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PubMed1995

The civilian version of the Mississippi PTSD Scale: a psychometric evaluation.

This three-part study examined the reliability and validity of the civilian version of the Mississippi Scale for Combat-Related PTSD using data from the nonveteran participants in the National Vietnam Veterans Readjustment Study. The Civilian Mississippi Scale had a raw score distribution that was roughly symmetric, with an acceptable degree of dispersion and a reasonably high internal consistency reliability coefficient. Overall, however, measurement precision was weaker than that for the military version of the instrument, and confirmatory factor analytic findings differed from those found for the military version. Preliminary investigations of validity were in the form of correlations with indices of stressful life events, a PTSD symptom count, and measures of demoralization and active expression of hostility. The Civilian Mississippi Scale emerged from the various analyses as a PTSD measure with potential but requiring further validational study and perhaps some refinement.

Adaptation, Psychological↗
PubMed1995

Warzone violence in Vietnam: an examination of premilitary, military, and postmilitary factors in PTSD in-patients.

The impact of childhood victimization and other premilitary factors on warzone abusive violence was examined with 177 Vietnam combat veteran inpatients. Premilitary and military variables were also examined in relationship to postmilitary variables, including violence and PTSD. Statistical analyses showed that none of the premilitary variables predicted warzone violence. High combat exposure did, however, predict warzone abusive violence and PTSD. In addition, participation in warzone violence predicted postmilitary violence to self, spouse, and others. Although high rates of childhood victimization and high levels of combat exposure were found, neither predicted postmilitary violence, criminal activities, drug/alcohol problems, or suicide attempts. Low childhood adjustment ratings and school suspensions predicted adult alcohol abuse and drug abuse, respectively. These findings and their implication for treatment are discussed.

Adult↗
PubMed1995

Diagnosis and treatment of combat stress reaction: current attitudes of military physicians.

This study examined the attitudes of 203 Israel Defense Forces (IDF) military physicians regarding the causes and treatment of combat stress reaction. The findings indicate that subjects tended primarily to endorse situational rather than predispositional explanations for the causation of the CSR. They attributed the highest levels of responsibility for treatment to the frontline physician and to commanders, and the least amount of responsibility to the casualty himself. These findings suggest that military physicians do not hold CSR casualties responsible for the causation or the treatment of the stress reaction. CSR is now viewed within the "medical model." It is considered by doctors to be within the purview of medicine and CSR casualties are considered legitimate objects of medical concern. The stigma attached to the phenomenon in the past thus appears to have diminished considerably.

Adult↗
PubMed1995

Mental health officers' causal explanations of combat stress reaction.

This study examined causal attributions for combat stress reaction (CSR) among 117 Israel Defense Forces (IDF) mental health officers. The impact of case characteristics (the level of objective stress in the situation, reaction of others in the same situation, soldier's previous functioning, and type of symptomatology) and respondent characteristics (professional affiliation, therapeutic orientation) on these attributions was also examined. Results show that mental health officers view CSR primarily as a response to external circumstances; it is not generally seen as resulting from personality traits or intrapsychic processes. Findings also indicate that causal attributions were influenced at least to some degree by the clinicians' professional affiliation, their therapeutic orientation, and their knowledge of the casualty's prior functioning.

Adult↗
PubMed1995

Oscillating between denial and recognition of PTSD: why are lessons learned and forgotten?

Consistent observations suggest that denial of PTSD and blaming of its victims are not isolated omissions or distortions but a pattern that spans over time, crosses national and cultural boundaries, and defies accumulated knowledge. This article traces the origins of these attitudes and offers three explanations: (a) mental health professionals are unable to transcend prevailing cultural and social norms; (b) they are "blinded" by professional theories; and (c) denial may stem from a fundamental human difficulty in comprehending and acknowledging our own vulnerability.

Anxiety↗
PubMed1994

Relationship of cynical hostility and PTSD among Vietnam veterans.

The personality construct of cynical hostility, as measured by the Cook-Medley scale (an MMPI subscale), has been implicated as a risk factor for cardiovascular disease. A literature review suggests that Vietnam veterans exhibit many cynical hostility-like characteristics. We examined the association between Cook-Medley scores and PTSD among Vietnam and other-era veterans. Study 1 involved analyses of data from 1293 MMPIs administered at Department of Veterans Affairs in Honolulu between 1986-1991. Cook-Medley scores were highly correlated with MMPI PTSD scores, and Vietnam Era veterans obtained higher scores than veterans from other eras. In Study 2, twenty nine Vietnam veterans with PTSD disability ratings obtained very high Cook-Medley scores which were higher than Vietnam Era veterans without rated PTSD. Findings indicate that the cynical hostility literature has considerable relevance for study of PTSD and suggest that PTSD veterans may have heightened risk for developing cardiovascular disease. Several directions for future research are suggested.

