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Biomedical subjects

M Creamer

Publications and source records attributed to M Creamer.

17 recordsLinked to original sources
PubMed2004

Psychological health of Australian veterans of the 1991 Gulf War: an assessment using the SF-12, GHQ-12 and PCL-S.

BACKGROUND: Elevated rates of psychological morbidity and symptomatology have been widely reported in 1991 Gulf War veterans. The present study used brief self-report instruments to compare the psychological health of Australian Gulf War veterans with that of a randomly sampled military comparison group. METHOD: The 12-item Short Form Health Survey (SF-12), 12-item General Health Questionnaire (GHQ-12), Posttraumatic Stress Disorder Checklist--Specific (PCL-S) and Military Service Experience (MSE) questionnaire were administered to 1424 male Australian Gulf War veterans and 1548 male Australian Defence Force members who were operational at the time of the Gulf War conflict, but were not deployed there. RESULTS: The Gulf War veterans exhibited poorer psychological health, as measured by the above three instruments, than the comparison group members. For Gulf War veterans, the number of stressful experiences, as measured by the MSE questionnaire, was correlated with scores on the three instruments. SF-12 mental health component summary scores and PCL-S caseness, but not GHQ-12 caseness, differed significantly between Gulf War veterans and comparison group members who had been on at least one active deployment. CONCLUSIONS: More than a decade after the 1991 Gulf War, Australian Gulf War veterans are exhibiting higher levels of current (past month) psychological ill-health, as measured using the GHQ-12 and PCL-S, as well as lower mental health status, as measured by the SF-12, than the comparison group. Although not a replacement for formal psychiatric diagnosis, instruments such as those above may aid in the assessment of veterans' psychological health.

Adult↗
PubMed2002

Self-reported problems: a comparison between PTSD-diagnosed veterans, their spouses, and clinicians.

This study investigated self-reported problems in a sample of help-seeking Vietnam veterans, comparing the veteran's own view with clinician and spouse perspectives, with the aim of examining convergence in reports across different informants. Veterans with PTSD (N = 459) were asked to list and rate their five most serious problems. Spouses and treating clinicians completed the same questionnaire in relation to the veteran. Rates of endorsement for each problem area, and levels of agreement between raters, were calculated. Veterans, spouses, and clinicians were all likely to rate anger as a high priority, with veterans also likely to nominate anxiety and depression. Spouses were likely to nominate more observable behavioural problems such as interpersonal difficulties and avoidance, while clinicians were likely to nominate indications of psychopathology, such as anxiety, depression, and intrusive thoughts. Agreement across raters was generally high, although interpretation of agreement levels was complex.

Anger↗
PubMed2001

The validity of the PTSD checklist as a measure of symptomatic change in combat-related PTSD.

Little research to date has examined the ability of self-report measures to assess changes in symptom severity and diagnostic status as a function of treatment. This study investigated the validity of the posttraumatic stress disorder (PTSD) checklist (PCL) as a measure of symptomatic change following programmatic treatment. A sample of 97 Vietnam veterans with combat-related PTSD was assessed using the clinician-administered PTSD scale (CAPS) and the PCL prior to, and 9 months following, participation in a PTSD treatment program. Using the CAPS as the "gold standard" measure of PTSD symptomatology, the PCL demonstrated high diagnostic accuracy pre- and posttreatment. However, significant variations in accuracy were evident in the ability of the PCL to determine the presence and severity of individual symptoms at each time point. In addition, as symptoms improved from pre- to posttreatment, and approached the threshold criteria, the PCL demonstrated reductions in diagnostic accuracy. As a measure of overall symptomatic change, the PCL underrated improvement in comparison to the CAPS. The results supported the use of an overall cut-off score of 50 on the PCL for a diagnosis, and an item score of 3 for symptom criterion, in this population.

Adult↗
PubMed2001

Post-traumatic stress disorder: findings from the Australian National Survey of Mental Health and Well-being.

