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PubMed1992

The Northfield experiments.

The Northfield Experiments took place at Hollymoor Hospital, Northfield, Birmingham, during World War II. The first experiment was conducted by Bion & Rickman. The second evolved gradually; many people contributed to its success, including Foulkes, Main and Bridger. The experiments were an important landmark in the evolution of theory and practice in group psychotherapy and in the therapeutic community movement. They were not carried out solely as responses to the need for mass treatment of neurotic disorders among army personnel; antecedent factors, the theoretical orientation of the practitioners and the nature of army life were equally important. The two experiments differed in pace and in recognition of the needs of higher-order systems, particularly the military hierarchy. They shared many underlying concepts, including responsibility to society, the therapeutic use of groups (including the hospital community) and an emphasis on process. Lessons learned at Northfield remain relevant to the practice of psychiatry today.

Combat Disorders↗

PubMed1994

Efficacy of buspirone in the treatment of posttraumatic stress disorder: an open trial.

Although numerous psychotropic medications have a reported efficacy in posttraumatic stress disorder (PTSD), treatment of the condition remains largely empirical. The animal model of inescapable stress (IS) produces many physiological changes similar to PTSD in humans. The azapirones (e.g., buspirone, gepirone) are effective in alleviating the signs of IS in animals and should theoretically be effective in alleviating the symptoms of PTSD in humans. An open trial of buspirone in 8 patients meeting DSM-III-R criteria for posttraumatic stress disorder was conducted. Measurement tools included the Structured Interview for PTSD (SI-PTSD), Impact of Life Events Scale (ILES), and Beck Depression Inventory (BDI). Seven out of 8 patients exhibited a significant reduction in symptoms as measured by the SI-PTSD and BDI. The response was less significant on the ILES. Buspirone may be effective in alleviating the symptoms of PTSD. Further clinical trials to confirm this apparent efficacy appear warranted.

Arousal↗

PubMed1998

Posttraumatic stress disorder and other predictors of health care consumption by Vietnam veterans.

A total of 641 randomly selected Australian veterans of the Vietnam War were interviewed about their use of health care in the previous two weeks to determine what factors contributed to health care consumption. Seventy-three variables were examined by univariate linear regression and then grouped into seven categories relating to age, physical and mental health, predisposition to posttraumatic stress disorder (PTSD), deployment and repatriation experiences, and membership in veterans groups. PTSD was associated with an additional cost of $79 in health care for the two-week period. Each physical diagnosis was associated with an additional $28. Alcohol consumption was not related to health care costs. Other important variables contributing to costs were depression, educational status, the quality of the repatriation experience, and social support.

Adult↗

PubMed2005

[Psychological trauma in psychiatric textbooks published in german - the dominating view of psychiatrists between 1945 and 2002].

AIM: The study investigates the concepts of psychological trauma and their changes over time in psychiatric textbooks published in German between 1945 and 2002, assuming that textbooks reflect the established and dominating views of their time. METHOD: [corrected] In psychiatric textbooks, the terminology, concepts of illness, and recommendations for assessment and treatment concerning psychological trauma were analysed. RESULTS: The concept of psychological trauma that had existed since 1916 continued to dominate textbooks up until the 1960s. Findings on holocaust survivors entered textbooks not before the mid 1970s. Since the mid 1990s, the concept of Post-Traumatic Stress Disorder has been widely established in textbooks. CONCLUSION: Changes of dominating views on this issue in textbooks appear to have been extremely slow and occurred with significant delays in the past. The change of the dominating view in the 1970s was linked to the establishment of a new generation of leading psychiatrists. Since the introduction of PTSD, psychiatric textbooks have given up a previously negative attitude towards patients suffering from psychological trauma.

Attitude of Health Personnel↗

PubMed1999

A model of war zone stressors and posttraumatic stress disorder.

We present a theoretical model of field placement, war zone stressors (fighting, death and injury of others, threat of death or injury to oneself, killing others, participating in atrocities, harsh physical conditions and insufficiency of resources in the environment) and posttraumatic stress disorder (PTSD). Theater veterans from the National Vietnam Veterans Readjustment Study were divided randomly into two subsamples of 599 each. The model was developed on the first subsample and cross-validated on the second using structural equation modeling. The model provides a theoretically and empirically satisfactory description of the anatomy of war zone stressors and their role in the etiology of PTSD, but it leaves unanswered important questions regarding the etiological role of insufficiency of resources in the environment.

Adult↗

PubMed1995

Eye movement desensitization/reprocessing: its use in resolving the trauma caused by the loss of a war buddy.

EMDR resulted in the rapid relief of symptoms of posttraumatic stress disorder in refractory traumatic imagery in a Vietnam veteran. The results were maintained at nine-month follow-up. EMDR appears to be a viable technique in anecdotal reports but the limitations of a single-case study and the lack of adequate large controlled studies prevent generalization beyond a case-by-case assessment. Despite controversial reports, it appears that more rigorous evaluation of EMDR needs to be done to document the factors that operate in the use of EMDR.

