Biomedical subjects

Loretta S Malta

Publications and source records attributed to Loretta S Malta.

10 recordsLinked to original sources

PubMed2006

A meta-analysis of structural brain abnormalities in PTSD.

This series of meta-analyses examined structural abnormalities of the hippocampus and other brain regions in persons with PTSD compared to trauma-exposed and non-exposed control groups. The findings were significantly smaller hippocampal volumes in persons with PTSD compared to controls with and without trauma exposure, but group differences were moderated by MRI methodology, PTSD severity, medication, age and gender. Trauma-exposed persons without PTSD also showed significantly smaller bilateral hippocampal compared to non-exposed controls. Meta-analyses also found significantly smaller left amygdala volumes in adults with PTSD compared to both healthy and trauma-exposed controls, and significantly smaller anterior cingulate cortex compared to trauma-exposed controls. Pediatric samples with PTSD exhibited significantly smaller corpus callosum and frontal lobe volumes compared to controls, but there were no group differences in hippocampal volume. The overall findings suggested a dimensional, developmental psychopathology systems model in which: (1) hippocampal volumetric differences covary with PTSD severity; (2) hippocampal volumetric differences do not become apparent until adulthood; and (3) PTSD is associated with abnormalities in multiple frontal-limbic system structures.

Adult↗

PubMed2005

Meta-analytic review of event-related potential studies in post-traumatic stress disorder.

In recent years there has been an accumulation of studies that have utilized the measurement of event-related potentials (ERP) to examine the neuroelectric correlates of hypothesized alterations in information processing in persons with post-traumatic stress disorder (PTSD). The objective of this meta-analysis was to summarize the findings of ERP PTSD research, including studies that have examined P50 auditory sensory gating, augmenting-reducing P200, and P300 in target detection oddball tasks. The results suggest that persons with PTSD exhibit alterations in the amplitude and latency of ERP within these paradigms that support the hypothesis that changes in information processing can accompany PTSD. The results were also consistent with recent cognitive neuropsychological findings in PTSD research.

Brain↗

PubMed2005

Psychiatric and behavioral problems in aggressive drivers.

Motor vehicle accidents (MVAs) are a leading cause of accidental death and injury, and aggressive driving has been identified as a risk factor for MVAs. Assessing psychiatric and behavioral disturbances in aggressive drivers is germane to the development of prevention and intervention programs for this population. The present study compared the prevalence of psychiatric diagnoses and behavioral problems in young adult drivers with self-reported high driving aggression to that of drivers with low driving aggression. Aggressive drivers evidenced a significantly higher current and lifetime prevalence of Oppositional Defiant Disorder, Alcohol and Substance Use Disorders, and Cluster B Personality Disorders, and a significantly greater lifetime prevalence of Conduct Disorder, Attention-Deficit/Hyperactivity Disorder, and Intermittent Explosive Disorder. Aggressive drivers also had a significantly greater prevalence of self-reported problems with anger, as well as a greater family history of anger problems and conflict. The findings suggest that prevention and intervention programs designed to reduce aggressive driving may need to address the presence of psychiatric and behavioral problems that could potentially complicate treatment or impede responses to treatment.

Adult↗

PubMed2004

Two studies of psychiatric morbidity among motor vehicle accident survivors 1 year after the crash.

We assessed the psychiatric co-morbidity associated with chronic posttraumatic stress disorder (PTSD) (1-2 years) secondary to personal injury motor vehicle accidents (MVAs) in two studies. In Study 1, we compared the results of SCID assessments for 75 treatment-seeking MVA survivors (51 with PTSD and 24 with symptoms but no PTSD). In Study 2, we compared similar results among 132 MVA survivors who had been followed prospectively for 12+ months after their accidents (19 with PTSD, 32 who had PTSD but who had remitted, and 81 who never met criteria for PTSD). We found comparable levels of current co-morbid major depression (53%), any mood disorder (62-68%), generalized anxiety disorder (26%) and any anxiety disorder (42%) for both groups of participants with chronic PTSD. These rates of co-morbidity were higher than those found in non-PTSD comparison groups with similar MVA histories.

Accidents, Traffic↗

PubMed2004

One- and two-year prospective follow-up of cognitive behavior therapy or supportive psychotherapy.

We followed up over 90% of 57 motor vehicle accident survivors, who completed a controlled comparison of cognitive behavioral therapy (CBT) to supportive psychotherapy (SUPPORT). One-year results showed a continued significant advantage on categorical diagnosis (PTSD or not) and structured interview measures (CAPS) for CBT over SUPPORT. Other measures generally showed the same results. At two years, we were able to follow-up only 75% of one-year completers. Although there continued to be arithmetic differences favoring CBT over SUPPORT, with these attenuated samples only differences on PTSD Checklist and Impact of Event Scale scores and in overall categorical diagnoses were significant. There was very modest improvement from end of treatment to the two-year follow-up.

Accidents, Traffic↗

PubMed2004

Startle responses in motor vehicle accident survivors: a pilot study.

