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Results for “Stress Disorders, Traumatic”

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PubMed1995

Myocardial infarction and post-traumatic stress disorder.

Studies concerning the development of a post-traumatic stress disorder related to severe illness are scarce. The confrontation with myocardial infarction may be a very stressful event. Twenty-three patients consecutively admitted for first myocardial infarction were studied. After two years 1 of 18 survivors had been suffering from a partial post-traumatic stress disorder. Similarities and differences in the psychological reactions following potential traumatic events are discussed.

Adult↗

PubMed1996

Classification of veterans with post-traumatic stress disorder using visual brain evoked P3s to traumatic stimuli.

BACKGROUND: Post-traumatic stress disorder (PTSD) typically involves a re-experiencing of traumatic events. In a previous P3 study it was found that PTSD patients react both selectively and involuntarily to combat-related pictures, exhibiting augmented P3 event-related potentials and thus providing a brain activity measure. The clinical application of these findings in differentiating PTSD patients from controls was tested. METHOD: Twenty Israeli combat veterans suffering from PTSD and 20 age-matched veterans without PTSD were evaluated. P3 potentials were recorded at Pz and Cz in response to visual motor-task target stimuli (pictures of domestic animals), non-target probe stimuli (combat-related pictures), and non-target irrelevant stimuli (pictures of furnishings and flowers). RESULTS: Using the Fisher Linear Discrimination Method the P3 measures correctly classified 90% of the PTSD patients and 85% of the controls. CONCLUSIONS: Visual P3s recorded in response to combat-related pictorial stimuli may introduce an efficient tool for studying higher brain activity in PTSD, complementing other behavioural and psychophysiological measurements.

Adult↗

PubMedDate not supplied

Parental murder and suicide: post-traumatic stress disorder in children.

TOPIC: Post-traumatic stress disorder (PTSD) diagnosed in a 9-year-old who witnessed her parents' murder and suicide. PURPOSE: To provide a historical overview of PTSD in children in general and to discuss one case study in particular. SOURCES: Personal observations and experiences, and a review of both classic and contemporary literature in child psychiatry and developmental psychology. CONCLUSIONS: Supportive psychotherapy for a traumatized child with clinical supervision for the care-giver showed evidence of the recovery process in one PTSD case study.

Adult↗

PubMed1999

Alterations in brain structure and function associated with post-traumatic stress disorder.

Neuroimaging studies in post-traumatic stress disorder (PTSD) have revealed changes in brain structure and function that may underlie the symptoms of PTSD. Two brain areas that have been consistently implicated in PTSD include the hippocampus and prefrontal cortex. Several studies showed that PTSD is associated with reduction in volume of the hippocampus, a brain area involved in learning and memory, as measured with magnetic resonance imaging (MRI). Positron emission tomography (PET) studies showed dysfunction of medial and orbital prefrontal cortex during PTSD symptom provocation and in response to traumatic reminders. Decreased benzodiazepine receptor binding was found in the medial prefrontal cortex as measured with neuroimaging in PTSD. The hippocampus and medial prefrontal cortex play important roles in memory and emotional regulation, and dysfunction in these areas may underlie memory deficits and pathological emotions in PTSD.

Brain↗

PubMed2002

Longitudinal course of salivary cortisol in post-traumatic stress disorder.

OBJECTIVE: In chronic post-traumatic stress disorder (PTSD) lowered cortisol secretion and hypersuppression to dexamethasone has been described repeatedly. However, so far no longitudinal data on the natural course or on the effect of therapy are available. METHOD: We measured basal and post-dexamethasone morning salivary cortisol in a drug-free patient with chronic PTSD (DSM-IV) monthly for nearly 2 years and assessed PTSD and depressive symptoms. RESULTS: Salivary cortisol decreased dramatically 3 months after the traumatic event and in the further course showed an inverse relation to fluctuating but gradually improving PTSD symptoms. Post-dexa-methasone cortisol was suppressed below the detection limit early after trauma and rose again more than 1 year post-trauma. CONCLUSION: Both the potential renormalization of low cortisol levels in improving chronic PTSD and the putative vulnerability to develop PTSD in subjects with increased dexamethasone suppression need further research.

