Biomedical subjects

L Hyer

Publications and source records attributed to L Hyer.

At least 19 recordsLinked to original sources

PubMed1999

The interaction of posttraumatic stress disorder and depression among older combat veterans.

The question whether depression is related to trauma as part of posttraumatic stress disorder (PTSD) itself or whether it represents autonomous symptoms occurring separately (from PTSD) has not been answered. We addressed two issues: (a) What is the relationship between PTSD and depression as measured by continuous measures on outcomes? and (b) By removing depression components from the PTSD diagnosis, what is the impact on standard outcomes? Older veterans from World War II or Korea were interviewed and given self-report measures on PTSD and depression. The CAPS-1 and the MMPI-D were used as the continuous measures for PTSD and depression. The outcome measures were health status, overall adjustment, social support, and physiological status. Results showed that depression influenced health status and social support: PTSD did not contribute to the equation. The CAPS-1 also was further divided into CAPS-PTSD and CAPS-D (depression) based on item content. For adjustment and health status, PTSD asserted a greater influence; for social support and heart rate, depression was the greater influence. Discussion addressed the fact that depression is an important consideration in the expression of PTSD.

Adaptation, Psychological↗

PubMed1997

EMDR minus eye movements equals good psychotherapy.

Eye Movement Desensitization and Reprocessing (EMDR) is a therapy roughly equal in efficacy to others currently available. It is argued that this treatment method is efficacious independent of the value of its component parts (e.g., eye movements) and is successful because it applies common and generally accepted principles of psychotherapy. Ten curative principles of this procedure are discussed as reflective of sound psychotherapy practice. It is hoped that an understanding of this therapy from the perspective of the practice and theory of psychotherapy will assist in its study.

Abreaction↗

PubMed1997

Validation of the MCMI-III PTSD scale among combat veterans.

The new MCMI-III Posttraumatic Stress Disorder (PTSD) scale was validated on 104 combat veterans who were divided into two groups, PTSD Treatment Group and Non-PTSD Treatment Group. PTSD status was carefully determined by clinical interview and therapists' reports. The Combat Exposure Scale, the Mississippi Scale for Combat-related PTSD, and the Impact of Events Scale were also given. Analysis showed that the MCMI-III PTSD scale had a low internal consistency, but that it significantly differentiated the two groups and significantly correlated to those on other PTSD self-report scales. This scale appeared to be influenced by an acquiescent response style. Further validation studies are needed.

Adult↗

PubMed1997

Interaction of posttraumatic stress disorder and major depressive disorder among older combat veterans.

This study investigated the interaction of PTSD and major depressive disorder with common aging-related variables for a community sample of older World War II and Korean War veterans. Older veterans (N = 139) were divided into PTSD and depressed groups on the basis of interviewers' measures and compared on overall adjustment, social support, and health status. Only PTSD affected adjustment and health status.

Aged↗

PubMed1996

Effects of Outward Bound Experience as an adjunct to inpatient PTSD treatment of war veterans.

There is a paucity of studies on Outward Bound Experiences (OBE) with adult psychiatric populations and, more notably, with trauma victims. This study evaluates the efficacy of OBE as an adjunct to specialized inpatient PTSD treatment with survivors of chronic combat-related PTSD (N = 219) at two Veterans Administration Medical Centers. On several measures of PTSD and general adaptation, results showed that the five-day OBE did not differ from standard treatment of PTSD survivors. Two other issues were addressed: identification of successful and non-successful subjects as a result of OBE, and exploration of objective versus subjective measures among this chronic group. Finally, as a post-study analysis, inferred curative components of the OBE were discussed as each appeared to impact on the participants.

Adult↗

PubMed1996

Assessment of older combat veterans with the clinician-administered PTSD scale.

A study of the posttraumatic stress disorder (PTSD) among older combat veterans of World War II and the Korean Conflict was conducted. The Clinician-Administered PTSD Scale (CAPS) was given to 125 older combat veterans, along with a computerized variant of the Structured Clinical Interview for DSM-III-R for PTSD, the SCID-DTREE. (The SCID-DTREE was itself validated against the full SCID). Results showed the CAPS to be a good discriminator of PTSD: Out of the 125 cases, only 9 were misclassified using the SCID-DTREE as the base measure, a 93% efficiency. An alpha on the full CAPS was .95. This suggests that the CAPS is an appropriate scale for use with older combat veterans.

Aged↗

PubMed1996

Modes of long-term coping with trauma memories: relative use and associations with personality among Vietnam veterans with chronic PTSD.