Combat Disorders↗

PubMed1985

MCMI characteristics of DSM-III posttraumatic stress disorder in Vietnam veterans.

Compared the MCMI profiles of 25 veterans with a diagnosis of Posttraumatic Stress Disorder (PTSD) with those of 25 veterans carrying psychiatric disorders which typically cause problems in the differential diagnosis of PTSD. The PTSD group had higher elevations on nine of the 20 MCMI scales (all ps less than .05). Profiles were also significantly different in shape and scatter. A discriminant analysis accounted for 100% of the variance and correctly classified 88% of the patients. Resulting MCMI profiles appear to be consistent with DSM-III criteria for PTSD.

Combat Disorders↗

PubMedDate not supplied

[Posttraumatic stress disorder in Bosnian war veterans: analysis of stress events and risk factors].

The aim of this study was to determine the incidence of Post-Traumatic Stress Disorder (PTSD), the characteristics of stress-related events, and the risk factors for the development of PTSD. The total patient sample consisted of 100 Bosnian war veterans. Watson's PTSD module was used in establishing PTSD diagnosis. Patients fulfilled the following questionnaires: personal data form, Posttraumatic Symptom Scale PTSS-10 (Holen), Impact of Event Scale (Horowitz), Life Event Scale, and Eysenck Personality Inventory. PTSD was diagnosed in 30% of the examined patients. Larger number of stress-related events, particularly of those regarded as life-threatening, wounding/death of a close person, and material losses were more frequent in persons with PTSD. The risk factors for the development of PTSD in this study were: age (30-40), marital status (married), lower level of education, the front-line combat exposure, neurotic manifestations, family problems in childhood, and neuroticism.

Adolescent↗

PubMed1998

Homicides in war and peace in Croatia.

This work shows the interdisciplinary investigation of homicides in the Osijek area during the war and prewar periods. Similarities between the prewar and wartime perpetrators are related to social-demographic characteristics. Nevertheless, significant differences are found in the homicidal method of selection among victims and participation of victims involved. The major contributing factors in homicide genesis were acute alcohol intoxication and personality disorder among perpetrators. Besides these factors, the war stressors and access to firearms were significant factors during the war homicides. Prevention efforts should be directed toward consequential measures and further investigation suggests that the emphasis must be put on victimological aspects of the homicide problem. This work is a review of an interdisciplinary investigation of prewar and war homicides in the city of Osijek district. It provides confirmation of how the number of war homicides relate to the prewar number.

Alcoholism↗

PubMedDate not supplied

Sleep disturbance and computerized axial tomographic scan findings in former prisoners of war.

Ten drug-free former American prisoners of war (POWs), captured on Bataan and Corregidor by the Japanese in World War II, participated in a study of the relationship between structural brain abnormalities on computerized axial tomographic (CT) scans and sleep electroencephalographic (EEG) findings. All subjects had complaints of sleep disturbances and other posttraumatic stress disorder (PTSD)-related symptoms. Six of 10 subjects had no stage 4 sleep, and had significantly higher mean ventricular brain ratios (VBRs). Structural brain measures such as VBRs and global sulcal widening (GSW) correlated significantly with the number of awakenings; GSW also correlated significantly with time spent asleep. However, because data from normal age-matched controls are not available, it remains to be seen whether our findings are PTSD specific.

Aged↗

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↗

PubMed1993

Post-traumatic stress disorder in Australian prisoners of the Japanese: a clinical study.

The clinical findings of examination of 11 Australian prisoners of the Japanese (POWs (J)) are reported. They were examined for evidence, past or present, of Post-Traumatic Stress Disorder (PTSD). Three currently satisfied the DSM-III-R criteria for a diagnosis of PTSD and at least three more would probably have done so if a complete assessment had been possible. All but two described many of the symptoms of PTSD and would probably have satisfied the criteria for the diagnosis at some time following their release from captivity. The subjects were all seen between mid 1988 and mid 1990 and the difficulties of the study and its implications are discussed.

Adult↗

PubMed1991

[Demand for care in traumatic war neuroses].

Psychiatrists who must take care of patients suffering of Post Traumatic Stress Disorders are often surprised in front of the strength of repetition of the related frightful experience. Therapeutics methods which are more often used (Abreaction and Narcissism reconstruction by varied technics) have showed their limits. Leaning on their experience and referring to psycho-analytic teaching, the authors show the interest of the individual psychotherapy. They propose not to be strongly affected by the massive aspect to the "trauma" and to permit as far as possible the installation of the transfer.

Adult↗

PubMed1997

The Honolulu posttraumatic stress disorder stimulus set.

We present word and picture stimuli constituting a validated stimulus set appropriate for cognitive investigations of posttraumatic stress disorder (PTSD). Combat related and neutral words and pictures were rated by Vietnam veterans with PTSD and by three comparison groups along four dimensions: unpleasantness, Vietnam relevance, stressfulness, and memorability. There were distinctive patterns of responses by the PTSD group which efficiently discriminated the individuals in this group from those in the control groups. These stimuli have the potential to be developed as a diagnostic instrument.

Adult↗

PubMed2005

Weight loss and PTSD symptom severity in former POWs.

