Biomedical subjects

Matt J Gray

Publications and source records attributed to Matt J Gray.

10 recordsLinked to original sources

PubMed2005

Which instruments are most commonly used to assess traumatic event exposure and posttraumatic effects?: A survey of traumatic stress professionals.

We report findings from a Web-based survey of the International Society for Traumatic Stress Studies' members (n = 227) regarding use of trauma exposure and posttraumatic assessment instruments. Across clinical and research settings, the most widely used tests included the Posttraumatic Stress Diagnostic Scale, Trauma Symptom Inventory, Life Events Checklist, Clinician-Administered Post-traumatic Stress Disorder (PTSD) Scale, PTSD Checklist, Impact of Event Scale-Revised, and Trauma Symptom Checklist for Children. Highest professional degree, time since degree award, and student status yielded no differences in extent of reported trauma assessment test use.

Adult↗

PubMed2005

Beyond exposure for posttraumatic stress disorder (PTSD) symptoms: broad-spectrum PTSD treatment strategies.

Although cases of posttraumatic stress disorder (PTSD) with comorbid disorders are common, the first generation of PTSD treatment approaches, including exposure and cognitive-behavioral therapy, generally ignore symptoms beyond those specific to PTSD. Optimum PTSD treatment outcome requires more comprehensive strategies, and the development and empirical testing of broader approaches is the focus of the articles that follow in this special issue. After providing some background on PTSD and PTSD treatment, this paper gives an overview of these treatment and prevention papers, which represent second-generation strategies to help trauma-exposed individuals.

Humans↗

PubMed2005

Behavioral interventions for recent trauma: empirically informed practice guidelines.

Despite the successes in the treatment of chronic trauma-related distress, little attention has been devoted to developing behavioral interventions to be delivered soon after traumatic exposure in an effort to promote positive posttraumatic adjustment and to minimize the likelihood of enduring psychopathology. As a result, other forms of early intervention have filled this void and have been widely disseminated and applied, despite the lack of compelling evidence attesting to their efficacy. This article reviews the literature bearing on early interventions for trauma, including the encouraging outcomes of recently developed behavioral treatments. Empirically informed practice guidelines for intervening with recently traumatized individuals are presented. Future treatment development efforts will need to address an issue that has been largely neglected in traditional treatment models for traumatized populations-that of traumatic bereavement. Behavioral interventions may be particularly well-equipped to address this source of distress.

Behavior Therapy↗

PubMed2004

Enhancing patient satisfaction and increasing treatment compliance: patient education as a fundamental component of PTSD treatment.

Posttraumatic Stress Disorder (PTSD) is the modal mental health problem afflicting combat veterans. In addition to the significant distress resulting from the disorder itself, PTSD has been associated with significant medical comorbidity and increased utilization of medical services. Interventions have historically focused on targeting symptoms directly, with comparatively little attention to systematically educating patients about the etiology and maintenance of the disorder and associated features and treatment issues. This descriptive study summarizes an eight-week PTSD patient education and orientation group. Seventeen patients admitted consecutively to the PTSD Clinic at a large VA hospital completed surveys of patient satisfaction with services and motivation to comply with treatment regimens upon completion of the group. Participants reported very high satisfaction with services, increased awareness of PTSD treatment options, greater optimism and symptom improvement and enhanced motivation to continue with treatment as a result of attending the group.

Humans↗

PubMed2004

A longitudinal analysis of PTSD symptom course: delayed-onset PTSD in Somalia peacekeepers.

Posttraumatic stress disorder (PTSD) typically follows an acute to chronic course. However, some trauma victims do not report significant symptoms until a period of time has elapsed after the event. Although originally dismissed as an artifact of retrospective methodologies, recent prospective studies document apparent instances of delayed-onset PTSD. Little is known currently about factors associated with the delayed onset of PTSD. This study was designed to examine the course of PTSD in a sample of 1,040 U.S. military peacekeepers who served in Somalia. A small but nontrivial subset of participants endorsed clinically significant levels of PTSD after a period of minimal distress, the magnitude of which cannot be ascribed to minor waxing and waning of symptoms. War-zone exposure and perceived meaningfulness of the mission, as rated by soldiers after returning to the United States, predicted symptom course over the next 18 months.

Adult↗

PubMed2004

Psychometric properties of the life events checklist.

