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Results for “Combat Disorders”

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PubMed1995

Assessment of psychological distress in Persian Gulf troops: ethnicity and gender comparisons.

This study reports results of psychological assessment among military participants in Operation Desert Storm, a more diverse ethnic and gender mix of American troops than has been mobilized for previous military operations. Symptoms of current psychological distress, including negative mood states, somatic complaints, and posttraumatic stress disorder, in addition to personal and trauma characteristics, were measured in 653 Persian Gulf war-zone-exposed and 259 stateside-duty troops to test the hypothesis that ethnic minority status and female gender are associated with greater levels of psychological distress following war-zone duty. Findings point to potentially negative sequelae to war-zone stress in a portion of troops and suggest that ethnic minorities, but not necessarily women, may be more vulnerable to psychological risk.

Adult↗

PubMed1993

Use of art therapy with post-traumatic stress disordered veteran clients.

1. The post-traumatic stress disordered veteran client may exhibit a cluster of problematic behaviors that are integral to current maladaptive coping patterns. 2. These coping patterns can be successfully addressed through a multidisciplinary therapeutic approach that emphasizes client-controlled expression of emotions and client-focused step-by-step behavior modification. 3. Art therapy and nursing, in a collaborative approach, can facilitate individual and group interventions that promote expression of feelings, congruency between experience and self-concept, and feelings of effectiveness in behavioral change.

Adaptation, Psychological↗

PubMed2005

Inhibition of autoantigen expression by (-)-epigallocatechin-3-gallate (the major constituent of green tea) in normal human cells.

Autoimmune disorders, characterized by inflammation and apoptosis of target cells leading to tissue destruction, are mediated in part by autoantibodies against normal cellular components (autoantigens) that may be overexpressed. For example, antibodies against the autoantigens SS-A/Ro and SS-B/La are primary markers for systemic lupus erythematosus and Sjögren's syndrome. Recently, studies in animals demonstrated that green tea consumption may reduce the severity of some autoimmune disorders, but the mechanism is unclear. Herein, we sought to determine whether the most abundant green tea polyphenol, (-)-epigallocatechin-3-gallate (EGCG), affects autoantigen expression in human cells. Cultures of pooled normal human primary epidermal keratinocytes and of an immortalized human salivary acinar cell line were incubated with 100 microM EGCG (a physiologically achievable level for topical application or oral administration) for various time periods and then analyzed by cDNA microarray analysis, reverse transcription-polymerase chain reaction, and Western blotting for expression of several major autoantigen candidates. EGCG inhibited the transcription and translation of major autoantigens, including SS-B/La, SS-A/Ro, coilin, DNA topoisomerase I, and alpha-fodrin. These findings, taken together with green tea's anti-inflammatory and antiapoptotic effects, suggest that green tea polyphenols could serve as an important component in novel approaches to combat autoimmune disorders in humans.

Autoantigens↗

PubMed1999

Psychological conditions diagnosed among veterans seeking Department of Defense Care for Gulf War-related health concerns.

The Comprehensive Clinical Evaluation Program is a US military program that provides a voluntary, clinically oriented evaluation for Gulf War health concerns. This article presents administrative data on psychological conditions (as coded using the International Classification of Diseases, 9th Revision) from the first year of the program. The most commonly diagnosed psychological conditions were medically unexplained physical-symptom syndromes; depression and anxiety, including post-traumatic stress disorder; and alcohol abuse or dependence. Psychological conditions were significantly related to a higher number of workdays lost, and the 19% of veterans with a primary diagnosis of a psychological condition reported 28% of the lost workdays among veteran who participated. Stressful Gulf War experiences were weakly but significantly related to psychological conditions. We conclude that among Gulf War veterans seeking evaluation for Gulf War-related health concerns, psychological conditions are common and are associated with important occupational morbidity.

Adult↗

PubMed1997

Inpatient treatment of war-related posttraumatic stress disorder: a 20-year perspective.

These papers show that long-stay inpatient PTSD programs provide treatment that is quite different from other programs but that they are neither as effective, from a psychometric perspective, nor as helpful, from the veterans' subjective perspective, as has been expected. VA treatment of PTSD is changing its focus and is being influenced by three distinct societal forces, in addition to data from studies like these: (1) the continuing effort of American society to come to terms with its Vietnam War experience; (2) the crisis of U.S. health care costs; and (3) the emergence of a movement to "re-invent" government and to increase public accountability through performance data.

Combat Disorders↗

PubMed1999

Posttraumatic stress disorder and interpersonal functioning in Vietnam War veterans: a mediational model.

This study examines the association between posttraumatic stress disorder (PTSD) and interpersonal functioning in a New Zealand community sample of 756 Vietnam War veterans. The results support previous research findings showing that PTSD adversely affects veterans' interpersonal relationships, family functioning, and marital/dyadic adjustment and show that the effects of PTSD on family functioning and dyadic adjustment are mediated by severity of interpersonal problems. It is suggested that higher levels of PTSD affect the ability of veterans to initiate and maintain interpersonal relationships and that these interpersonal problems are evident in poorer levels of family functioning and poorer dyadic adjustment.

