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PubMed1981

Treatment of traumatic war neurosis with phenelzine.

Traumatic war neurosis may become a chronic, debilitating condition that resists treatment interventions. Five patients with traumatic war neurosis had favorable therapeutic responses to phenelzine sulfate. These patients did not respond to multiple previous therapeutic trials with antipsychotics, tricyclic antidepressants, and psychotherapy with or without medication. With phenelzine, the patients felt calmer and stopped having nightmares and flashbacks of traumatic war material. Startle reactions and aggressive, violent outbursts also ceased.

Adult↗
PubMed2006

Physical and mental health costs of traumatic war experiences among Civil War veterans.

BACKGROUND: Hundreds of thousands of soldiers face exposure to combat during wars across the globe. The health effects of traumatic war experiences have not been adequately assessed across the lifetime of these veterans. OBJECTIVE: To identify the role of traumatic war experiences in predicting postwar nervous and physical disease and mortality using archival data from military and medical records of veterans from the Civil War. DESIGN: An archival examination of military and medical records of Civil War veterans was conducted. Degree of trauma experienced (prisoner-of-war experience, percentage of company killed, being wounded, and early age at enlistment), signs of lifetime physician-diagnosed disease, and age at death were recorded. SETTING AND PARTICIPANTS: The US Pension Board surgeons conducted standardized medical examinations of Civil War veterans over their postwar lifetimes. Military records of 17,700 Civil War veterans were matched to postwar medical records. MAIN OUTCOME MEASURES: Signs of physician-diagnosed disease, including cardiac, gastrointestinal, and nervous disease; number of unique ailments within each disease; and mortality. RESULTS: Military trauma was related to signs of disease and mortality. A greater percentage of company killed was associated with signs of postwar cardiac and gastrointestinal disease (incidence risk ratio [IRR], 1.34; P < .02), comorbid nervous and physical disease (IRR, 1.51; P < .005), and more unique ailments within each disease (IRR, 1.14; P < .005). Younger soldiers (<18 years), compared with older enlistees (>30 years), showed a higher mortality risk (hazard ratio, 1.52), signs of comorbid nervous and physical disease (IRR, 1.93), and more unique ailments within each disease (IRR, 1.32) (P < .005 for all), controlling for time lived and other covariates. CONCLUSIONS: Greater exposure to death of military comrades and younger exposure to war trauma were associated with increased signs of physician-diagnosed cardiac, gastrointestinal, and nervous disease and more unique disease ailments across the life of Civil War veterans. Physiological mechanisms by which trauma might result in disease are discussed.

Adolescent↗
PubMed1996

Social maladjustment indicators in PTSD patients' families of origin.

We compared the frequencies with which PTSD patients, psychiatric controls, and hospital employee controls reported that their fathers, mothers, and oldest siblings of each sex had been incarcerated or had received psychiatric/psychological treatment. We also compared estimates of the number of psychiatric hospitalizations, incarcerations, courses of outpatient treatment, treatment sessions, and days of institutionalization undergone by the relatives. Only a chance number of significant differences appeared, which suggests that general psychosocial maladjustment in one's family of origin does not appear to increase trauma survivors' risk for PTSD.

Adult↗
PubMed1996

Effects of Outward Bound Experience as an adjunct to inpatient PTSD treatment of war veterans.

There is a paucity of studies on Outward Bound Experiences (OBE) with adult psychiatric populations and, more notably, with trauma victims. This study evaluates the efficacy of OBE as an adjunct to specialized inpatient PTSD treatment with survivors of chronic combat-related PTSD (N = 219) at two Veterans Administration Medical Centers. On several measures of PTSD and general adaptation, results showed that the five-day OBE did not differ from standard treatment of PTSD survivors. Two other issues were addressed: identification of successful and non-successful subjects as a result of OBE, and exploration of objective versus subjective measures among this chronic group. Finally, as a post-study analysis, inferred curative components of the OBE were discussed as each appeared to impact on the participants.

Adult↗
PubMed1996

Effects of stressful stimuli: a comparison between two time periods.

Studies of the effects of stressful stimuli that occurred sometime in the past have generally found both intrusion and avoidance as consequences. The present investigation used Horowitz et al.'s (1979) Impact of Events Scale to compare the responses of victims who had been recently evacuated to a hotel after a missile attack on their home with a similar group one year later. Although during the attacks intrusion responses were found to be significantly higher than avoidance, the means on the two mental states did not differ significantly one year after. In addition, intrusion was found to be more highly correlated with several functioning measures; this latter trend becoming more pronounced at Time 2. Implications of the findings and limitations of the study were mentioned.

Adaptation, Psychological↗
PubMed1997

Minnesota Multiphasic Personality Inventory profiles of Vietnam combat veterans with posttraumatic stress disorder and their children.

Forty children of 28 fathers who are Vietnam veterans with posttraumatic stress disorder (PTSD) completed the Minnesota Multiphasic Personality Inventory. Each of the fathers had at least one elevated clinical scale. Fathers averaged eight elevated clinical scales, and compared to more recent norms, fathers averaged seven elevated clinical scales. Seventy-eight percent of the children had at least one clinically elevated scale (averaging three elevated clinical scales). Compared to contemporary normal adolescents and adults, 65% of children had at least one clinically elevated scale (still averaging three elevated clinical scales). No consistent MMPI profile patterns emerged within or across the two groups. No gender differences were detected among child MMPI profiles. Forty percent of the children reported illegal drug use, and 35% reported behavior problems. Fifteen percent of children reported previous violent behavior. Eighty-three percent of the children reported elevated Cook-Medley hostility scores as compared to an age-matched national normative sample. Children with higher PK scores were also significantly more likely to report higher Cook-Medley hostility scores. Forty-five percent of children reported significant elevations on the PTSD/PK subscales.

Adolescent↗
PubMed1999

W. H. R. Rivers and the war neuroses.

W. H. R. Rivers was the most famous member of the Cambridge Expedition to the Torres Strait. At the time, he was a physician and had an international reputation as a researcher in physiological psychology. The expedition signaled the beginning of his career in social anthropology, but also a long hiatus in his activities in medicine. His clinical interests revived during World War I. As an officer in the Royal Army Medical Corps (RAMC), Rivers became a leading proponent of "psychological medicine." Today, his war-time psychiatry is remembered mainly in association with his patient, Siegfried Sassoon. This article focuses on his wartime activities, his clinical practices, and his theories concerning the war neuroses and the unconscious. The currently popular view of Rivers as a quasi-Freudian humanist is challenged.

Combat Disorders↗