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Biomedical subjects

J E McCarroll

Publications and source records attributed to J E McCarroll.

At least 19 recordsLinked to original sources
PubMed2001

Child emotional maltreatment: a 2-year study of US Army cases.

OBJECTIVE: Reports of childhood emotional maltreatment have increased greatly over the past decade. The objective of this research was to determine the types of emotional maltreatment substantiated in a community of US Army families residing temporarily in Germany. Such a description may help to improve the understanding of how a jurisdictional body defines emotional maltreatment in day-to-day practice. METHOD: Data were obtained from a review of the minutes of case review committees (CRCs) for 181 cases of child emotional abuse in 1997-1998. We determined the type, number, and severity of incidents, the substantiation rate, and the situations to which children were exposed. RESULTS: The most frequently substantiated type of incident was witnessing domestic violence, 60% of all cases. Primary emotional abuse was found in 26% of cases, while emotional abuse in conjunction with child physical abuse or child neglect was found in 14% of cases. The more severe the case, the more likely it was to be substantiated. CONCLUSIONS: Emotional maltreatment was substantiated more as a single type than in combination with other forms of maltreatment. Seeing emotional abuse as a single entity may allow clinicians to focus on a relationship or situation (such as spouse abuse) that is potentially harmful to a child. However, recognizing the emotionally abusive aspects of child physical abuse and neglect could allow an expanded treatment plan that could include treatment of the emotionally abusive behavior to strengthen the relationship of the caregiver to the child, in addition to the focus on the physical abuse and neglect.

Adolescent↗
PubMed2001

Effects of exposure to death in a war mortuary on posttraumatic stress disorder symptoms of intrusion and avoidance.

Exposure to the dead has been an important subject for traumatic stress research, considering that such exposure is a risk factor for posttraumatic stress disorder (PTSD). Individuals required to handle the dead from war are exposed to multiple stressors. No previous studies, however, have examined pre- and post-responses to traumatic death. We studied the pre-post responses of 352 military men and women who worked in the mortuary that received the dead from the Persian Gulf War (Operation Desert Storm) in 1990 to 1991. The respondents were volunteers and nonvolunteers for assignment to the mortuary; some had prior experience in handling the dead and some did not. Symptoms of intrusion and avoidance were measured before and after exposure. Four groups were examined based on the degree of exposure to remains. Age, sex, volunteer status, and prior experience handling remains were statistically controlled. Post-exposure intrusion symptoms increased significantly for all groups exposed to the dead. Increased post-exposure avoidance symptoms were present in the two groups with the greatest exposure to remains. There were no significant increases in intrusion or avoidance in the unexposed group.

Adult↗
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

Posttraumatic stress disorder in U.S. Army Vietnam veterans who served in the Persian Gulf War.

We reviewed U.S. Army medical boards (136 cases) held between October 1990 and July 1994 for posttraumatic stress disorder (PTSD) that involved participation in the Persian Gulf War of 1990 to 1991. Thirty-five percent of these soldiers (34 cases) had also served in Vietnam. Their records were compared with the records of 102 other soldiers also medically retired for PTSD who served in the Persian Gulf War but did not serve in Vietnam. Approximately one-half of the Vietnam group developed PTSD symptoms in anticipation of deployment to the Persian Gulf. Those soldiers with prior Vietnam service had statistically significant odds ratios for PTSD (between about 5 and 24) compared with soldiers without Vietnam service. These findings indicate that for some persons with prior war experience, the threat of another war is sufficient to exacerbate symptoms or provoke a new episode of PTSD and this risk is substantially greater than that for soldiers without such experience.

Acute Disease↗
PubMed1996

Posttraumatic stress symptoms following forensic dental identification: Mt. Carmel, Waco, Texas.

OBJECTIVE: This study was conducted to determine risk factors for posttraumatic stress in medical care professionals who perform postmortem identifications. METHOD: Thirty-one dentists (29 men and two women) who had identified the dead from the fire at the Branch Davidian compound in April 1993 were compared to 47 dentists (45 men and two women) who lived in the area but had not identified any of these remains. Posttraumatic symptoms in both groups were measured by using the Impact of Event Scale and the Brief Symptom Inventory. For the remains handlers only, the subjective distress of handling remains and the social support received during the procedure were reported. RESULTS: Higher scores on the Impact of Event Scale intrusion subscale, the overall Impact of Event Scale, and the obsessive-compulsive subscale of the Brief Symptom Inventory were found for the remains handlers than for the comparison group. Within the remains handler group, distress was significantly related to the hours of exposure to the remains, prior experience handling remains, age, and the support received from spouses and co-workers during the identifications. CONCLUSIONS: Posttraumatic stress symptoms can be expected in some health professionals who perform postmortem identifications. Prior experience and social support may mitigate some of these responses.

Adult↗
PubMed1995

Gruesomeness, emotional attachment, and personal threat: dimensions of the anticipated stress of body recovery.

Previous research has shown that exposure to grotesque death has been associated with posttraumatic stress disorder and higher levels of stress have been associated with mortuary workers who anticipated handling remains than those who did not. Additional research is presented here to further clarify the nature of the anticipated stress of handling the dead. Anticipated stress of handling human remains was rated for 13 different situations by 479 persons (384 men and 95 women) without such experience, but whose job was likely to require it. Factor analysis of their ratings revealed three psychological dimensions: the gruesomeness of the remains, an emotional link between the viewer and the remains, and personal threats to the remains handler. Suggestions for preventive measures, training, and interventions for those who may handle remains are made.

