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Results for “Combat Disorders”

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At least 721 records · Page 40Linked to original sources

PubMed1997

Assessing the structure, content, and perceived social climate of residential posttraumatic stress disorder treatment programs.

This study utilized a comprehensive assessment of program structure, content, and social climate to determine whether specialized residential posttraumatic stress disorder (PTSD) programs (SIPUs, n = 19) can be differentiated from general psychiatric units (GPUs, n = 18) within the Department of Veterans Affairs. Significant differences between program types were found: SIPUs were more clearly differentiated from the larger hospital system, had more strict patient selection criteria and program regulations, longer length of stays and lower admission rates, and spent more program time on PTSD symptoms and war zone experiences than GPUs. Veterans in the SIPUs (n = 453) rated the programs significantly higher on most social climate measures than veterans with PTSD in the GPUs (n = 153), indicating that veterans perceived these programs as more active, supportive, and better structured.

Adult↗

PubMed2004

Emotional-processing in posttraumatic stress disorder II: startle reflex modulation during picture processing.

This study examined the impact of a trauma-related stressor on subsequent emotional behavior in veterans with (n = 35) and without (n = 24) posttraumatic stress disorder (PTSD). Self-report and physiological responses, including acoustic startle, were recorded during viewing of emotionally evocative photographs at baseline and following exposure to trauma-related and non-trauma-related stressors. The 2 groups exhibited equivalent patterns of emotional response across self-report and physiological measures at baseline. In contrast, following the trauma challenge, participants with PTSD showed a pattern of startle modulation suggestive of greater defensive reactivity and reduced visual perceptual engagement. These findings, along with augmented corrugator EMG reactivity during the same interval, suggest that trauma-related reexperiencing primes subsequent negative emotional responding in individuals with PTSD.

Adaptation, Psychological↗

PubMed1992

Comparison of the MMPI-PTSD subscale with PTSD and substance abuse patient populations.

War-related PTSD frequently presents as a dual disorder. Questions have been raised about whether the MMPI-PTSD subscale developed by Keane, Malloy, and Fairbank (1984) is identifying a separate PTSD syndrome or is a measure of generalized distress common to various diagnostic categories, including substance abuse. In this study, veterans with PTSD with and without substance abuse were compared to veterans with substance abuse only on the MMPI-PTSD subscale (n = 22 in each of the four categories). Results support the ability of the test to distinguish between groups of veterans with PTSD and those with substance abuse only. The findings lend indirect support to the validity of a distinct PTSD symptom cluster.

Alcoholism↗

PubMed1994

The comorbidity of post-traumatic stress disorder and suicidality in Vietnam veterans.

Vietnam veterans (N = 232) recruited from three sources were assessed for suicidal thinking and behaviors, and symptoms of posttraumatic stress disorder (PTSD) and depression. Findings support the notion that suicidal thoughts are prevalent in this group, with veterans in psychotherapy reporting a greater likelihood of such symptoms (82.6%) than veterans in the community (35.7%) or those seeking assistance through a veteran's outreach center (66.7%). Thoughts of ending one's life and a previous suicide attempt were significantly correlated with a diagnosis of PTSD (r = .53, p < .001; and r = .33, p < .001, respectively). Veterans with a diagnosis of PTSD and depression or dysthymia were also more likely to report suicidal thinking and behaviors than veterans with only one of the diagnoses.

Adult↗

PubMed2003

Physiologic responses to sudden, loud tones in monozygotic twins discordant for combat exposure: association with posttraumatic stress disorder.

BACKGROUND: Larger heart rate responses to sudden, loud (startling) tones represent one of the best-replicated psychophysiologic markers for posttraumatic stress disorder (PTSD). This abnormality may be a pretrauma vulnerability factor, ie, it may have been present prior to the event's occurrence and increased the individual's likelihood of developing PTSD on traumatic exposure. Alternately, it may be an acquired PTSD sign, ie, it may have developed after the traumatic exposure, along with the PTSD. Studying identical twins discordant for traumatic exposure offers an opportunity to resolve these competing origins. METHODS: Subjects included pairs of Vietnam combat veterans and their non-combat-exposed, monozygotic twins. Combat veterans were diagnosed as having current PTSD (n = 50) or non-PTSD (ie, never had) (n = 53). All subjects listened to a series of 15 sudden, loud tone presentations while heart rate, skin conductance, and orbicularis oculi electromyogram responses were measured. RESULTS: Consistent with previous reports, averaged heart rate responses to the tones were larger in Vietnam combat veterans with PTSD. These larger responses were not shared by their non-combat-exposed co-twins, whose responses were similar to those of the non-PTSD combat veterans and their non-combat-exposed co-twins. This result remained significant after adjusting for a number of potentially confounding factors. CONCLUSIONS: The results suggest that larger heart rate responses to sudden, loud tones represent an acquired sign of PTSD rather than a familial vulnerability factor.