BACKGROUND: We report on the epidemiology of post-traumatic stress disorder (PTSD) in the Australian community, including information on lifetime exposure to trauma, 12-month prevalence of PTSD, sociodemographic correlates and co-morbidity. METHODS: Data were obtained from a stratified sample of 10,641 participants as part of the Australian National Survey of Mental Health and Well-being. A modified version of the Composite International Diagnostic Interview was used to determine the presence of PTSD, as well as other DSM-IV anxiety, affective and substance use disorders. RESULTS: The estimated 12-month prevalence of PTSD was 1-33%, which is considerably lower than that found in comparable North American studies. Although females were at greater risk than males within the subsample of those who had experienced trauma, the large gender differences noted in some recent epidemiological research were not replicated. Prevalence was elevated among the never married and previously married respondents, and was lower among those aged over 55. For both men and women, rape and sexual molestation were the traumatic events most likely to be associated with PTSD. A high level of Axis 1 co-morbidity was found among those persons with PTSD. CONCLUSIONS: PTSD is a highly prevalent disorder in the Australian community and is routinely associated with high rates of anxiety, depression and substance disorders. Future research is needed to investigate rates among other populations outside the North American continent.

Adolescent↗
PubMed2001

Risk factors for posttrauma reactions in police officers: a longitudinal study.

This prospective, longitudinal study investigated risk factors in the development of psychological ill health and posttraumatic stress symptoms in a sample of 223 junior police officers. Participants were assessed using a self-report methodology during training and again 12 months later on a range of personality, trauma exposure, and symptom measures. Risk factors for general psychological ill health at phase 2 of the research were found to comprise mostly stable, preexisting characteristics such as personality style, gender, and trait dissociation. Conversely, specific traumatic stress symptoms were more heavily influenced by experiences in the intervening 12 months, such as severity of incident exposure and peritraumatic dissociation. The implications for differential intervention are discussed.

Adult↗
PubMed1999

Treatment outcome in Australian veterans with combat-related posttraumatic stress disorder: a cause for cautious optimism?

This study investigated treatment outcome in combat-related posttraumatic stress disorder (PTSD). Participants were 419 Australian Vietnam veterans who completed a 12-week hospital-based program. A comprehensive protocol assessed PTSD, comorbidity, and social functioning at admission and at 3 and 9 months posttreatment. Overall, the group showed significant improvements in core PTSD symptoms, anxiety, depression, alcohol abuse, social dysfunction, and anger. Changes occurred mostly between admission and 3 months posttreatment, with gains maintained at 9 months. Ratings by patients and their partners indicated perceived improvement and strong satisfaction with treatment. Nevertheless, treatment gains were variable and, for most veterans, considerable pathology remained following the programs. The current study provides grounds for cautious optimism in the treatment of combat-related PTSD.

Alcoholism↗
PubMed1999

MMPI-2 data for Australian Vietnam Veterans with combat-related PTSD.

Considerable attention has been devoted to the MMPI in the assessment of combat-related PTSD. To date, published data have focused almost exclusively on American Vietnam veterans. This study investigated MMPI-2 profiles of 100 Australian Vietnam veterans admitted to an intensive PTSD treatment program. Comparisons with United States (U.S.) data suggested strong similarities between the American and Australian populations in terms of F-scale elevations and typical 3-point code types (8-7-2). However, the American samples showed relatively higher elevations of Scales 4 and 6, suggesting social alienation and a tendency to externalize, while a subgroup of Australian veterans showed a greater propensity for somatization (Scale 1). The results provide overall support for the generalizability of American MMPI data to an alternative cultural group of combat veterans.

Australia↗
PubMed1996

A profile of help-seeking Australian veterans.