To determine the relationship between weight loss suffered by former prisoners of war during captivity during World War II and the Korean Conflict and current posttraumatic stress disorder (PTSD) symptoms, the Clinician-Administered PTSD Symptom Scale, a lifetime stressor checklist, and the Structured Clinical Interview for DSM-IV were administered to 102 former prisoners of war. Preconfinement and postconfinement weights and length of confinement were obtained from military medical records. Percentage of body weight lost during captivity was significantly higher in those subjects with PTSD and correlated with current PTSD symptom severity. Length of confinement was not associated with current PTSD symptoms.

Aged↗

PubMed1988

Development of autoimmunity in MRL/lpr mice and the effects of drugs on this murine disease.

MRL/lpr mice spontaneously develop a systemic Lupus erythematosus (SLE)-like disease with a wide range of clinical and serological characteristics that mimic not only human SLE but other autoimmune disorders. such as Sjögren's syndrome, and rheumatoid arthritis (RA). Unlike other murine SLE-like disorders, these mice have circulating rheumatoid factor (RF) and develop histological changes in their joints. Therapy of this disease with cyclophosphamide (CY), cyclosporin A, prednisolone, or leflunomide (HWA 486) resulted in very differing effects. Treating these mice with HWA 486 or cyclophosphamide (CY) resulted in a decrease in the amount of autoantibodies, and immune complex deposits on the glomeruli. HWA 486 therapy led to restoration of the depressed immune response of MRL/lpr mice. In the established disease, prednisolone (Pr), cyclosporin A (CSA), and HWA 486 could inhibit the proteinuria and return the urine-protein values to normal levels, but, unlike HWA 486, neither PR nor CSA could extend the longevity of these animals. The MRL/lpr mouse should prove to be very useful as a model for SLE, RA, and for discovering novel drugs to combat such disorders.

Animals↗

PubMed2007

Prospective study of posttraumatic stress disorder symptoms and coronary heart disease in the Normative Aging Study.

CONTEXT: Various correlates of posttraumatic stress disorder (PTSD), such as high levels of sympathetic activation and hypothalamic-pituitary-adrenal axis dysregulation, have been linked to arterial damage and coronary heart disease (CHD) risk. While psychological disturbance is frequently found among patients with cardiac disease, whether psychological problems precede or occur as a result of having a potentially fatal disease is not clear. To our knowledge, no prospective studies to date have evaluated whether PTSD is associated with increased risk of CHD. OBJECTIVE: To test the hypothesis that high levels of PTSD symptoms may increase CHD risk, using 2 different measures of PTSD. DESIGN: Prospective cohort study. SETTING: Community-dwelling men from the Greater Boston, Mass, area who served in the military. PARTICIPANTS: Data are from the Veterans Affairs Normative Aging Study. Men who completed either the Mississippi Scale for Combat-Related PTSD in 1990 (n = 1002) or the Keane PTSD scale in 1986 (n = 944) were included in the study. MAIN OUTCOME MEASURE: Incident CHD occurring during follow-up through May 2001. RESULTS: Levels of PTSD symptoms in this cohort were low to moderate. Men with preexisting CHD at baseline were excluded, and PTSD was measured with the Mississippi Scale for Combat-Related PTSD. For each SD increase in symptom level, men had age-adjusted relative risks of 1.26 (95% confidence interval, 1.05-1.51) for nonfatal myocardial infarction and fatal CHD combined and 1.21 (95% confidence interval, 1.05-1.41) for all of the CHD outcomes combined (nonfatal myocardial infarction, fatal CHD, and angina). Findings were replicated using the Keane PTSD scale and somewhat strengthened after controlling for levels of depressive symptoms. CONCLUSIONS: To our knowledge, this is the first study to demonstrate a prospective association between PTSD symptoms and CHD even after controlling for depressive symptoms. These results suggest that a higher level of PTSD symptoms may increase the risk of incident CHD in older men.

Adult↗

PubMed2005

Posttraumatic stress disorder is associated with attenuated baroreceptor sensitivity among female, but not male, smokers.

BACKGROUND: The relationship between posttraumatic stress disorder (PTSD) and parasympathetic nervous system (PNS) functioning was investigated using baroreflex sensitivity (BRS). We hypothesized that individuals with PTSD would exhibit lower BRS than those without PTSD. METHODS: Participants were 80 PTSD patients and 50 controls aged 18-68 years. All participants were smokers, many were veterans (55%), and 60 were women. Beat-to-beat BP was collected during a 5-min baseline rest periods from which estimates of BRS were derived using the sequence method. RESULTS: Women with PTSD exhibited lower BRS (M = 10.5, S.D. = 5.1) than women without PTSD (M = 14.6, S.D. = 10.7). For men, PTSD diagnosis was not associated with BRS, p > .05. CONCLUSIONS: Among women, PTSD was associated with reduced PNS functioning. Men with PTSD did not have attenuated BRS, which may be due to sample characteristics, such as age and combat veteran status. Reduced PNS activity may predispose women with PTSD to poorer cardiovascular health.

Adolescent↗