The aim of the present study was to investigate startle responses in motor vehicle accident (MVA) survivors to trauma-related, startle, and neutral sounds. Participants were 17 MVA survivors, 11 of whom participated in a controlled treatment study comparing cognitive-behavioral treatment (CBT) and supportive therapy (ST) versus a waitlist condition. Though participants differed significantly in their pretreatment clinical status and symptom severity, these differences were not reflected by group differences in EMG (at orbicularis oculi) to the stimuli at the initial assessment. Some cue-specificity was found, as all participants showed larger startle responses to trauma-related sounds, compared to startle and neutral sounds. At posttreatment, a significant reduction in EMG reactivity to all stimuli was observed in participants who received active treatment (either CBT or ST), compared to waitlist controls. The use of startle responses as a PTSD treatment outcome index is discussed.

Accidents, Traffic↗

PubMed2003

A controlled evaluation of cognitive behavioural therapy for posttraumatic stress in motor vehicle accident survivors.

Seventy-eight motor vehicle accident survivors with chronic (greater than 6 months) PTSD, or severe sub-syndromal PTSD, completed a randomized controlled comparison of cognitive behavioral therapy (CBT), supportive psychotherapy (SUPPORT), or a Wait List control condition with two detailed assessments. Scores on the CAPS showed significantly greater improvement for those in CBT in comparison to the Wait List and to the SUPPORT conditions. The SUPPORT condition in turn was superior (p=0.012) to the Wait List. Categorical diagnostic data showed the same results. An analysis of CAPS scores including drop-outs (n=98) also showed CBT to be superior to Wait List and to SUPPORT with a trend for SUPPORT to be superior to Wait List. The CBT condition led to significantly greater reductions in co-morbid major depression and GAD than the other two conditions. Results held up well at a 3-month follow-up on the two active treatment conditions.

Accidents, Traffic↗

PubMed2003

The psychophsiology of aggressive drivers: comparison to non-aggressive drivers and pre- to post-treatment change following a cognitive-behavioural treatment.

Twenty drivers were remanded to our treatment program by the courts following arrests related to serious aggressive driving behaviors. Ten additional drivers entered our program in response to our advertisements thus identifying themselves as aggressive drivers. Psychophysiological assessments were conducted on all 30 drivers and heart rate (HR), systolic and diastolic blood pressure (SBP and DBP), and skin resistance level (SRL) were measured in response to exposure to a mental arithmetic neutral stressor, two idiosyncratic, audio-taped, aggressive driving vignettes (audio 1 and audio 2), and one non-driving related fearful vignette. Fourteen non-aggressive driving controls also completed the assessment. The results indicated that the aggressive drivers (ADs) showed significantly more SBP responsivity during audio 1 and audio 2 and significantly less SBP reactivity during the mental arithmetic stressor than the controls. The aggressive drivers then completed a four-week, group intervention which included relaxation techniques specifically targeting aggressive driving behaviors. The same psychophysiological assessment was conducted at post-treatment. The results showed significant pre- to post-treatment decreases in HR, p<0.003, SBP, p<0.01, and DBP, p<0.02 during audio 1. Similarly, decreases were evident in audio 2 in SBP, p<0.03 only. No decreases in reactivity occurred during the neutral stressor or fearful situation.

Accidents, Traffic↗

PubMed2002

Changes in physiological arousal to gambling cues among participants in motivationally enhanced cognitive-behavior therapy for pathological gambling: a preliminary study.

Despite somewhat high attrition and relapse rates, cognitive-behavioral interventions for pathological gambling seem promising. As a possible remedy to these problems, we conducted a preliminary study of gambling-specific cognitive-behavior therapy (CBT) with the addition of motivational enhancement techniques (MET) for the treatment of pathological gamblers. Data on psychophysiological arousal upon exposure to imagined gambling vignettes were collected at both pre- and posttreatment. Results indicate that participants showed decreases in degree of arousal during the vignettes from pre- to posttreatment. There was also a strong dose-response relationship between reductions in gambling symptoms and reductions in arousal. These findings are discussed, as are their implications for further study of pathological gambling.

Adult↗

PubMed2002

Personality disorders and posttraumatic stress disorder in motor vehicle accident survivors.

This study examined the impact of a co-occurring personality disorder on the development and remission of posttraumatic stress disorder (PTSD) in 158 motor vehicle accident (MVA) survivors followed prospectively for 1 year. Participants were assessed 1 to 4 months after trauma and at 6-month and 1-year follow-up evaluations during 1991 through 1993. These archival data were analyzed in the present study. The prevalence of at least one personality disorder was 13.3%, with the majority (52.4%) presenting with obsessive-compulsive personality disorder. Persons with a personality disorder were significantly more likely to be diagnosed with PTSD at 1-year follow-up evaluation. For persons diagnosed with PTSD at the initial assessment, those with a personality disorder were significantly less likely to remit by 1 year. The presence of a preexisting personality disorder may increase the risk of chronic PTSD and impede remission.

Accidents, Traffic↗