Biomedical subjects

John Briere

Publications and source records attributed to John Briere.

9 recordsLinked to original sources

PubMed2006

Dissociative symptoms and trauma exposure: specificity, affect dysregulation, and posttraumatic stress.

Although dissociation is often described as a posttraumatic response, the actual statistical association between trauma exposure and dissociative symptoms is surprisingly small. This suggests that that some dissociative phenomena may be unrelated to trauma, or may be related in more complex ways. Analysis of the normative data for the Multiscale Dissociation Inventory revealed significant dissociative symptoms in only 8% of trauma-exposed individuals from the general population. However, 90% of those with at least one clinically significant dissociation scale on the Multiscale Dissociation Inventory reported a trauma history, and significant dissociation was found in only 2% of nontraumatized individuals. A history of interpersonal violence, number of different types of trauma exposure, posttraumatic stress, and affect dysregulation were univariate predictors of dissociative symptomatology in trauma-exposed participants, but only posttraumatic stress and affect dysregulation were multivariate predictors. Trauma is probably an important, but insufficient, condition for the development of dissociative symptomatology. Additional risk factors, such as high posttraumatic stress and/or reduced affect regulation capacities, may determine whether trauma exposure results in clinically significant dissociation.

Adolescent↗

PubMed2005

Is dissociation a multidimensional construct? Data from the Multiscale Dissociation Inventory.

The dimensionality of dissociation was examined in a combined sample of 1,326 general population, clinical, and university participants who completed the Multiscale Dissociation Inventory (MDI). Principal components analysis identified five moderately intercorrelated factors (mean r = .39): Disengagement, Identity Dissociation, Emotional Constriction, Memory Disturbance, and Depersonalization/Derealization. Differential relationships were found between individual MDI factors and demographics, trauma history, clinical status, posttraumatic stress, and scores on other dissociation measures. Surprisingly, after controlling for sex and age, trauma exposure accounted for only 3 to 7% of the variance in MDI factors. The notion of dissociation as a general trait was not supported. Instead, dissociation may represent a variety of phenomenologically distinct and only moderately related symptom clusters whose ultimate commonality is more theoretical than empirical.

Adolescent↗

PubMed2005

Phenomenology and psychological assessment of complex posttraumatic states.

The authors offer a framework for the assessment of psychological responses associated with exposure to early onset, multiple, or extended traumatic stressors. Six prominent and overlapping symptoms clusters are described: altered self-capacities, cognitive symptoms, mood disturbance, overdeveloped avoidance responses, somatoform distress, and posttraumatic stress. A strategy for the structured, psychometrically valid assessment of these outcomes is introduced, and specific recommendations for use of various generic and trauma-specific child and adult measures are provided. Implications of trauma assessment for treatment planning are discussed.

Adolescent↗

PubMed2005

Peritraumatic and persistent dissociation in the presumed etiology of PTSD.

OBJECTIVE: Dissociative responses that occur at the time of a trauma (peritraumatic dissociation) have been described as a major risk factor for subsequent posttraumatic stress disorder (PTSD). The current study evaluated peritraumatic dissociation and PTSD from a multivariate perspective, along with a less-investigated phenomenon: trauma-specific dissociation that begins during or after an event and continues until the time of assessment (persistent dissociation). METHOD: In two studies, 52 local community participants and 386 participants from the general population with histories of exposure to at least one traumatic event were assessed for the presence of PTSD and were administered measures of dissociation and peritraumatic distress. RESULTS: In both studies, peritraumatic dissociation, persistent dissociation, peritraumatic distress, and generalized dissociative symptoms were associated with PTSD by univariate analyses. However, multivariate analyses in both studies indicated that PTSD status was no longer related to peritraumatic dissociation once other variables (especially persistent and generalized dissociation) were taken into account. In contrast, persistent dissociation was a strong predictor at univariate and multivariate levels. CONCLUSIONS: Trauma-related persistent dissociation is a substantial predictor of PTSD, whereas peritraumatic dissociation ceases to predict PTSD at the multivariate level. These findings suggest that it is less what happens at the time of a trauma (e.g., disrupted encoding) that predicts PTSD than what occurs thereafter (i.e., persistent avoidance).

Adult↗

PubMed2004

Adult sexual assault: prevalence, symptomatology, and sex differences in the general population.

The prevalence and impact of adult sexual assault (ASA) were examined in a stratified random sample of the general population. Among 941 participants, ASA was reported by 22% of women and 3.8% of men. Multivariate risk factors for ASA included a younger age, being female, having been divorced, sexual abuse in childhood, and physical assault in adulthood. Childhood sexual abuse was especially common among sexually assaulted men and women (61 and 59%, respectively). ASA victims were more symptomatic than their nonassaulted cohorts on all scales of the Trauma Symptom Inventory (TSI; J. Briere, 1995), despite an average of 14 years having passed since the assault. Assaulted men reported greater symptomatology than assaulted women, whereas nonassaulted men reported less symptomatology than nonassaulted women.

