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Biomedical subjects

L Hyer

Publications and source records attributed to L Hyer.

At least 37 records · Page 2Linked to original sources

Alexithymia among Vietnam veterans with posttraumatic stress disorder.

The authors studied 227 inpatients from a large Veterans Administration Medical Center to evaluate whether alexithymia is associated with posttraumatic stress disorder (PTSD) and to assess the validity of the Minnesota Multiphasic Personality Inventory (MMPI) alexithymia scale. Three groups--a carefully diagnosed PTSD group (N = 76), an alcohol abuse group (N = 76), and a general psychiatric group (N = 75)--were given a battery of psychological tests, including the MMPI, the Millon Clinical Multiaxial Inventory, and the Beck Depression Inventory, along with several cognitive measures. PTSD veterans were also evaluated on psychophysiologic indices (including a stressor) and on their subjective ratings to these indices. Results showed that alexithymia was more characteristic of PTSD patients than of the other groups. Also, alexithymia was inversely related to heart rate. Alexithymia was not significantly correlated with the subjective experience of stressors. The authors discuss the importance of the construct of alexithymia among PTSD patients and recommend the use of the alexithymia scale for these patients. The independence of this measure from the psychophysiologic condition of hyperarousal and the subjective experience of this state were also addressed.

Adult↗

MMPI F-K index among hospitalized Vietnam veterans.

The F-K index of the MMPI has been used as a marker of symptom overreporting. One population for which previous research has shown this pattern is Vietnam in-country veterans with PTSD. This study assessed the F-K index on 515 inpatients: 329 Vietnam in-country and 186 Vietnam-era patients. Normative data on psychiatric inpatients were presented. Also, a special MMPI subscale (MMPI-PTSD), a measure to identify PTSD among these veterans, was used. Results showed that all Vietnam veterans, especially in-country veterans, overreport symptoms to a high degree. The overall mean for in-country vets was 7.3. Also, when the special MMPI-PTSD subscale was used, a vast majority of in-country veterans who were in the PTSD range had high F-K index scores. Dissimulation as a symptom of PTSD was discussed.

Adult↗

Treatment outcomes of Vietnam veterans with PTSD and the consistency of the MCMI.

This study addresses two issues: treatment changes on the MCMI of Vietnam veterans with PTSD and test-retest reliability of the Millon Clinical Multiaxial Inventory (MCMI). Fifty Vietnam veterans carefully were identified for the diagnosis Post-Traumatic Stress Disorder (PTSD). They were admitted to a Special PTSD Treatment Unit that consisted of an intense 5-week period with focus on the revivified Vietnam experience. They also were given the MCMI at two points in time, treatment inception and 35 days later at discharge. Results show that 17 of 20 scales on the MCMI changed in the negative direction as a result of treatment. Also, the MCMI has adequate test-retest reliability, and the personality scales (with the exception of Borderline) have higher reliability coefficients than do symptom scales. The use of the MCMI is encourged both as a monitor of treatment for these veterans and for its stability.

Combat Disorders↗

Distance from mother and father among alcoholics.

The relationship of parental closeness to current behavior and related psychopathological indices is studied among alcoholics. Seventy alcoholics from an inpatient treatment unit and thirty medical inpatients were given a battery of alcohol related measures. These measures included a scale assessing the psychological distance from mother and father, a social closeness measure, an index of anger, a locus of control measure, along with basic alcohol-related information. In addition, the alcoholic sample was given psychometric measures of depression and cognition. Results show that perceived distance from parents is greater among alcoholics than medical patients. Comparison analyses of mother and father distance scores on the study variables of alcohol-related and psychometric measures yielded only a few differences. Correlational analyses showed, however, that distance from mother and father is related to parental alcohol abuse and parents not being at home but not to current behavior (except anger).

Adult↗

MMPI overreporting by Vietnam combat veterans.

The MMPI-PTSD scale is the only psychometric measure that has been cross-validated on Vietnam veterans for the determination of PTSD. Despite this, there may be problems with this scale related to symptom exaggeration. Three groups of Vietnam inpatients (N = 75) were defined carefully by both clinical and actuarial methods--PTSD combat, Non-PTSD combat, and Non-combat. This study applied symptom exaggeration methods based on the MMPI obvious/subtle items and on the F scale to these groups. Results show that all the items of this scale are either obvious or neutral, that a carefully distinguished PTSD group differentially responds to these obvious and neutral items relative to other inpatient Vietnam groups, and that the F scale is exaggerated by the PTSD group. In addition, a separate analysis on an independent sample of 50 combat and 50 non-combat Vietnam veterans showed that the combat group endorsed the obvious items on selected scales by 20 T score points at higher rates than other groups. Caution in the use of the MMPI-PTSD scale is discussed.

Humans↗

Key determinants of the MMPI-PTSD subscale: treatment considerations.