Adult↗

PubMed2004

The role of endogenous opioids in the placebo effect in post-traumatic stress disorder.

The concept of the placebo effect has received a considerable attention over the past several decades. The placebo effect has been observed in different psychiatric disorders, including post-traumatic stress disorder (PTSD), a chronic and severe disorder precipitated by exposure to a psychologically distressing event. The placebo response rates in patients with PTSD range from 19% to 62%. A considerable number of research publications suggest that endogenous opioids are involved in the mechanisms of the placebo effect. Endogenous opioid peptides play an important role in stress response and in the pathophysiology of PTSD. Therefore, endogenous opioids may be involved in the neurobiology of the placebo effect in PTSD. Possibly, the endogenous opioid system mediates the effect of placebo on all 3 PTSD symptom clusters (re-experiencing symptoms, avoidance and numbing, and physiologic arousal). The placebo effect-related activation of the endogenous opioid system may result in an improvement in intrusive symptomatology and symptoms of increased arousal because the administration of exogenous opioids improve these symptoms. The placebo effect-related activation of the endogenous opioid system may have a mood-enhancing effect, and, consequently, diminish avoidance and numbing. Multiple neurotransmitter and neuroendocrine pathways may be involved in the mechanisms of the placebo effect in PTSD. Further studies of the neurobiology of the placebo effect on patients with PTSD and other psychiatric disorders may produce interesting and important results.

Dynorphins↗

PubMed2002

Post-traumatic stress disorder in burned patients.

UNLABELLED: The essential feature of post-traumatic stress disorder is the development of characteristic symptoms following exposure to a traumatic stressor involving direct personal experience of an event that involves threat of death oactual r serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (DSM IV). The aim of this work is to assess the prevalence of post-traumatic stress disorder (PTSD) among the burned victims and its predicting factors. METHODS: Patients were recruited at the Burns Department in the Ibn Rushd University Hospital during the period between 1 October 1998 and 1 October 1999. All patients were psychiatrically interviewed and answered a questionnaire. The diagnosis of PTSD was done according to DSM IV criteria. Results were analyzed on Epi info software. RESULTS: Sixty patients gave their consent to participate in this study. The 23.3% met criteria for PTSD and 55% for major depressive disorder. In short, PTSD was related to age, explosion of gas containers for cooking purposes, depression and low social functioning. Otherwise, no relationship was found between PTSD and gender, length of hospitalization or severity of burn. CONCLUSION: Post-traumatic stress disorder remains a poorly known entity by clinicians and under-diagnosed in burned patients. Considering the frequency of this pathology, an anti-depressant treatment and a psychotherapeutic relationship are necessary to improve the health and the quality of life of these patients.

Adolescent↗

PubMed2001

Evaluation of post-traumatic stress disorders.

This paper introduces important considerations in the evaluation of psychological reactions to traumatic events. Proper assessment should include consideration of psychometric, cultural, and ethical issues. Mental disorders frequently observed in the aftermath of trauma (acute stress disorder and post-traumatic stress disorder) and stress (adjustment disorders) are defined, and the reader is provided with information on both general and specific resources for their evaluation.

Humans↗

PubMed1994

Sleep disorders in the elderly: depression and post-traumatic stress disorder.

We report on two studies of sleep in the elderly. (1) One hundred and ninety-eight Spanish outpatients aged over 65 who met ICD-10 criteria for either a depressive episode, a recurrent, or a persistent mood disorder were compared with a matched population of depressives aged under 55. Factorial analysis and multiple regression showed that sleep complaints in the older group correlated less with severity of depression and had a less stable response to pharmacological treatment. (2) Post-traumatic stress disorder (PTSD) symptoms and sleep complaints were studied in 817 World War II veterans from Alsace-Lorraine who had been forcibly drafted into the Wehrmacht and subsequently detained as prisoners of war in Russia. The diagnosis of PTSD was associated with more severe wartime stressors and long internment. Eighty percent of respondants still report recurrent distressing dreams of wartime or captivity events after over 45 years. We analyzed sleep complaints in two elderly populations. Part one describes a Spanish study which compared the nosological significance and treatment response of sleep complaints in depressives aged over 65 or under 55. In part two, we study sleep complaints in former Alsatian prisoners of war (POWs) and analyze the influence of previous stressors and the aging process.