Combat Disorders↗

PubMed1994

Psychopathology in war-zone deployed and nondeployed Operation Desert Storm troops assigned graves registration duties.

Early psychopathology outcomes were compared in troops mobilized for Persian Gulf graves registration duty but differentiated by war-zone deployment. Constructs of interest were Axis I psychiatric disorders, particularly posttraumatic stress disorder (PTSD), negative affect states, and somatic complaints. Psychometric instruments, including the Structured Clinical Interview for DSM-III-R, were administered to troops attending drill exercises. Although similar in personal characteristics and reporting low rates of premorbid psychopathology, groups differed in the prevalence of PTSD diagnoses, anxiety and anger symptoms, and somatic complaints. Current and lifetime PTSD rates of 48% and 65%, respectively, suggest that the psychological aftermath of war-zone participation involving the gruesome task of handling human remains was profound.

Adaptation, Psychological↗

PubMed2006

The co-occurrence of posttraumatic stress disorder symptoms and pain: is depression a mediator?

Although recent studies suggest that posttraumatic stress disorder (PTSD) symptoms and pain may be related, the possible mediational role of depression in this relationship has not been examined. This study sought to examine this question in a sample of 130 male veterans seeking assessment or treatment for deployment-related PTSD. Results suggest that PTSD and pain are moderately related (r = .29) but that this relationship is fully mediated by depression. Our findings have important clinical implications: Treatment of PTSD and pain in veteran populations should include careful assessment and regular monitoring of depression.

Adolescent↗

PubMed1997

Discussion: treatment of prolonged posttraumatic stress disorder--learning from experience.

Reports of limited treatment effect in Vietnam veterans with PTSD are discussed. Survivors of multiple traumata who suffer from complex PTSD and who live in poverty and distress may not properly represent the general case of PTSD. Yet the lessons learned suggest that attempts to treat prolonged PTSD by rederessing causation are ineffective. The appropriateness of targeting symptoms is also challenged. Previously heralded rethorics of healing trauma should be replaced by careful assessment of residual disability in a social context. Recognizing treatment-resistance in PTSD could lead to favorably investigating interventions of modest effect, to shifting from exploration to rehabilitation, and to redefining outcome measures such that changes in a variety of domains are appreciated.

Chronic Disease↗

PubMed1996

Race and outcome of treatment for veterans suffering from PTSD.

This study examines the relationship between racial group membership and psychometrically measured outcomes 4, 8 and 12 months after program entry in a program for veterans seeking treatment for war-related posttraumatic stress disorder (PTSD). Longitudinal assessment data were gathered and used to compare service use, clinicians' improvement ratings and psychometrically assessed clinical change among Black (n = 122) and White (n = 403) veterans treated at six geographically diverse sites. There were no significant differences between Blacks and Whites on any of the clinicians' improvement ratings, or on 13 of the 17 outcome measures. In this prospective study of veterans suffering from long-standing, severe PTSD, no consistent or sustained differences were observed between racial groups, in improvement whether measured as psychometric change or by clinicians' ratings.

Black or African American↗

PubMed2006

Beyond trauma-focused psychiatric epidemiology: bridging research and practice with war-affected populations.

This article examines the centrality of trauma-focused psychiatric epidemiology (TFPE) in research with war-affected populations. The authors question the utility of the dominant focus on posttraumatic stress disorder and other disorders of Western psychiatry, and they identify a set of critical research foci related to mental health work with communities affected by political violence. Core assumptions of TFPE and its roots in logical positivism and the biomedical model of contemporary psychiatry are explored. The authors suggest that an alternative framework--social constructivism--can serve as a bridge between researchers and practitioners by helping to refocus research efforts in ways that are conceptually and methodologically more attuned to the needs of war-affected communities and those working to address their mental health needs.

Biomedical Research↗

PubMedDate not supplied

Desert Storm syndrome: sick soldiers and dead children?

Ill-health has been reported by many soldiers and others deployed in the Persian Gulf during the Gulf War of 1991. Iraqi children have also been reported as suffering from an undiagnosed wasting disease. Little conclusive information has come to light; this paper reviews what is known at present, largely from anecdotal reports. Symptoms reported differ from post-traumatic stress syndrome as reported after previous conflicts; some are suggestive of a direct effect on the immune system. Various possible causes are examined, including post-traumatic stress disorder, infection, prophylactic medication, exposure to chemical and biological warfare agents, exposures resulting from oil spills and fires, and exposure to depleted uranium ammunition. The latter was used extensively for the first time in the Gulf War, and is manufactured and test-fired in Britain. The passive role of the British government in following up such reports is noted, in contrast with the more active official responses in the United States. It is suggested that Desert Storm Syndrome is one example of multiple assault upon the body's immune system.