Acoustic Stimulation↗

PubMed1989

Treatment outcomes of Vietnam veterans with PTSD and the consistency of the MCMI.

This study addresses two issues: treatment changes on the MCMI of Vietnam veterans with PTSD and test-retest reliability of the Millon Clinical Multiaxial Inventory (MCMI). Fifty Vietnam veterans carefully were identified for the diagnosis Post-Traumatic Stress Disorder (PTSD). They were admitted to a Special PTSD Treatment Unit that consisted of an intense 5-week period with focus on the revivified Vietnam experience. They also were given the MCMI at two points in time, treatment inception and 35 days later at discharge. Results show that 17 of 20 scales on the MCMI changed in the negative direction as a result of treatment. Also, the MCMI has adequate test-retest reliability, and the personality scales (with the exception of Borderline) have higher reliability coefficients than do symptom scales. The use of the MCMI is encourged both as a monitor of treatment for these veterans and for its stability.

Combat Disorders↗

PubMed1992

Problems in families of male Vietnam veterans with posttraumatic stress disorder.

Interviews were conducted with a nationally representative sample of 1,200 male Vietnam veterans and the spouses or co-resident partners of 376 of these veterans. The veteran interview contained questions to determine the presence of posttraumatic stress disorder (PTSD) and items tapping family and marital adjustment, parenting problems, and violence. The spouse or partner (S/P) interview assessed the S/P's view of these items, as well as her view of her own mental health, drug, and alcohol problems and behavioral problems of school-aged children living at home. Compared with families of male veterans without current PTSD, families of male veterans with current PTSD showed markedly elevated levels of severe and diffuse problems in marital and family adjustment, in parenting skills, and in violent behavior. Clinical implications of these findings are discussed.

Adaptation, Psychological↗

PubMed1990

"A dream is the fulfillment of a wish': traumatic dream, repetition compulsion, and the pleasure principle.

This paper describes the case of a battle veteran who suffered from a repetitive traumatic dream and symptoms of a traumatic stress disorder. Psychodynamic exploration revealed the basic wish-fulfilling aspects of both the dream and the fact of its repetition. The patient's obsessional preoccupation with his war experiences was also in significant part determined by unconscious wishes to repeat the infantile experience it represented. It is suggested that the repression of pleasure according to the classic psychoanalytic model is as important a dynamic in the dreams and symptoms associated with specific traumata as with any other neuroses. The question is raised as to whether a repetition compulsion, of normal or pathological intensity, may reflect the wish to repeat a descriptively unconscious pleasurable component of a disturbing experience, as well as to master it.

Adult↗

PubMed2006

Decoupling neural networks from reality: dissociative experiences in torture victims are reflected in abnormal brain waves in left frontal cortex.

From a neuroscience perspective, little is known about the long-term effect of torture. Dissociative experiences and posttraumatic stress disorder are often the results of this experience. We examined psychological dissociation within a group of 23 torture victims and report its manifestations within neural networks in the human brain. In particular, we observed that dissociative experiences are associated with slow abnormal brain waves generated in left ventrolateral frontal cortex. Given that focal slow waves often result from depriving neural networks of major input, the present results may indicate decoupling of frontal affective processors from left cortical language areas. This interpretation is consistent with the fact that disturbed access to structured verbal memory concerning traumatic events is a core feature of the dissociative experience.

Adult↗

PubMed1991

Patterns of appraisal and coping across different stressor conditions among former prisoners of war with and without posttraumatic stress disorder.