Adult↗

PubMed1987

Post-traumatic stress disorder in the general population. Findings of the epidemiologic catchment area survey.

There have been numerous studies of post-traumatic stress disorder in trauma victims, war veterans, and residents of communities exposed to disaster. Epidemiologic studies of this syndrome in the general population are rare but add an important perspective to our understanding of it. We report findings on the epidemiology of post-traumatic stress disorder in 2493 participants examined as part of a nationwide general-population survey of psychiatric disorders. The prevalence of a history of post-traumatic stress disorder was 1 percent in the total population, about 3.5 percent in civilians exposed to physical attack and in Vietnam veterans who were not wounded, and 20 percent in veterans wounded in Vietnam. Post-traumatic stress disorder was associated with a variety of other adult psychiatric disorders. Behavioral problems before the age of 15 predicted adult exposure to physical attack and (among Vietnam veterans) to combat, as well as the development of post-traumatic stress disorder among those so exposed. Although some symptoms of post-traumatic stress disorder, such as hyperalertness and sleep disturbances, occurred commonly in the general population, the full syndrome as defined by the Diagnostic and Statistical Manual of Mental Disorders, third edition, was common only among veterans wounded in Vietnam.

Catchment Area, Health↗

PubMed2001

Risk and preventive factors of post-traumatic stress disorder (PTSD): alcohol consumption and intoxication prior to a traumatic event diminishes the relative risk to develop PTSD in response to that trauma.

BACKGROUND: Previous reports examined the effects of selected pre- (e.g. female gender, previous trauma), peri- (e.g. the horror of the trauma, threatened death) or post-exposure (e.g. the physical injury caused by the trauma) risk factors on the development of post-traumatic stress disorder (PTSD), an anxiety disorder associated with a traumatic event outside the range of usual human experience. We hypothesized that alcohol consumption prior to traumatic events may reduce the incidence rate of PTSD. The aim of this study was to examine the effects of the above risk factors and preventive factors, such as alcohol consumption, on the development of PTSD. METHODS: An epidemiological cohort study was carried out on 127 victims trapped in a ballroom fire. Data were collected, 7-9 months after the traumatic event, by means of the Composite International Diagnostic Interview (CIDI) and structured interviews, aimed to assess the above pre-, peri- and post-exposure factors. Logistic regression analysis was used to examine the association of PTSD with the etiologic factors and to delineate those risk factors which contribute most to the development of PTSD. RESULTS: Female gender, the number of previous trauma, a past history of simple phobia, threatened death, trauma exposure, hospitalization for trauma-induced injuries and the presence of burns increased the odds of PTSD, whereas a sense of control during the trauma, and alcohol consumption and intoxication decreased the odds of PTSD. Six factors made independent contributions to the prediction of PTSD, i.e. the number of previous trauma, a past history of simple phobia, loss of control (increase the odds), a sense of control, alcohol consumption and alcohol intoxication (decrease the odds). CONCLUSIONS: The results of this study show that the development of PTSD is determined by the effects of pre-, peri- and post-exposure risk factors and may be prevented by the effects of peri-traumatic factors, such as sense of control, alcohol consumption and intoxication.

Adult↗

PubMed1994

The ability of naive subjects to report symptoms of mild brain injury, post-traumatic stress disorder, major depression, and generalized anxiety disorder.

Diagnoses of major depression, post-traumatic stress disorder, generalized anxiety disorder, and mild brain injury are based in substantial part on the self-reported symptoms of patients. This study found that 96.9% of untrained subjects were able to endorse symptoms on checklists to meet the DSM-III-R self-report criteria for major depression, 96.9% for generalized anxiety disorder, and 86% for PTSD. For the non-DSM-III-R diagnosis of mild brain injury, 63.3% of subjects were able to correctly identify 5 or more of 10 symptoms associated with this condition. Forensic examiners are advised to exercise special care in utilizing evaluation procedures that are of a leading nature, such as symptom checklists in which examinees may exhibit response biases.