Adult↗

PubMed1997

Psychosocial treatments for posttraumatic stress disorder: a critical review.

Posttraumatic stress disorder (PTSD) has been the subject of growing recognition since its inception in 1980. Owing in part to the relatively recent inclusion of PTSD in the psychiatric nomenclature, research is only beginning to address its treatment in methodologically rigorous studies. In this review, we discuss issues such as prevalence of trauma and of PTSD, and gold standards for treatment outcome research. We then critically review the extant literature on the treatment of PTSD. Finally, we include a discussion of issues specific to various trauma populations and factors that may influence treatment efficacy across types of trauma.

Combat Disorders↗

PubMed1993

Debriefing: from military origin to therapeutic application.

1. The objective of the debriefing process is the prevention of post-traumatic stress disorder (PTSD). Risk factors for PTSD can be classified into three categories: premorbid personality, the environment, and the trauma itself. 2. Nurses are in a position to intervene using debriefing at primary, secondary, and tertiary levels of prevention. 3. Debriefing, individually and in groups, is an effective intervention in preventing the adverse reactions incurred by a traumatic stressor. The use of a debriefing model counteracts the tendency to suppress the powerfully affective component of the traumatic experience.

Adaptation, Psychological↗

PubMed1994

Substance abuse and post-traumatic stress disorder comorbidity.

This article reviews the extant literature on substance abusers with and without a comorbid diagnosis of post-traumatic stress disorder (PTSD) and reveals the discontinuity between clinical lore and empirical research. Included is an overview of PTSD-substance abuse theoretical models and comorbidity prevalence rates, as well as an evaluation of the comparative data on treatment outcome and psychosocial factors, such as coping skills, for PTSD versus non-PTSD substance abusers. In addition, we discuss the controversy surrounding sequential versus simultaneous treatment approaches for such 'dually-diagnosed' patients. We conclude by identifying gaps in current knowledge about the nature and impact of PTSD on substance abuse treatment outcome and outlining needs for future research.

Combat Disorders↗

PubMed1988

Tribulin in post-traumatic stress disorder.

Tribulin (endogenous monoamine oxidase inhibitor/benzodiazepine receptor binding inhibitor) output was measured in the urine of 18 patients with post-traumatic stress disorder (PTSD) and 13 controls. The level of the two inhibitory activities was highly significantly correlated in the group as a whole. There was no difference between output of either inhibitor in patients and controls. However, when the PTSD group was subdivided according to various psychometric ratings, a pattern of output did emerge. Levels of both inhibitory activities were higher in agitated compared with non-agitated subjects, and lower in extroverts compared with introverts. This finding supports the view that tribulin output is raised in conditions of greater arousal.

Arousal↗

PubMed1993

Coping of school-age children in the sealed room during scud missile bombardment and postwar stress reactions.

Children's coping behaviors in the sealed room (a shelter against chemical and biological weapons) during scud missile attacks in the Persian Gulf war were examined in relation to postwar stress reactions. Three weeks after the war, 5th, 7th, and 10th graders (N = 492) completed questionnaires assessing coping behaviors and emotional responses in the sealed room, as well as current stress reactions and posttraumatic stress disorder (PTSD). Despite an underlying feeling of tension, the dominant emotional stance in the sealed room was one of detached optimism. Common forms of coping involved information seeking, checking, and wishful thinking. Emotion-focused coping such as avoidance and distraction strategies was associated with less postwar stress reactions than persistence at direct problem-focused actions once the minimal actions available had been undertaken. Fifth graders were found to use less emotion-focused and more problem-focused coping strategies than were the 7th and 10th graders.

Adaptation, Psychological↗

PubMed1994

Psychological sequelae following the Gulf War. Factors associated with subsequent morbidity and the effectiveness of psychological debriefing.

BACKGROUND: The aim was to study the effect of brief counselling and psychological debriefing following a trauma on subsequent morbidity. METHOD: We investigated psychological morbidity in 62 British soldiers whose duties included the handling and identification of dead bodies of allied and enemy soldiers during the Gulf War. Of these soldiers, 69% received a psychological debriefing on completion of their duties. The subjects completed by post a demographic questionnaire, the General Health Questionnaire (GHQ-28) and the Impact of Events Scale. RESULTS: After nine months 50% had evidence of some psychological disturbance suggestive of posttraumatic stress disorder (PTSD); 18% had sought professional help; 26% reported relationship difficulties. Neither prior training nor the psychological intervention appeared to make any difference to subsequent psychiatric morbidity. Morbidity at nine months was more likely in those with a history of psychological problems and those who believed their lives had been in danger in the Gulf. CONCLUSIONS: These findings show that a psychological debriefing following a series of traumatic events or experiences does not appear to reduce subsequent psychiatric morbidity and highlights the need for further research in military and civilian settings.

Adult↗