Seventy-five "in country" Vietnam combat psychiatric inpatients were given a battery of measures upon admission to the medical center. These included the MMPI, VETS Adjustment Scale, State-Trait Anxiety Scale, Rotter Locus of Control, Profile of Mood Scale, and a variation of the Figley Stress Scale that measures current stress. Post-traumatic stress disorder (PTSD) was determined by the MMPI-PTSD subscale. Ten of the battery variables were used as predictors for a multiple regression analysis on the MMPI-PTSD subscale. Results yielded a multiple R of .89 for two predictors, Figley Stress Scale and Rotter Locus of Control (external). Patients with PTSD, therefore, suffer most from perceived and experienced current stressors and a low sense of control. Arguments are made for more present-centered and interpersonal strategies in the treatment of PTSD combat veterans.

Adult↗

Depression, anxiety, paranoid reactions, hypochondriasis, and cognitive decline of later-life inpatients.

The relationships among the psychopathological states of depression, anxiety, hypochondriasis, paranoid reactions, and cognitive decline for later-life psychiatric inpatients were addressed. The relationship of these variables to life satisfaction, health, pain, and behavior was also considered. Sixty later-life (older than 55 years) psychiatric patients on an acute geropsychiatric unit were administered a battery of psychological scales; Mini Mental State, Beck Depression Inventory (somatic and psychological components), State-Trait Anxiety Scale, MMPI Paranoia scale (and Harris-Lingoes subscales), the Hypochondriasis Scale (Institutional Geriatric), Life Satisfaction Scale-Z, and self-rated pain responses. In addition, these patients were rated on the MACC-Behavioral Adjustment Scale and the Cumulative Illness Rating Scale. Results showed that there is a high degree of interrelationship among the psychopathological variables except cognition. Independent stepwise regression showed that life satisfaction was accounted for by hypochondriasis and anxiety; health, by depression; pain, by hypochondriasis; and behavior, by cognition.

Aged↗

Depression among alcoholics.

The relationships of cognition, health status, and age to depression among alcoholics were studied. Eighty male alcoholics in an alcohol treatment unit were rated on health status and given a battery of psychological tests and scales. These included the Hooper VOT (cognition) and several self-rated depression indices: MMPI-Depression, MCMI-Dysthymic, BDI-Total (BDI-Somatic and BDI-Psychological), and the Geriatric Depression Scale (GDS). Results showed that depression was present in this sample at mild clinical levels. Regression analyses showed that age was the most influential factor on the MMPI-D and BDI-Somatic. Age also was most influential on the GDS, with health status contributing. However, except for somatic depression, the amount of explained variance was small. Despite this, it is argued that age is a contributing factor to depression among alcoholics, especially the somatic elements of depression.

Adult↗

Older age treatment expectations.

The relationship between age and treatment expectation (TE) has been virtually ignored. This study assessed the TE and posthospital adjustment of 5,347 psychiatric patients, 4,361 younger (less than 55) and 986 older (greater than 55). Patients were evaluated on admission with self- and other rating adjustment scales and again at 3-months postdischarge. One factor in the self-rating scale included TE. Outcome measures involved posthospital adjustment (self- and other rated), both corrected and noncorrected for initial adjustment levels. Results show that TE rises with age. There is also some indication that higher TE leads to better adjustment. Older age and higher TE in combination, however, do not translate into better community adjustment. Also, differences between younger and older patients in TE are most pronounced in psychotics and in older patients not fully or currently employed.

Adult↗

Treatment expectancy among psychiatric inpatients.

Treatment expectation (TE) is an important variable in treatment outcome. This study addressed two issues: The relationship of TE to treatment outcome and an identification of background and treatment variables most related to TE. As part of a cooperative study at 18 Veterans Administration Medical Centers on 79 general psychiatric wards, psychiatric inpatients were given the Veterans Adjustment Scale (VETS), and a significant other was mailed a Personal Adjustment and Role Skills Scale (PARS) at admission and 3 months after discharge. A Treatment Expectation measure was obtained from the VETS Scale at admission. Background and treatment factors also were obtained. Selected analyses controlled for the effects of patient input characteristics allowing for better outcome measures. Analyses also were cross validated. Results show that TE is related to treatment outcome and that a coterie of background and treatment variables are related to TE. Three factors especially influence TE-age, high vigor, and less alienation.

Adaptation, Psychological↗

MMPI scales and subscales: patterns of older, middle-aged, and younger inpatients.

There has been virtually no research on the relationship of age and MMPI subscales, such as the Harris and Lingoes, Wiggins, Subtle/Obvious, and other specialized subscales. One hundred younger (less than or equal to 39), middle-aged (40-49), and older (greater than or equal to 50) psychiatric inpatients were compared on the basic 13 MMPI scales and 77 MMPI subscales. Results showed that, as a whole, older patients tended to respond more conservatively to these scales, to show less pathology, and to endorse fewer subtle/obvious items than the other age groups. They responded, however, lower on Dominance, on Hostility, and on Social Maladjustment. Later-life patients also endorsed differentially many of the Harris and Lingoes 4 and 6 subscales in the less pathological direction than did the other groups.

Adult↗