Adolescent↗
PubMed1995

Working with traumatic material: effects on Holocaust Memorial Museum staff.

Preparation for the opening of the United States Holocaust Memorial Museum in Washington, D.C., in April 1993, exposed workers to potentially disturbing personal artifacts of Holocaust victims and other reminders of the horrors of the Holocaust. The process of psychological consultation is described, and the resultant approaches to interventions designed to lower distress among museum workers and volunteers are discussed.

Adaptation, Psychological↗
PubMed1995

Anticipatory stress of handling human remains from the Persian Gulf War. Predictors of intrusion and avoidance.

High levels of distress were found in military mortuary workers prior to the arrival of the human remains from the Persian Gulf War of 1991. To better understand the stress of anticipating the handling of remains, we performed stepwise multiple regression analyses to identify the best predictors of intrusive thoughts and avoidant thoughts and behavior, two of the primary symptoms of posttraumatic stress disorder. After volunteer status and sex were controlled, fear and discomfort with mutilation and the grotesque, as measured by the Mutilation Questionnaire, and defensiveness or denial, as measured by the Marlowe-Crowne Scale, were significant predictors of intrusion and avoidance in the inexperienced group. In the experienced group, only the Mutilation Questionnaire predicted intrusion and avoidance. Results have implications for selection, training, and interventions for mortuary workers and other disaster workers whose job includes exposure to human remains.

Adult↗
PubMed1995

Symptoms of PTSD following recovery of war dead: 13-15-month follow-up.

OBJECTIVE: The authors explored whether individuals who participated in the recovery of war dead were more likely to experience later symptoms of posttraumatic stress disorder (PTSD) than were individuals who were not involved in the recovery of war dead. METHOD: PTSD symptoms were assessed by questionnaire in men and women who had or had not handled human remains during the Persian Gulf War: 116 men and women who had and 118 who had not handled human remains participated in the study 3-5 months after returning from the war; 55 of the subjects who had and 56 of those who had not handled human remains participated in a follow-up assessment 13-15 months after their return. RESULTS: Subjects who had been involved in the recovery of war dead had significantly higher symptom levels than comparison subjects at both time points. CONCLUSIONS: After more than 1 year, individuals who had handled human remains during wartime were at higher risk for PTSD symptoms than those who had not.

Adult↗
PubMed1993

Handling bodies after violent death: strategies for coping.

Interviews with and observations of experienced and inexperienced personnel were conducted to determine their coping strategies before, during, and after their work with the bodies of people who had died violently. Avoidance, denial, and social support from the work group and spouse appeared to facilitate coping. The implications of these findings for therapeutic intervention are discussed.

Accidents, Aviation↗
PubMed1993

Traumatic stress of a wartime mortuary. Anticipation of exposure to mass death.

Exposure to traumatic death is a risk factor for posttraumatic stress disorder. For some groups, anticipation of such exposure may contribute to traumatic stress. We studied the anticipated stress of working in the Operation Desert Storm mortuary in two groups prior to the arrival of the dead. We examined those who would handle remains (mortuary workers, N = 386, 330 men and 56 women) and those who would not (support workers, N = 87, 67 men and 20 women). These two groups were a mixture of volunteers and nonvolunteers as well as persons with and without experience in handling the dead. The mortuary workers had higher levels of preexposure distress than support workers; nonvolunteer mortuary workers had higher levels of distress than volunteers. Female mortuary workers had higher levels of distress than males, although this effect was modest. Experienced mortuary workers reported fewer intrusive and avoidant symptoms than did inexperienced workers. Those persons at highest risk for generalized distress as well as intrusive and avoidant symptoms were inexperienced nonvolunteer mortuary workers.

Adult↗
PubMed1993

Anticipation of handling the dead: effects of gender and experience.

In addition to the direct psychological effects of disaster stressors, anticipation of stress can itself be debilitating. We examined the relationship between the anticipated stress of handling the dead and gender and experience. Experienced persons had lower anticipated stress than inexperienced persons. Inexperienced, females had higher anticipated stress than inexperienced males; experienced males and females did not differ. Results provide support for an 'inoculation' theory of stress buffering in disaster workers.

Adaptation, Psychological↗
PubMed1993

Symptoms of posttraumatic stress disorder following recovery of war dead.

Persons who handled human remains in Operation Desert Storm (N = 116) were compared with those who did not handle remains (N = 118) on symptoms of posttraumatic stress disorder. Subjects who handled remains reported more intrusive and avoidant symptoms than other subjects. Subjects who were inexperienced at handling remains had more symptoms than those who were experienced. Within the experienced group, there was a significant correlation between the number of remains handled and level of symptoms reported.

Adolescent↗
PubMed1993

Clients, problems, and diagnoses in a military community mental health clinic: a 20-month study.

A descriptive epidemiologic study was performed using intake data from an Army community mental health clinic. This clinic was on a U.S. Army non-training post; data were collected over a 20-month period. Two diagnoses, occupational problem and phase of life or other life circumstance problem, were utilized by clinicians in 51% of all cases. Axis I diagnoses were found in 21% of the cases and medication was prescribed in 7%. Women were over-represented relative to men. We concluded that the patterns of diagnoses reflected the demand characteristics of the military environment. One implication of this study is that psychiatric care must be examined in the context of the community and not just as an administrative or economic system.

Community Mental Health Services↗