While considerable information is available regarding American Vietnam veterans, surprisingly little has appeared concerning veterans of other nationalities who served in the Vietnam war. This paper provides a preliminary profile of help-seeking Australian veterans in order to afford a comparison with the available American data. Collected in the context of a review of the Vietnam Veterans Counselling Service (VVCS), demographic data suggest that the client population is similar in many ways to that of the American posttraumatic stress disorder (PTSD) Clinical Teams. Problems commonly reported by clients of VVCS included posttraumatic stress, relationship difficulties, anxiety, depression, and problems with pensions and benefits. A postal survey of a sub-sample of current clients revealed a mean score on the Combat Exposure Scale of 19.27 and a mean score on the Mississippi Scale for PTSD of 118.43. Again, these findings are broadly comparable with those of American help-seeking veterans.

Adaptation, Psychological↗
PubMed1995

The Beck Anxiety Inventory in a non-clinical sample.

This study investigated the properties of the Beck Anxiety Inventory (BAI) in a sample of 326 undergraduate students. Scores on the BAI were compared with data from the State-Trait Anxiety Inventory and the Beck Depression Inventory. The BAI demonstrated good psychometric properties, with a high level of internal consistency. Relatively low test-retest correlations, in comparison with the STAI-Trait, suggested that the scale was functioning as a state measure. Factor analysis revealed a unifactorial solution on the first administration (a time of low stress), but a two factor solution similar to that proposed initially by Beck, Epstein, Brown and Steer (Journal of Consulting and Clinical Psychology, 56, 893-897, 1988) at the second administration (hypothesised to be a time of increased stress). Thus, the two factor structure of the BAI (characterised by physical and cognitive symptoms) may not be distinguishable in the normal population in the absence of an external stressor. An apparent strength of the BAI was its superior ability in differentiating anxiety from depression when compared with the STAI. A combined factor analysis of the BAI and STAI-State revealed two distinct factors, suggesting that the scales may actually be measuring separate, although not necessarily independent, constructs. It is suggested that the high discriminant validity demonstrated by the BAI may have been achieved at the expense of some construct validity.

Adolescent↗
PubMed1994

Eye movement desensitization and reprocessing in posttraumatic stress disorder: a pilot study using assessment measures.

Spectacular claims have been made regarding the efficacy of eye movement desensitization and reprocessing (EMDR) in the treatment of posttraumatic stress disorder (PTSD), but almost entirely on the basis of patients' reports and without objective criteria. This study reports on the treatment of eight patients with a diagnosis of PTSD who received EMDR treatment over four sessions. Assessment measures included two structured interviews, three self-report inventories, and the electromyogram (EMG). Assessments were conducted pre and posttreatment, and at 3-month follow-up. Despite some residual pathology at posttreatment and follow-up, significant improvements were obtained on all measures and across all PTSD symptom clusters. Compared with other treatments of PTSD, change was achieved in far fewer sessions.

Adaptation, Psychological↗
PubMed1992

Reaction to trauma: a cognitive processing model.

We integrated existing cognitive processing models of posttrauma reactions into a longitudinal model. Data were obtained after a multiple shooting in a city office block. The subject group comprised 158 office workers who were in the building at the time of the shootings. The methodology of this research was a repeated measures survey, with data collection at 4, 8, and 14 months posttrauma. Measures included the Impact of Events Scale (IES) and the Symptom Checklist-90-Revised. A path analysis was performed with the IES as an indication of cognitive processing. Intrusion and avoidance were shown to mediate between exposure to trauma and symptom development. Intrusion was also found to be negatively related to subsequent symptom levels. The findings provide provisional support for a cognitive processing model.

Adaptation, Psychological↗
PubMed1990

Cognitive processing in post-trauma reactions: some preliminary findings.

The current study investigated a model of post-trauma reactions proposed initially by McFarlane (1988 a). Two separate data sets, one obtained following a multiple shooting and the other reported by McFarlane following a natural disaster, were examined. The findings of both studies provide support for a cognitive processing conceptualization of the development of post-trauma reactions.

