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PubMed1977

Some personality characteristics of soldiers exposed to extreme war stress: a follow-up study of post-hospital adjustment.

A group of 17 Israeli soldier psychiatric casualties of the Yom Kippur war were readministered the MMPI and intensively interviewed a year after they had been discharged from a psychiatric ward. A comparison between the hospitalization and post-hospitalization MMPI profiles yielded no significant difference on any of the scales. Thus, the degree of emotional distress experienced by these veterans continues to be extraordinarily high and is characterized by extreme depression, anxiety and extensive physical complaints. The interview reports are completely consistent with the MMPI data. These data emphasize the prolonged effect of combat stress and highlight the special problems that these men face in re-entering their social community.

Adult↗
PubMed1982

The Lebanese Fear Inventory: a normative report.

Recorded the incidence and type of war-related anxiety reactions that were observed over a 2-year period at a Lebanese outpatient counseling clinic and constructed a 15-item Likert-type inventory. The instrument was administered to 206 outpatients who were suffering from a wide range of somatic illnesses, and descriptive statics as well as estimates of internal consistency were calculated. A series of Hotelling T2 tests and an F test revealed that there were sex differences among 13 of the items as well as between the total scores. Cronbach alpha coefficients were calculated for each item by sex as well as for the overall male and female scores. The observed coefficients spoke well for the instrument's internal consistency. The data were discussed, and recommendations for further research and cross-cultural investigations were made.

Adolescent↗
PubMed1984

Decision-making, professional discipline, and program affiliation: selection of an inpatient treatment alternative.

Used a hypothetical case history to examine the clinical decision-making of a group of 75 mental health practitioners representing the disciplines of alcohol/drug counseling, nursing, psychiatry, psychology, and social work. The variables of professional discipline, program affiliation, work setting, and influential case history items were studied in relation to clinicians' selection of an inpatient treatment alternative. All clinicians, including para-professionals, performed similarly in that they followed an internally consistent process of reasoning in identifying influential case history items and using them in decision-making. Program affiliation and work setting had no biasing effect on decision-making, and only social workers showed a clear indication of a "set" related to their professional discipline. The implications of these findings for multi-disciplinary settings are discussed.

Adult↗
PubMed1989

PTSD 40 years later: incidence and person-situation correlates in former POWs.

A statewide sample of WWII ex-POWs (N = 442) responded to questionnaires that sampled current and past difficulties with PTSD-related symptoms; an incidence of serious difficulties with these symptoms of 56% was revealed. Retrospective reports of temporal patterns revealed no consistent patterns of symptom occurrence, but, rather, a waxing and waning of difficulties over the 40-year period. Unexpectedly, measures of severity of the POW experiences did not predict current symptomatology. Rank at time of capture, however, was consistently and strongly predictive of PTSD. It is suggested that PTSD is a highly persistent phenomenon and that both situation and person variables contribute to the development and maintenance of PTSD.

Combat Disorders↗
PubMed1989

MMPI F-K index among hospitalized Vietnam veterans.

The F-K index of the MMPI has been used as a marker of symptom overreporting. One population for which previous research has shown this pattern is Vietnam in-country veterans with PTSD. This study assessed the F-K index on 515 inpatients: 329 Vietnam in-country and 186 Vietnam-era patients. Normative data on psychiatric inpatients were presented. Also, a special MMPI subscale (MMPI-PTSD), a measure to identify PTSD among these veterans, was used. Results showed that all Vietnam veterans, especially in-country veterans, overreport symptoms to a high degree. The overall mean for in-country vets was 7.3. Also, when the special MMPI-PTSD subscale was used, a vast majority of in-country veterans who were in the PTSD range had high F-K index scores. Dissimulation as a symptom of PTSD was discussed.

Adult↗
PubMed1989

Clinical meaning of the Keane PTSD Scale.

A correlational study that included 82 male inpatient alcoholics was conducted to determine the clinical meaning of the Keane PTSD Scale of the MMPI. The PTSD Scale was correlated with the variables of the Shipley Institute of Living Scale, the Life Purpose Questionnaire, the Existential Depression Test, and the standard MMPI measures, plus the A, R, Es and MacAndrew Scales. The pattern of correlations suggested that the PTSD scale measures general psychological maladjustment and dysphoric feelings rather than any specifiable syndrome. The strong correlation with the Welch A, which measures a general level of maladjustment, suggests that the PTSD and Welch A scales are measuring the same factor. The PTSD scale, therefore, appears to provide very little information about this population beyond that available from the overall clinical profile and the Welch A scale.

