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Biomedical subjects

L C Terr

Publications and source records attributed to L C Terr.

At least 19 recordsLinked to original sources
PubMed1999

Children's symptoms in the wake of Challenger: a field study of distant-traumatic effects and an outline of related conditions.

OBJECTIVE: The Challenger space shuttle explosion in January 1986 offered an opportunity to determine what, if any, symptoms of posttraumatic stress disorder (PTSD) and bereavement normal latency-age children and adolescents would develop after a distant, horrifying event. METHOD: With a structured interview, the authors assessed the symptoms of 153 randomly selected children from Concord, N.H., and Porterville, Calif. Responses were statistically compared between East Coast children, who saw the event on television and who generally cared more about the teacher aboard Challenger, and West Coast children, who heard about it first; between latency-age children and adolescents; and between children seen 5-7 weeks later and those same children seen 14 months later. RESULTS: More than 60% of the subjects feared at least one stimulus related to Challenger within the first 5-7 weeks of the explosion. The East Coast and latency-age groups appeared significantly more symptomatic than did the West Coast and adolescent groups. Over the 14-month study period, most symptoms dramatically faded. However, adolescents' diminished expectations for the future in general increased, and latency-age children's changed approach to space careers held relatively steady. Three East Coast latency-age children met the DSM-III-R symptom requirements for PTSD in 1986; no children met these in 1987. CONCLUSIONS: Children's symptomatic patterns after Challenger relate to the patterns for PTSD listed in diagnostic manuals and to three symptoms not in the DSM-IV list. To the authors, distant traumas appear to be one of a newly defined spectrum of trauma-related conditions that include relatively evanescent symptoms and a few longer-lasting ones. These symptoms may affect large numbers of normal children.

Adolescent↗
PubMed1997

Children's thinking in the wake of Challenger.

OBJECTIVE: The Challenger spacecraft explosion in 1986 offered an opportunity to study the thinking of normal children after a sudden and distant disaster, differences in thinking among children of different levels of emotional concern and different ages, and changes in their thinking over time. METHOD: The authors studied six thinking patterns known to characterize childhood posttraumatic stress disorder and four additional hypothesized patterns in 153 randomly selected children of Concord, N.H. (who watched the explosion on television) and Porterville, Calif. (who heard about it later). They compared the structured-interview responses of the more involved (East Coast) and less involved (West Coast) children, of the latency-age children and the adolescents, and of the children initially (5-7 weeks after the explosion) and 14 months later. RESULTS: The children exhibited the 10 predictable thinking patterns. They initially defended themselves, denying the reality of the explosion. They later fantasized about it. They tried to cope by seeking additional information on their own, at home, and at school. Most children talked about Challenger, but a minority of the latency-age youngsters avoided related talk and thoughts. The adolescents experienced more paranormal thinking, philosophical changes, and negative attitudes. Over the year, omens, paranormal experiences, and Challenger-based fantasies tended to disappear, but negative views about institutions and the world's future held steady or increased. CONCLUSIONS: The children's thinking followed predictable patterns. A higher degree of emotional involvement (East Coast children) was strongly linked to these thinking patterns, as was being an adolescent. Distant disasters appear to set up commonalities of thought that might come to characterize certain generations of children.

Adaptation, Psychological↗
PubMed1996

Children's memories in the wake of Challenger.

OBJECTIVE: The Challenger spacecraft explosion of Jan. 28, 1986, offered an opportunity to study the memories of normal latency and adolescent children of different emotional involvements following one sudden and distant disaster. How would children of various levels of concern express their memories? And if studied over time, how would these narratives change? Would there be developmental differences? And would there be false details of memory? METHOD: The authors set out to compare the memories of 153 children from Concord, N.H. (who watched the explosion on television), and Porterville, Calif. (who heard about it). The structured-interview responses of involved and less involved children; latency-age versus adolescent children; and those seen initially (5-7 weeks after the explosion) versus those same children seen later (at 14 months) were statistically compared. RESULTS: The vast majority of children's memories of Challenger were clear, consistent, and detailed, with highlighting of personal placement, who else was there, and personal occurrences linked to the event. Those children who were less emotionally involved demonstrated significantly less clarity, consistency, and correct ordering of sequences and were less likely to remember personal placement, other people who were there, and related personal incidents. About 30% of all children in this study misunderstood something about Challenger and incorporated these misunderstandings into their memories as false details. Latency-age children continued to harbor false details for 14 months, as opposed to the adolescents. CONCLUSIONS: Childhood memories of the Challenger space shuttle explosion appeared predictable, were related to patterns of memory that have been observed following single, unrepeated traumas, and reflected age and stage differences.

Adolescent↗
PubMed1993

Reliability of the Part II board certification examination in psychiatry: examination stability.

OBJECTIVE: The aim of this study was to examine the reliability (examination stability) of the American Board of Psychiatry and Neurology (ABPN) Part II (oral) examination in psychiatry. METHOD: The authors analyzed the consistency (agreement between grades given by two independent examiners) for a 1-year examination cycle using a weighted kappa statistic and compared different parts of the examination (live patient and videotape), different examination sites, different days, and different times of the day. RESULTS: There was no significant difference in agreement between examiners by different parts of the examination, examination site, day of the week, or time of day. CONCLUSIONS: The stability of the Part II ABPN examination in psychiatry is not influenced significantly by the format or site of administration. Candidate performance is the predominant factor in the determination of passing or failing grades.