Adaptation, Psychological↗
PubMed1989

Post-traumatic stress disorder: some diagnostic and clinical issues.

The development of post-traumatic stress disorder (PTSD) in a group of 42 individuals exposed to a multiple homicide was examined. A comparison of DSM-III and DSM-III-R indicated that 74% qualified for a diagnosis of PTSD using DSM-III, but only 33% met the criteria outlined in DSM-III-R. The most commonly reported symptoms were found to be intrusive recollections of the event and exaggerated startle response. In general, those symptoms that are new additions in the revised version were the least frequently reported, whilst guilt, which has been excluded from DSM-III-R, was experienced by 38% of the sample. It is suggested that the new criteria may not cluster with the core syndrome of PTSD.

Guilt↗
PubMed1988

The role of interpersonal perception in dyadic adjustment.

The discrepancy between the way individuals perceive themselves and the way they are perceived by their partners has been proposed as an indicator of dyadic adjustment. The present study employed the CPI to investigate the relation of interpersonal perception within dyads and real similarity of spouses to marital satisfaction. The subjects were 20 married couples. Support was provided for the use of the real similarity-assumed similarity-accuracy paradigm in studies of interpersonal perception. No sex differences were found in the ability of individuals to predict their spouse's responses on the CPI. Accuracy of prediction was correlated significantly with scores on the Hogan Empathy scale for males, but not for females. Conversely, accuracy was related significantly to dyadic adjustment in the case of females, but not males. Real similarity also was correlated positively with dyadic adjustment. Avenues for further research are suggested.

Adaptation, Psychological↗
PubMed1978

An investigation of the role of 'hypnosis', hypnotic susceptibility and hypnotic induction in the production of age regression.

In response to criticisms of the methodology of Barber's(1969)experiments, a 2x2 factorial design, varying hypnotic susceptibility and hypnotic treatment, was used to study the role of 'hypnosis' in the production of age regression by suggestion. Twenty subjects of high hypnotic susceptibility and 20 subjects of low hypnotic susceptibility were randomly allocated to one of two treatment conditions:hypnotic induction procedure or motivational instructions. Both treatments were followed by suggestions to regress to the age of seven years. Two measures of age regression were taken:the Draw-A-Man-Test and a subjective rating of the reality of the experience. The results showed significant effects of both variables, with high suceptibility and induction treatment producing better regression on both measures than low susceptibility and motivation treatment. Hypnotic susceptibility was the stronger of the two variables. The ranking of the four conditions corresponded with predictions of hypnotic depth from the state theory of hypnosis, but the findings were not inconsistent with the non-state theory. The drawings of all regressed groups were more mature than the norms for the age of seven and the drawings of a group of seven year old children.

Adult↗
PubMedDate not supplied

Demands for vascular access in a renal dialysis unit: implications for a regional vascular unit.

BACKGROUND: The development of regional dialysis units and the expanding indications for dialysis has led to increased demand for vascular access surgery. Consequently, the provision and maintenance of access, and the management of related complications has created a considerable burden on vascular surgical units in hospitals providing renal replacement therapy (RRT). AIMS: The objectives of our study were to review our experience with a variety of vascular access modalities for haemodialysis and to quantify the associated surgical workload. METHODS: We reviewed our experience in a consecutive group of dialysis patients who had access surgery for RRT in a regional hospital setting. RESULTS: Between January 1995 and January 2000, 69 patients entered the long-term dialysis programme in the Mid-Western region (population = 320,000). Of the 158 procedures performed, 138 (87%) were for access creation, and 20 (13%) related to access revision procedures. Twenty patients (29%) developed a total of 30 access related complications. Vascular access procedures accounted for 10% of the vascular surgical workload (1598 procedures) in the five-year period. CONCLUSION: Vascular access is an important part of the haemodialysis services and surgical expertise should be available at local level to cope with likely demand.

Adolescent↗