Little is known about how individuals who develop chronic posttraumatic stress disorder (PTSD) cope with recurring trauma memories, or how enduring personality characteristics influence such coping. Focusing on 110 hospitalized Vietnam combat veterans with chronic PTSD, this exploratory study assessed the relative frequency of using eight ways of coping with war memories, and associations between relative use of these strategies and eight dysfunctional personality styles. As a secondary issue, associations between coping strategies, combat exposure, and PTSD severity were also examined. Consistent with prior findings, these veterans predominantly used emotion-focused and avoidant strategies to cope with war memories. Differing personality styles and relative use or nonuse of particular coping strategies were also associated in psychologically coherent ways. These preliminary findings are discussed in relation to methodologic and future research issues.

Adaptation, Psychological↗

PubMed1996

Personality scales as predictors of older combat veterans with posttraumatic stress disorder.

The sparse literature on Posttraumatic Stress Disorder among older combat veterans has not explored individual personality styles. 120 older combat veterans who were treatment-seeking in medical and psychiatric outpatient clinics, were assessed whether two personality styles (identified in other research as potentially reflective of PTSD) added to the problems of PTSD beyond the information associated with the stressors of combat and aging. Analyses indicated that the personality style, Sensitivity, was significantly related to PTSD beyond these other factors.

Aged↗

PubMed1994

MCMI-II high-point codes: severe personality disorder and clinical syndrome extensions.

The MCMI-II is becoming more widely used in both clinical practice and research settings. From a research perspective, one area that has not received a great deal of attention is high-point codes. While the MMPI has a very lengthy history of high-point code analysis and ancillary interpretative manuals, the MCMI-II has no such traditional data base. The present study determined the prevalence of single and two-point high codes in a large sample of VA patients. Additionally, associated severe personality scales and clinical syndrome scales are delineated as a function of the 20 most common profiles. These 20 common profiles accounted for 82% of the patients.

Adult↗

PubMed1994

Cluster analysis of MCMI and MCMI-II on chronic PTSD victims.

A cluster analysis was used to identify groups of inpatients with confirmed post-traumatic stress disorder (PTSD) due to combat. In Study 1 the MCMI was administered to 256 subjects, in addition to the MMPI, PTSD measures, and background variables. Three clusters resulted: a Traumatic Personality (8-2), Schizoid Influence (8-2-1), and Antisocial Influence (8-6). Comparison on the MCMI symptom scales, MMPI, and PTSD scales showed that the Antisocial Influence cluster was "healthier" on all measures. The Schizoid Influence was most psychopathological. In Study 2 the MCMI-II was administered to 136 new subjects who met the same criteria as in Study 1. Four clusters resulted: Global (1-2-6A-6B-8A-8B), Subclinical (1), Aggressive (6A-6B-8A), and Detached/Self-defeating (1-2-8A-8B).

Adult↗

PubMed1994

Relationship of NEO-PI to personality styles and severity of trauma in chronic PTSD victims.

The relationship of the NEO-PI to personality disorders was evaluated in a clinical population. Eighty subjects with post-traumatic stress disorder (PTSD) were given this measure, along with the MCMI-II and PTSD and combat scales. Two questions were addressed: (1) What is the relationship of NEO-PI domains and facets to personality disorders?; and (2) What is this scale's relationship to PTSD problems? Results support previous studies that employed a clinical population, but with lower correlation coefficients. For the most part, then, the NEO-PI domains and facets correlated in expected ways with the MCMI-II. On PTSD measures, N accounted for the majority of the variance, but other domains were entered when independent regression equations were calculated to account for different personality disorders.

Adult↗

PubMed1992

Validation of PTSD measures for older combat veterans.

This study evaluated three nosologically similar older groups (Older PTSD, POW, and Older Psychiatric) and a group of Younger PTSD veterans from Vietnam. Group membership was derived from index admission diagnoses and clinical validation of status. Groups were compared on the MMPI, PTSD measures, background variables, health measures and an outcome measure. Results showed that the Older PTSD group is closer to the Younger PTSD group than to the other groups on the MMPI and PTSD measures and also that members of this group remain in the hospital longer than do members of the other older groups. Parameters of effective test classification showed the PTSD measures to be helpful in correct identification of this disorder for the older groups.

Age Factors↗

PubMed1992

Relationship between the Millon Clinical Multiaxial Inventory and the Millon-II: value of scales for Aggressive and Self-defeating personalities in Posttraumatic Stress Disorder.

This study addressed two issues, the interrelationship between the Millon Clinical Multiaxial Inventory (MCMI) and the Millon II (MCMI-II) and the value of the new personality scales, Aggressive and Self-defeating, in a sample with diagnoses of combat-related Posttraumatic Stress Disorder. 100 confirmed cases of combat-related Posttraumatic Stress Disorder were given a battery of measures including both Millon inventories and the Minnesota Multiphasic Personality Inventory (basic scales and selected subscales). They were rated on discharge status during a structured treatment program. Basic treatment and background information were also obtained. Analysis showed scores on the MCMI-II scales were higher but generally reflective of MCMI scales and that the Self-defeating personality style tends to be reflective of greater psychopathology, suicidal problems, treatment/disposition difficulties, overreporting of symptoms, and intensity of problems. Discussion encouraged the use of the MCMI-II with special emphasis given to the Self-defeating style in this group with Posttraumatic Stress Disorder.