Little is known about how survivors of extreme events cope with traumatic memories and subsequent negative life experiences. The present study compared (a) repatriated prisoners of war (RPWs) from World War II (WW II) with chronic posttraumatic stress disorder (PTSD), (b) RPWs without PTSD, and (c) noncombat veterans on measures of general psychological functioning, appraisal, and coping. Appraisal and coping were assessed under 2 stressor conditions: memories of war/captivity and recent negative life events. RPWs with PTSD reported poorer general psychological functioning; significantly less control over memories of WW II: and more frequent use of self-isolation, wishful thinking, self-blame, and social support in an effort to cope with these memories than did the 2 comparison groups. Fewer between-groups differences were found for the recent stressor condition. Findings are discussed in terms of factors that may explain the perseverance of coping difficulties associated with PTSD.

Adaptation, Psychological↗

PubMedDate not supplied

Posttraumatic stress disorder revisited.

In this review we trace the history of and professional discussion on psychological traumatization due to "railroad spine syndrome," "shell-shock syndrome," and "war neuroses," as well as the more or less endemic "posttraumatic stress disorder" of today. Psychological trauma engenders longlasting consequences in the biological, intrapsychic, and social organization of individuals. Medical experts have reported a shift in attention from exogenous to endogenous and back to exogenous causes, as indicated by new diagnostic systems (DSM-IV and ICD-10). As far as the relevant literature is concerned, the medical profession demonstrates the same partial amnesia as their patient counterparts. The purpose of this review is to overcome this fragmented memory and thus reach a more integrated view of what constitutes psychological trauma by reviewing trauma-related articles published in Psychosomatic Medicine. Moreover, we point out the direction in which research is desperately needed and ought to develop.

Arousal↗

PubMed2005

Glycine receptors regulate dopamine release in the rat nucleus accumbens.

BACKGROUND: The mesolimbic dopamine (DA) system seems to be centrally involved in regulating reward-related behavior and consequently has been implicated in addictive processes, such as alcoholism and drug addiction. This DA system has also been implicated in psychosis and in regulating hedonia/anhedonia, important components of mania and depression. Given the potentially great importance of the mesolimbic DA system for several psychiatric disorders, it is of major interest to delineate the mechanisms and dynamics underlying DA regulation and release. Recently strychnine-sensitive glycine receptors (GlyR) have attracted some interest in this matter. METHODS: Western blot and in vivo microdialysis (couplied to high-pressure liquid chromatography with electrochemical detection), as well as reversed microdialysis, in awake, freely moving, adult male Wistar rats. RESULTS: Here we demonstrate by means of Western blot that alpha GlyR subunit proteins are expressed in the rat nucleus accumbens (nAc), a major target of the mesolimbic DA system. We further show that reversed microdialysis of the competitive GlyR antagonist strychnine into the nAc concentration-dependently (2-200 microM) and in a reversible manner decreases accumbal extracellular DA levels. Conversely, reversed microdialysis of the agonist glycine increases accumbal DA levels in some rats but not others. The strychnine-induced depression of the accumbal DA levels is antagonized by simultaneous local perfusion of glycine. CONCLUSIONS: The present results indicate that GlyRs in the nAc are tonically activated and of importance for regulating extracellular DA levels. The possibility of pharmacologically interfering with GlyRs to combat psychiatric disorders, in which the mesolimbic DA system is implicated, such as alcoholism, drug addiction, and psychosis, should be explored.

Animals↗

PubMedDate not supplied

A single session, group study of exposure and Eye Movement Desensitization and Reprocessing in treating Posttraumatic Stress Disorder among Vietnam War veterans: preliminary data.

This report summarizes data gathered thus far from an ongoing study. Two groups (total N = 12) of Vietnam War veterans diagnosed with Posttraumatic Stress Disorder (PTSD) received a single session of exposure or Eye Movement Desensitization and Reprocessing (EMDR) focusing on the veterans' most distressing war experience. Group assignment was random, treatment providers were blind to assessment data, and the pre- and posttreatment assessor was blind to treatment assignment. Both groups showed improvement on the Impact of Event Scale. EMDR treatment resulted in greater positive changes in within-session Subjective Units of Discomfort levels and on self-monitored severity of intrusive recollection. A trend toward decreased heart rate reactivity was observed in both groups. Results must be considered carefully due to the small number of subjects used in the study.

Analysis of Variance↗

PubMed2002

Shame and posttraumatic stress disorder.