Adult↗
PubMed1994

Childhood abuse experiences and combat-related PTSD.

Current literature on the etiology of combat-related PTSD strongly implicates combat trauma exposure as a primary etiological factor. However, studies of premilitary variables have produced conflicting results, perhaps in part due to methodological inconsistencies and failure to employ standardized measures. The present study examines one premilitary variable, childhood physical abuse history. Using a standardized measure developed by child abuse researchers, forty-five percent of veterans with PTSD were identified as recipients of abusive physical punishment during childhood. A positive correlation between physical abuse history and severity of combat-related PTSD was found. These preliminary findings set the stage for further investigation of the child abuse variable and underscore the need for treatment of veterans with combat-related PTSD which addresses developmental traumagenic events.

Adult↗
PubMed1994

Dissociative states induced by relaxation training in a PTSD combat veteran: failure to identify trigger mechanisms.

PTSD is often treated with anxiety management techniques, including relaxation training. A case report is presented which describes a PTSD combat veteran who experienced dissociative states induced by relaxation training. Hypnotherapy subsequently identified traumatic memories which were recalled during relaxation training but triggering mechanisms for the recall of these traumatic memories were not identified.

Adaptation, Psychological↗
PubMed2004

No adverse effect of ABVD chemotherapy in a patient with chronic hepatitis C and Hodgkin's disease.

There is insufficient information on the effects of chemotherapy protocols for Hodgkin's disease (HD) and the course of coexisting hepatitis C virus (HCV) infection. A single literature case reported a patient with HD who developed fulminant hepatitis and hepatic coma after receiving chemotherapy. The case described here is of a female patient previously exposed to prolonged war stress, complicated by intravenous drug abuse and chronic hepatitis C. One year after diagnosis of HCV infection she was diagnosed with HD (nodular sclerosis type II, clinical stage IIIB). The patient received six cycles of ABVD chemotherapy (doxorubicin, bleomycin, vinblastine and dacarbazine) resulting in complete remission of HD. There was no hepatitis flare either during or after chemotherapy. In conclusion, there were no adverse effects of the ABVD regimen on the course of HCV infection in this patient who was successfully treated for HD. Because concurrent HCV infection and HD is extremely rare, we discuss here the possibility of the synergistic contribution of chronic war stress and hepatitis C infection in the pathogenesis of HD.

Adult↗
PubMed2005

Treatment of the stress casualty during operation Iraqi freedom one.

INTRODUCTION: Service members with mental health issues during Operation Iraqi Freedom receive evaluation and treatment at different echelons of care. Mental health teams consist of professionals and paraprofessionals assigned to Combat Stress Control units, Division Mental Health Sections, and Combat Support Hospitals. METHODS: Army doctrine for mental health care is delineated and examples describing how mental health personnel must be flexible in this challenging environment and are useful mental health tools for commanders in the operational environment are presented. DISCUSSION: Specific treatment issues related to the combat environment during Operation Iraqi Freedom are discussed in relation to each team and in light of doctrine.

Combat Disorders↗
PubMed2004

The bane of "inhumane" weapons and overkill: an overview of increasingly lethal arms and the inadequacy of regulatory controls.

Weapons of both defense and offense have grown steadily in their effectiveness--especially since the industrial revolution. The mass destruction of humanity, by parts or in whole, became reality with the advent of toxic agents founded on chemistry and biology or nuclear weapons derived from physics. The military's new non-combat roles, combined with a quest for non-lethal weapons, may change the picture in regard to conventional defense establishments but are unlikely to deter bellicose tyrants or the new terrorists from using the unlimited potential of today's and tomorrow's arsenals. The author addresses the issues that are raised by this developing situation with the intent of seeking those ethics that will enable us to survive in a future and uncertain world.

Bioterrorism↗
PubMed1982

Implosive therapy in the treatment of combat related fears in a world war II veteran.

A 55-year old veteran with combat related fears of 36 years' duration was successfully treated in three sessions of implosive therapy, each lasting approximately 1 hr. This improvement followed 15 hospitalizations over the preceding 30 month period, and previous unsuccessful treatment efforts including prescription of antabuse, an inpatient alcohol treatment program, and an agoraphobia treatment program conducted on an outpatient basis. Treatment gains were maintained over a 2 year follow-up period.

Behavior Therapy↗