The Life Events Checklist (LEC), a measure of exposure to potentially traumatic events, was developed at the National Center for Posttraumatic Stress Disorder (PTSD) concurrently with the Clinician Administered PTSD Scale (CAPS) to facilitate the diagnosis of PTSD. Although the CAPS is recognized as the gold standard in PTSD symptom assessment, the psychometric soundness of the LEC has never been formally evaluated. The studies reported here describe the performance of the LEC in two samples: college undergraduates and combat veterans. The LEC exhibited adequate temporal stability, good convergence with an established measure of trauma history -- the Traumatic Life Events Questionnaire (TLEQ) -- and was comparable to the TLEQ in associations with variables known to be correlated with traumatic exposure in a sample of undergraduates. In a clinical sample of combat veterans, the LEC was significantly correlated, in the predicted directions, with measures of psychological distress and was strongly associated with PTSD symptoms.

Adult↗

PubMed2003

The relationship between dispositional pessimistic attributional style versus trauma-specific attributions and PTSD symptoms.

Because a relatively small percentage of individuals who experience a traumatic event ultimately develop posttraumatic stress disorder (PTSD), it is incumbent upon researchers to identify factors of vulnerability and risk. One possible risk factor is attributional style or the types of causes individuals habitually offer for negative life events. This study examined the association between pessimistic attributional style and symptoms of PTSD. Because of methodological problems with the traditional questionnaire measurement of dispositional attributional style, this investigation added a structured content analysis of participants' trauma narratives to examine associations between trauma-specific attributions and PTSD symptoms. Dispositional attributional style, measured by the attributional style questionnaire (ASQ), was significantly associated with PTSD symptoms, but trauma-specific attributions more strongly predicted symptoms.

Adult↗

PubMed2002

Symptom presentations of older adult crime victims: description of a clinical sample.

Psychological sequelae of interpersonal violence in older adults remain understudied. Existing investigations focused on the clinical presentation of older adults who were traumatized as young adults (e.g., combat veterans). Consequently, little is known about the clinical correlates of trauma in recently victimized older adults. This descriptive study attempt to fill this void by documenting the symptom status and demographic features of 36 treatment-seeking older adult crime victims. Results indicated that older adult crime victims who seek services are a multiply traumatized group. They experienced significant financial, educational, medical, and social stressors that may complicate their clinical picture and treatment progress. Additionally, older adult crime victims experienced moderate-to-severe levels of psychopathology as evidenced by symptoms endorsed on an array of structured clinical interviews and paper-and-pencil measures designed to measure symptoms of Posttraumatic Stress Disorder (PTSD), depression, and panic.

Age Factors↗

PubMed2002

Emotional numbing in posttraumatic stress disorder: current and future research directions.

OBJECTIVE: Despite being understudied and poorly understood relative to the chronic fear, anxiety and other aversive emotional states that occur in the immediate aftermath of trauma, emotional numbing has become a core defining feature of posttraumatic stress disorder (PTSD). METHOD: This paper seeks to briefly review the literature bearing on these seemingly disparate emotional responses to trauma as well as theoretical accounts of emotional numbing that have been proffered to date. We then offer an alternative theory of post-traumatic emotional functioning and review empirical support for this model. RESULT: The experience of trauma produces very intense emotions such as overwhelming fear, horror, and anxiety, and these reactions can linger for a lifetime. Many trauma survivors also report restrictions in their emotional experience - a phenomenon most commonly referred to as emotional numbing. In contrast to previous accounts of posttraumatic emotional functioning our model posits that individuals with PTSD have difficulty expressing positive emotions as a result of re-experiencing states. We further argue that patients with PTSD are capable of experiencing and expressing the full range of emotions that were available pretraumatically. CONCLUSION: Our model holds that individuals with PTSD are not, in fact, 'emotionally numb' as a result of traumatic experience. Rather, PTSD is associated with hyperresponsivity to negatively valenced emotional stimuli. Consequently, patients with PTSD require more intense positive stimulation to access the full complement of appetitive or pleasant emotional behaviour.

Adult↗

PubMedDate not supplied

Acute psychological impact of disaster and large-scale tauma: limitations of traditional interventions and future practice recommendations.

Nearly everyone will experience emotional and psychological distress in the immediate aftermath of a disaster or other large-scale traumatic event. Although extremely upsetting and disruptive, the reaction is understood best as a human response to inordinate adversity, which in the majority of cases remits over time without formal intervention. Nevertheless, some people experience sustained difficulties. To prevent chronic post-traumatic difficulties, mental health professionals provide early interventions soon after traumatic exposure. These interventions typically take the form of single-session debriefings, which have been applied routinely following disasters. The research bearing on these traditional forms of early crisis interventions has shown that, although well-received by victims, there is no empirical support for their continued use. However, promising evidence-based, early interventions have been developed, which are highlighted. Finally, traumatic bereavement and complicated grief in survivors of disasters, an area largely neglected in the field, is discussed.

Bereavement↗