Guilt about surviving a traumatic event is thought to be an associated feature of posttraumatic stress disorder (PTSD). Shame is an emotion closely related to guilt but is a distinct affective state. Little is known regarding the role of shame in PTSD and there are no studies of PTSD where shame and guilt are examined simultaneously. We used a measure of shame- and guilt-proneness in 107 community residing former prisoner of war veterans all of whom had been exposed to trauma. The measure of shame-proneness was positively correlated with PTSD symptom severity whereas guilt-proneness was not. This study provides the first empirical data regarding a possible role for shame in PTSD and may have important therapeutic and theoretical implications.

Age Factors↗

PubMed1990

Suicidal behavior among chronic Vietnam theatre veterans with PTSD.

Suicidal behavior among Vietnam veterans with chronic Post-traumatic Stress Disorder (PTSD) was evaluated. Sixty chronic PTSD vets admitted to a Specialized PTSD Unit were divided into two groups based on the presence of suicidal behavior: 29 patients in a Suicide Group and 31 in a Non-suicide Group. Subjects were evaluated on symptoms, psychometric measures, military variables, adjustment factors, and pre-military parental patterns of discipline. Results showed that the Suicide Group possessed problems in paternal child-rearing patterns, current adjustment difficulties, and the PTSD symptoms of survival guilt and crying. In a regression analysis, paternal inconsistency of love, survivor guilt, and tendency to cry, in addition to age and sex, accounted for the significant variance of suicidal behavior.

Chronic Disease↗

PubMed1996

Effectiveness of short-term specialized inpatient treatment for war-related posttraumatic stress disorder: a role for adventure-based counseling and psychodrama.

Psychological tests were administered to 24 participants of an inpatient posttraumatic stress disorder (PTSD) treatment program both immediately before and following completion of treatment. Responses were compared to a treatment/wait list comparison group composed of 24 subjects awaiting entry into the program. All treatment/wait list comparison group subjects received weekly PTSD outpatient group therapy. Significant improvements were found in the inpatient treatment group in areas of hopelessness, feelings of guilt and shame, loneliness, and emotional expressiveness. Other indices of psychological functional, including interpersonal skills, gender role stress, anxiety, anger, and PTSD symptomatology did not change significantly in response to treatment. No positive changes in any area of psychological function occurred in the treatment/wait list comparison group. Implications for PTSD and areas of future research are discussed.

Adult↗

PubMed1992

The use of image habituation training with post-traumatic stress disorders.

An exposure treatment for patients suffering from post-traumatic stress disorder (PTSD) is described. Image habituation training (IHT) involves the patient in generating verbal descriptions of the traumatic event and recording these onto an audiotape. After the initial training session with the therapist, homework sessions of self-directed exposure in which the patient visualised the described event in response to listening to the audiotape were carried out. Of ten consecutive patients who received this treatment, six improved considerably after ten homework sessions, two showed moderate improvements, and two showed minimal improvement on a range of outcome measures. There were significant decreases in anxiety between and within homework sessions, suggesting that habituation did occur and was responsible for improvement. Treatment gains were maintained at six-month follow-up.

Adaptation, Psychological↗

PubMedDate not supplied

Continuity of care and clinical effectiveness: treatment of posttraumatic stress disorder in the Department of Veterans Affairs.

Evaluation of the quality of outpatient treatment for patients with severe psychiatric or addictive disorders has often focused on the assessment of continuity of care (COC) as measured with administrative data. However, there has been little empirical evaluation of the relationship of measures of COC and treatment outcomes. This study used hierarchical linear modeling to examine the relationship between 6 indicators of COC and 6 outcome measures in a multisite monitoring effort for veterans with war-related posttraumatic stress disorder. There were few consistently significant associations between COC and outcome measures. Although measures of COC at the level of individual patients were associated with reductions in substance abuse symptoms, when COC measures were averaged to the site level and examined with hierarchical linear modeling models, thereby reducing the impact of intrasite selection bias, they were not associated with any desired outcomes. COC measures, at least in the sample used for this study, are not consistently associated with desirable client outcomes and may therefore be less than ideal performance measures in outcome evaluations following inpatient treatment, except to the extent that COC is considered to be an intrinsic indicator of higher quality regardless of its relationship to outcomes.

Ambulatory Care↗