Adolescent↗

PubMed2004

Violence against women: outcome complexity and implications for assessment and treatment.

This article reviews the major forms of violence against women, including sexual assault, intimate-relationship violence, and stalking and outlines the known psychological effects of such victimization. Also discussed are a number of variables that combine to determine the effects of such victimization, including type and characteristics of the assault; victim variables such as demographics, psychological reactions at the time of the trauma, previous victimization history, current or previous psychological difficulties, and general coping style; and sociocultural factors such as poverty, social inequality, and inadequate social support. The implications of this complexity are explored in terms of psychological assessment and the frequent need for multitarget, multimodal treatment approaches.

Battered Women↗

PubMed2003

Prevalence and psychological sequelae of self-reported childhood physical and sexual abuse in a general population sample of men and women.

OBJECTIVE: This study examined the prevalence and psychological sequelae of childhood sexual and physical abuse in adults from the general population. METHOD: A national sampling service generated a geographically stratified, random sample of 1,442 subjects from the United States. Subjects were mailed a questionnaire that included the Traumatic Events Survey (TES) [Traumatic Events Survey, Unpublished Psychological Test, Harbor-UCLA Medical Center, Los Angeles] and the Trauma Symptom Inventory (TSI) [Trauma Symptom Inventory Professional Manual, Psychological Assessment Resources, Odessa, FL]. Of all potential subjects, 935 (64.8%) returned substantially completed surveys. RESULTS: Sixty-six men and 152 women (14.2% and 32.3%, respectively) reported childhood experiences that satisfied criteria for sexual abuse, and 103 males and 92 females (22.2% and 19.5%, respectively) met criteria for physical abuse. Twenty-one percent of subjects with one type of abuse also had experienced the other type, and both types were associated with subsequent adult victimization. After controlling for demographics, adult history of interpersonal violence, and other child abuse, childhood sexual abuse was associated with all 10 scales of the TSI, and physical abuse was related to all TSI scales except those tapping sexual issues. Sexual abuse predicted more symptom variance than did physical abuse or adult interpersonal victimization. Various aspects of both physical and sexual abuse experiences were predictive of TSI scores. Abuser sex, however, both alone and in interaction with victim sex, was not associated with additional TSI symptomatology. CONCLUSIONS: Childhood sexual and physical abuse is relatively common in the general population, and is associated with a wide variety of psychological symptoms. These relationships remain even after controlling for relevant background variables.

Adolescent↗

PubMed2002

Functional ability in executive variant Alzheimer's disease and typical Alzheimer's disease.

A frontal, or executive, variant of Alzheimer's disease (EAD) has been described in the literature in which frontal dysfunction accompanies temporal and parietal changes in the early stages of the illness. However, no study has empirically investigated associated aspects, such as neuropsychiatric symptoms, instrumental activities of daily living, or caregiver burden in this EAD subgroup. We compared the performance of two subgroups of mild Alzheimer's disease patients (e.g., EAD and typical Alzheimer's disease; TAD) on neuropsychological and associated measures. Results revealed that the EAD group, selected based on poor executive scores, did not significantly differ from the TAD group on nonexecutive neuropsychological tests of intelligence, language, verbal and nonverbal memory, or visual-spatial abilities. However, the EAD group evidenced more severe neuropsychiatric symptoms, impaired activities of daily living, and greater caregiver distress than the TAD group. Thus, the EAD subgroup is characterized by executive dysfunction, neuropsychiatric symptoms, and functional disability in excess of that seen in TAD. Whether our EAD subgroup represents an actual frontal variant of Alzheimer's disease awaits replication in a larger sample including neuroimaging and pathological confirmation, as well as longitudinal assessment of cognition and neuropsychiatric symptoms.

Activities of Daily Living↗

PubMed2002

The Inventory of Altered Self-Capacities (IASC): a standardized measure of identity, affect regulation, and relationship disturbance.

This article describes the Inventory of Altered Self-Capacities (IASC), a 63-item standardized measure of disturbed functioning in relation to self and others. The seven scales of the IASC are Interpersonal Conflicts, Idealization-Disillusionment, Abandonment Concerns, Identity Impairment, Susceptibility to Influence, Affect Dysregulation, and Tension Reduction Activities. The psychometric properties of the IASC were examined in general population, clinical, and university samples. The IASC was found to have internal consistency/reliability and validity in all three samples. Generally as predicted, IASC scales were associated with existing measures tapping borderline and antisocial personality features, depression, suicidality, substance abuse, somatization, and dysfunctional sexual behavior

Adolescent↗