Adult↗
PubMed1989

Carcinogenicity and teratogenicity vs. psychogenicity: psychological characteristics associated with self-reported Agent Orange exposure among Vietnam combat veterans who seek treatment for substance abuse.

This study asked, "What are the psychological characteristics of Vietnam combat veterans who claim Agent Orange exposure when compared with combat-experienced cohorts who do not report such contamination?" The question was researched among 153 heroin addicts, polydrug abusers, and chronic alcoholics who were seeking treatment: 58 reported moderate to high defoliant exposure while in combat; 95 reported minimal to no exposure while in Vietnam. The null hypothesis was accepted for measures of childhood and present family social climate, premilitary backgrounds, reasons for seeking treatment, patterns and types of illicit drug and alcohol use, interpersonal problems, intellectual functioning, and short-term memory. The null hypothesis was rejected for personality differences, however, those who self-reported high Agent Orange exposure scored significantly higher on MMPI scales F, Hypochondriasis, Depression, Paranoia, Psychasthenia, Schizophrenia, Mania, and Social interoversion. The results suggest that clinicians carefully assess attributional processing of those who report traumatic experience.

2,4,5-Trichlorophenoxyacetic Acid↗
PubMed1989

The military nurse experiment in Vietnam: stress and impact.

Demographic, health, and psychosocial data from two studies are presented on military nurses assigned to Vietnam. Army nurse subjects in the first study were grouped for comparison on three major variables: assignment to Vietnam before versus after the 1968 TET Offensive, type of nursing duties performed, and years of experience as a registered nurse (RN) prior to assignment in Vietnam. The second study compared another group of Army nurses with a group of Air Force and Navy nurses also assigned to Vietnam. Army nurses with less than two years RN experience prior to their assignment were found to be more at risk for such negative outcomes as difficulty establishing personal relationships and difficulty coping with stressful situations. Stress experiences, career dissatisfaction data, and health problems of military nurses and their children are reported. Also described are positive experiences of nurses in developing personal relationships in a rewarding professional environment.

Adaptation, Psychological↗
PubMed1991

Reliability and validity of a combat exposure index for Vietnam era veterans.

The reliability and validity of a self-report measure of combat exposure are examined in a cohort of male-male twin pairs who served in the military during the Vietnam era. Test-retest reliability for a five-level ordinal index of combat exposure is assessed by use of 192 duplicate sets of responses. The chance-corrected proportion in agreement (as measured by the kappa coefficient) is .84. As a measure of criterion-related validity, the combat index is correlated with the award of combat-related military medals ascertained from the military records. The probability of receiving a Purple Heart, Bronze Star, Commendation Medal and Combat Infantry Badge is associated strongly with the combat exposure index. These results show that this simple index is a reliable and valid measure of combat exposure.

Adult↗
PubMed1992

The Persian Gulf War: civilian war-related stress and the influence of age, religious faith, and war attitudes.

This study examined the stress response of 86 civilian subjects at the onset of the Persian Gulf War. The Impact of Events Scale (IES) and the Symptom Checklist-90-Revised (SCL-90-R) were used to measure participants' subjective stress response and symptoms of psychological distress. Subjects also completed a demographic questionnaire that included questions that ranged from religious affiliation to approval of the war effort. The study describes war-related stress and the influence of age, religious faith, and attitudes about war on reported levels of stress. Results indicate measurable levels of war-related stress in this civilian population.

Adolescent↗
PubMed1993

NEO-PI profiles in PTSD as a function of trauma level.

One hundred Vietnam veterans with combat-related PTSD were administered the NEO Personality Inventory (NEO-PI) and the Combat Exposure Scale and were sorted into three groups based on trauma exposure level. Results indicate no significant differences among the personality profiles of the three trauma-exposed groups. A normative NEO-PI profile for persons diagnosed with combat-related PTSD is presented, characterized by an extremely high Neuroticism score (T > 75) and an extremely low Agreeableness score (T < 25).

Adult↗
PubMed2000

Therapy with the elderly: introducing psychodynamic psychotherapy to the multi-disciplinary team.