Bias↗
PubMed1992

Mini-marathon groups: psychological "first aid" following disasters.

Large group counseling sessions for soldiers following battle have been commonly used since World War II. The author conceptualizes and demonstrates how these mini-marathon sessions can be adapted to support all ages and types of civilians involved in disasters. Mini-marathons take about 3 hours and are divided into three sections: story sharing, symptom sharing, and suggestions for self-help, including sharing tales of heroism and survival. After an initial mini-marathon session, a second session may be held emphasizing creativity. The author also describes how mini-marathons can be adapted for therapists who will lead their own sessions.

Adaptation, Psychological↗
PubMed1991

Childhood traumas: an outline and overview.

Childhood psychic trauma appears to be a crucial etiological factor in the development of a number of serious disorders both in childhood and in adulthood. Like childhood rheumatic fever, psychic trauma sets a number of different problems into motion, any of which may lead to a definable mental condition. The author suggests four characteristics related to childhood trauma that appear to last for long periods of life, no matter what diagnosis the patient eventually receives. These are visualized or otherwise repeatedly perceived memories of the traumatic event, repetitive behaviors, trauma-specific fears, and changed attitudes about people, life, and the future. She divides childhood trauma into two basic types and defines the findings that can be used to characterize each of these types. Type I trauma includes full, detailed memories, "omens," and misperceptions. Type II trauma includes denial and numbing, self-hypnosis and dissociation, and rage. Crossover conditions often occur after sudden, shocking deaths or accidents that leave children handicapped. In these instances, characteristics of both type I and type II childhood traumas exist side by side. There may be considerable sadness. Each finding of childhood trauma discussed by the author is illustrated with one or two case examples.

Adolescent↗
PubMed1991

Reliability of the Part II Board Certification Examination in Psychiatry: interexaminer consistency.

OBJECTIVE: The aim of the study was to examine the reliability (interexaminer consistency) of the American Board of Psychiatry and Neurology (ABPN) Part II (oral) examination in psychiatry. METHOD: Grades were assigned independently by two examiners who observed the same examination in a 1-year cycle (1,422 candidates, two examinations each). The consistency between these pairs of grades (pass, condition, fail) was analyzed using a weighted kappa statistic. RESULTS: There was perfect agreement between examiners in 67% of examinations, minor disagreement in 26%, and major disagreement in 7% (weighted kappa = 0.54-0.56). CONCLUSIONS: The Part II ABPN examination demonstrates fair to good reliability as measured by interexaminer consistency. Development of more explicit grading criteria should further improve examiner agreement in future examinations.

Educational Measurement↗
PubMed1990

Who's afraid in Virginia Woolf? Clues to early sexual abuse in literature.

Virginia Woolf, by self-admission, was a victim of repeated sexual abuses. At age 5 or 6 she was sexually mishandled by her older half brother, Gerald Duckworth. In her teenage years another older half brother, George Duckworth, misused her repeatedly. As a result of these abuses, Woolf suffered the special signs and symptoms of long-standing childhood psychic trauma--sexual numbing, emotional distancing, self-hypnosis, splitting, and dissociation. She also suffered some of the more ordinary signs and symptoms common to most childhood traumas--fears, perceptual repetitions, and repetitions in behavior (in this case, in writing). Interestingly, Virginia Woolf's fictional characters manifest the very same signs and symptoms Woolf manifested all of her life. The occasional reader may treat Woolf's fiction, because of these "symptoms," in much the same way that an actual childhood sex abuse victim is often treated--with boredom, disbelief, and failure to respond.

Child↗
PubMed1989

Family anxiety after traumatic events.

Victims of traumatic events--such as violent crimes, incidents of terrorism, or domestic violence--often later exhibit a variety of anxiety symptoms. The development of clinical anxiety after such tragedies may also affect the functioning of the entire family. It is vital that physicians recognize the relationship between the traumatic event and the resulting anxiety in the family. This recognition is a first step in the treatment process, which includes several other strategies for intervention with the individual and the family.

Adolescent↗
PubMed1985

Psychic trauma in children and adolescents.

The term childhood trauma has been well-accepted and frequently used since the turn of the twentieth century, yet until the early 1980s the condition itself was barely described and minimally explained. This article covers the current definitions and then critically reviews the literature, emphasizing the most recent studies on childhood trauma. It then briefly considers the current state of treatment and the promising areas of present day research.

Adaptation, Psychological↗
PubMed1984

Time and trauma.

Explore the source record for details and available documents.

Adolescent↗
PubMed1983

Child snatching: a new epidemic of an ancient malady.

Eighteen children kidnapped successfully or abortively by a parent were psychiatrically evaluated; 16 were found to have one or more of five functional changes: (1) aftereffects of severe fright or psychic trauma, (2) effects of mental indoctrination, (3) grief or rage about parental abandonment, (4) rejection of the offending parent, and (5) exaggerated identification with a parent or wish fulfillment about a parent. There are serious problems at the law-psychiatry interface regarding stolen children. Both fields must direct their efforts to the prevention of these family tragedies. Psychiatric evaluation is indicated for every child who returns from a child-stealing experience. Pediatricians and child psychiatrists may help the courts to understand the child's point of view by testifying regarding medical findings as well as by interpreting the child's testimony and behavior to the court.

Child↗