Adult↗

PubMed1991

A short form of the Mississippi Scale for Combat-Related PTSD.

At the present time, The Mississippi Scale for Combat-Related PTSD (Mississippi Scale) is the best paper-and-pencil measure of this disorder. This study carried out a test-retest reliability on 52 chronic Vietnam veterans with PTSD and established three psychometric criteria for item retention in order to establish a short form of the Mississippi Scale. Ten items met these criteria and had a test-retest reliability coefficient of .66 (under the most stringent of conditions, treatment). This 10-item measure (Miss-10) then was applied to 95 new PTSD cases. This scale yielded two factors, guilt and numbing/anger. Discussion addressed its use as part of a screening battery or for monitoring change across time.

Adult↗

PubMed1991

Hidden PTSD in substance abuse inpatients among Vietnam veterans.

Alcohol use patterns among Vietnam combat veterans is an area with little research. This study evaluated three groups of Vietnam subjects on a chemical dependency unit who had a current Axis I diagnosis of alcohol abuse. No subject possessed a PTSD diagnosis. Two groups involved in-country veterans divided by presence or absence of PTSD based on the MMPI-PTSD scale (In-country and PTSD). The third group did not experience combat and was below the mean on the MMPI-PTSD scale (Noncombat). These groups were compared on the MMPI and the Alcohol Use Inventory (AUI), a measure of alcohol use patterns. Results showed that the PTSD Group had significantly higher scores on the MMPI and AUI reflective of deteriorated and binge drinking patterns. Discussion focused on the "hidden" dimension of PTSD among chemically dependent Vietnam veteran inpatients. The Relapse Prevention model was endorsed.

Alcohol Drinking↗

PubMed1991

An MCMI-II item-level component analysis: personality and clinical factors.

The Millon Clinical Multiaxial Inventory, Version 2 (MCMI-II) was released to replace the MCMI-I. Research into the factor structure of the items of the MCMI-I showed components consistent with the underlying construction theory. No such work has been done with the new MCMI-II. For this study, we analyzed the personality disorder and clinical syndrome items across two subject samples. For 579 Veterans Administration patients and 492 normal college students, six personality factors were identified. The samples shared Hostility, Histrionic/Schizoid, Dependent, Compulsive, and a Sadistic variant. For the clinical syndrome items, eight factors were isolated for veterans and seven for normals. Depression, Alcohol Abuse, Drug Abuse, Crying, and Mania were shared factors. Most of the factors were found to be highly consistent with MCMI-II scale keyings.

Adult↗

PubMed1991

Similarities and differences between MMPI and MMPI-2 applications to the assessment of posttraumatic stress disorder.

The purpose of this study was to address the question: Is the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) comparable to the original MMPI in its applicability to the assessment of posttraumatic stress disorder (PTSD) among Vietnam combat veterans? The question was addressed by administering both the original MMPI and MMPI-2 to 29 subjects classified as meeting Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; DSM-III-R) criteria for PTSD and comparing MMPI and MMPI-2 scores in terms of: degree of association, code-type congruence, diagnostic hit rates (when compared to two other clinical samples, and one normal sample), and congruence of the Keane PTSD Scale (PK). Results reveal highly significant correlations between MMPI and MMPI-2 basic scales for the PTSD sample as well as congruence in 2-point codes comparable to previous studies. The MMPI-2 was found to identify effectively PTSD subjects from the other groups. Results also showed a high degree of association between the MMPI and MMPI-2 in regard to PK scores, although minor differences were found in PK raw scores between the two tests. Overall, the findings suggest a high degree of comparability between the MMPI and MMPI-2 in the assessment of PTSD.

Adult↗

PubMed1990

Suicidal behavior among chronic Vietnam theatre veterans with PTSD.

Suicidal behavior among Vietnam veterans with chronic Post-traumatic Stress Disorder (PTSD) was evaluated. Sixty chronic PTSD vets admitted to a Specialized PTSD Unit were divided into two groups based on the presence of suicidal behavior: 29 patients in a Suicide Group and 31 in a Non-suicide Group. Subjects were evaluated on symptoms, psychometric measures, military variables, adjustment factors, and pre-military parental patterns of discipline. Results showed that the Suicide Group possessed problems in paternal child-rearing patterns, current adjustment difficulties, and the PTSD symptoms of survival guilt and crying. In a regression analysis, paternal inconsistency of love, survivor guilt, and tendency to cry, in addition to age and sex, accounted for the significant variance of suicidal behavior.

Chronic Disease↗