Psychotherapy with the elderly has tended to be restricted to family or behavioural paradigms with some contribution from cognitive approaches, but at least until recently, very little input from psychodynamic therapy. The reasons for this are discussed and include both patient and therapist factors. Freud himself was pessimistic regarding the prospects of working with the elderly, a viewpoint he changed as he aged. As the discipline of old age psychiatry also matures there may be increasing scope for collaboration between the mental health of the elderly teams and psychodynamically orientated therapists. We describe here one model of such collaboration, a weekly case discussion seminar, conducted in an acute admission old age psychiatry in-patient unit. The role of the seminar in discussing difficult cases will be described and a case will be discussed to illustrate the work. Finally, recommendations for broadening the scope of the work are advanced.

Aged↗
PubMed1985

Lessons learned and forgotten: the need for prevention and mental health interventions in disaster preparedness.

Human beings have been subjected to the effects of both natural and man-made disasters for centuries. How humans have coped with catastrophes has been recorded through history. This review proceeds from an examination of the efforts in legislation and disaster research through a brief history of war-time experiences and treatment of combat stress reactions. As warfare changed, so did the ability of soldiers to cope. Likewise, treatment interventions to restore soldiers to effectiveness evolved with the changes in warfare. The treatment principles developed in war and the concepts recognized from the stress literature can be integrated to understand how the treatment interventions work. Examples of the delivery of mental health services are reviewed. The lesson learned during war were often forgotten after the war. It was not until the 1970s that the need for prevention and planning for mental health interventions during and after disasters was legislated. Research efforts are now focusing on planning, implementing interventions, and following survivors/victims for posttraumatic effects.

Combat Disorders↗
PubMed1991

Psychiatry, psychoanalysis, and politics during the First World War.

This article compares the therapeutic power used by psychiatrists and psychoanalysts serving in the German and Austro-Hungarian armies during World War I, and the ways in which their therapeutic techniques were related to governmental and military authority. When treating "shell shocked" soldiers, army psychiatrists were guided by nationalist commitment rather than concern for their patients. Whatever theoretical approach they took, they defined their therapeutic task as administrative intervention aimed to increase the docility of soldiers to the state and its military purposes. But violent means of coercion, designed to force neurotic soldiers back into duty, remained inefficient. Drawing from an alternative body of knowledge, army physicians influenced by Freud's writings, or trained in psychoanalysis, applied cathartic methods to treat the Central Powers' soldiers. Their approach was not only more humane, but also proved to be therapeutically more efficient.

Combat Disorders↗
PubMed1993

Do genes influence exposure to trauma? A twin study of combat.

Data from 4,029 male-male twin pairs who served in the United States military during the Vietnam era (1965-1975) were used to examine genetic and non-genetic factors that influence wartime exposure to traumatic events. Specific events examined were volunteering for service in Vietnam, actual service in Southeast Asia, a composite index of 18 combat experiences, and information from military records about being awarded combat decorations. Correlations within monozygotic (MZ) and dizygotic (DZ) twin pairs for volunteering for service in Vietnam were 0.40 and 0.22, respectively. For actually serving in Southeast Asia, the MZ correlation was 0.41 and the DZ correlation was 0.24. Analysis of twin pairs in which both siblings served in Southeast Asia (n = 820) demonstrated a correlation for self-reported combat experiences within MZ and DZ pairs of 0.53 and 0.30, respectively. Heritability estimates ranged from 35 to 47%. The family environment did not have a significant effect on any of the variables. Analyses of data from military records regarding being awarded a combat decoration provided very similar results to those found for self-reported combat experiences.

Adult↗
PubMed2006

Clinician to frontline soldier: a look at the roles and challenges of army clinical psychologists in Iraq.

Psychologists have a long and respected history of service during wartime that dates back to World War I. From the early days of scientific personnel selection, clinical psychologists have made a number of wartime contributions. Today, Army clinical psychologists serving in Iraq are providing behavioral health services as both clinicians and prevention specialists in order to meet the psychological and emotional needs of service members abroad. They are also performing as Army officers and soldiers contributing to the success of military operations as a whole. The authors, two clinical psychologists and Army officers currently deployed to Iraq, provide a small glimpse into the clinical and personal opportunities and challenges faced by wartime Army clinical psychologists.

Autobiographies as Topic↗