signs and PTSD in a treatment seeking sample of motor vehicle accident survivors.

Seeking to replicate earlier reports by Shalev et al. (1998) and R. A. Bryant, A. G. Harvey, R. M. Guthrie, and M. L. Moulds (2000) that elevated heart rate (HR) shortly after a trauma was predictive of later posttraumatic stress disorder (PTSD), we examined vital sign data on 74 treatment-seeking motor vehicle accident (MVA) survivors, taken in the Emergency Department (ED) following their MVAs. Contrary to expectations, we found that those with elevated HRs in the ED were significantly less likely to meet criteria for PTSD 13 months post-MVA and that those with elevated HRs had lower levels of posttraumatic stress symptoms. Likewise, those with current PTSD had lower ED values of HR and DBP than did those who did not currently meet criteria for PTSD.

Accidents, Traffic↗

PubMed2002

Personality disorders and posttraumatic stress disorder in motor vehicle accident survivors.

This study examined the impact of a co-occurring personality disorder on the development and remission of posttraumatic stress disorder (PTSD) in 158 motor vehicle accident (MVA) survivors followed prospectively for 1 year. Participants were assessed 1 to 4 months after trauma and at 6-month and 1-year follow-up evaluations during 1991 through 1993. These archival data were analyzed in the present study. The prevalence of at least one personality disorder was 13.3%, with the majority (52.4%) presenting with obsessive-compulsive personality disorder. Persons with a personality disorder were significantly more likely to be diagnosed with PTSD at 1-year follow-up evaluation. For persons diagnosed with PTSD at the initial assessment, those with a personality disorder were significantly less likely to remit by 1 year. The presence of a preexisting personality disorder may increase the risk of chronic PTSD and impede remission.

Accidents, Traffic↗

PubMedDate not supplied

Posttraumatic headache: biopsychosocial comparisons with multiple control groups.

OBJECTIVE: This study examined somatic, psychological, and cognitive functioning of subjects with posttraumatic headache in comparison with multiple control groups. BACKGROUND: Posttraumatic headache is not as widely studied as other forms of headache (eg, tension-type, migraine). Previous research has suggested poor psychological functioning in patients with posttraumatic headache in comparison with other groups of patients with pain; however, this group has yet to be compared with a group of persons who have experienced trauma but are headache-free. DESIGN AND METHODS: Nineteen subjects with posttraumatic headache were studied, with full assessments available for 14 participants. Comparison groups, containing 16 participants each, included another headache group, a nonheadache group, and a trauma (motor vehicle accident) survivor nonheadache group. Participants completed several measures assessing somatic, psychological, and cognitive functioning. RESULTS: Findings revealed that the posttraumatic headache group exhibited significantly poorer functioning than the comparison groups on several measures including the Psychosomatic Symptom Checklist, Postconcussion Syndrome Checklist, axis II psychiatric diagnoses, Minnesota Multiphasic Personality Inventory, and the Daily Hassles Scale (frequency and total). Additionally, they scored higher on the following: number of axis I psychiatric diagnoses, the Daily Hassles Scale (intensity), Beck Depression Inventory, State-Trait Anxiety Inventory, and State-Trait Anger Expression Inventory. The posttraumatic headache group was similar to the other trauma group on the Posttraumatic Stress Disorder Symptom Checklist and the Life-Trauma Checklist. CONCLUSIONS: This study confirmed the distress seen in this understudied population of persons with headache and highlights areas of focus for proper assessment and treatment of those with headache and who have had an accident.

Accidents, Traffic↗