Adolescent↗

PubMed1991

Cyproheptadine for combat nightmares in post-traumatic stress disorder and dream anxiety disorder.

Pharmacologic treatment of patients with post-traumatic stress disorder often involves antidepressant drugs. Combat nightmares often persist. The addition of cyproheptadine, in a median dose of 16-24 mg orally at night, controls the nightmares.

Adult↗

PubMed2004

[Post traumatic stress disorder among assault victims].

BACKGROUND: Urban violence is increasing in Metropolitan Santiago and assault victims may suffer from post traumatic stress disorders. AIM: To study the clinical and evolutive profile of post traumatic stress disorders among assault victims. MATERIAL AND METHODS: Retrospective review of medical records of assault victims with post traumatic stress disorder, that were attended at the Hospital del Trabajador between 1987 and 2000. The features of these patients were compared with other patients with post traumatic stress disorders not caused by assaults. RESULTS: The records of 140 subjects (88 female) aged 34.9+/-10.9 years old, were reviewed. Seventy one percent of subjects worked as clerks and 59% were attended during the first month after the assault. Treatment with psychotherapy and psychotropic drugs lasted a median of 60 days and 62% was discharged before completing three months of treatment. These subjects used more antidepressants and had more physical lesions than subjects with a post traumatic stress disorder not caused by assaults. CONCLUSIONS: Timely diagnosis and treatment of post traumatic stress disorders caused by assaults, results in a favorable outcome in two thirds of patients.

Adult↗

PubMed2004

Event-related potentials and EMDR treatment of post-traumatic stress disorder.

Ten patients suffering from post-traumatic stress disorder (PTSD) following a severe traumatic event, were assessed with event-related brain potentials (ERPs) in a modified oddball paradigm containing auditory standard, target, and novel tones. ERPs were assessed before and after a treatment session using the eye movement desensitization and reprocessing method. Compared to a control group that underwent sham treatment, ERPs of the patients showed a reduction of the P3a component in the post-treatment recording, suggesting a reduced orienting to novel stimuli and reduced arousal level after the treatment. Moreover, psychometric assessment revealed a marked improvement of the PTSD symptoms after treatment.

Adult↗

PubMed1993

Automatism and post-traumatic stress disorder.

A soldier with post-traumatic stress disorder (PTSD) who committed a criminal act during a dissociative episode is described. This report and other published cases indicate that criminal acts can occur during dissociative episodes among people who suffer from PTSD. However, the evidence suggests that such incidents are rare and may be overemphasised. There often seems to be little relationship between the crimes committed by war veterans and their war experiences.

Adult↗

PubMed1997

Post-traumatic stress disorder after childbirth: the phenomenon of traumatic birth.

CHILDBIRTH CAN BE A VERY PAINFUL EXPERIENCE, often associated with feelings of being out of control. It should not, therefore, be surprising that childbirth may be traumatic for some women. Most women recover quickly post partum; others appear to have a more difficult time. The author asserts that post-traumatic stress disorder (PTSD) may occur after childbirth. He calls this variant of PTSD a "traumatic birth experience." There is very little literature on this topic. The evidence available is from case series, qualitative research and studies of women seeking elective cesarean section for psychologic reasons. Elective cesarean section exemplifies the avoidance behaviour typical of PTSD. There are many ways that health care professionals, including physicians, obstetric nurses, midwives, psychologists, psychiatrists and social workers, can address this phenomenon. These include taking a careful history to determine whether a woman has experienced trauma that could place her at risk for a traumatic birth experience; providing excellent pain control during childbirth and careful postpartum care that includes understanding the woman's birth experience; and ruling out postpartum depression. Much more research is needed in this area.

Cesarean Section↗

PubMed2005

[post-traumatic stress disorder in the elderly].

Diagnosis of post traumatic stress disorder (PTSD) requires a past history of psychic traumatism and characteristic psychotraumatic symptoms like re-experiencing of the traumatic event, avoidance of stimuli associated with the traumatic event and increased arousal. In the elderly, PTSD prevalence rate is about 0.9% after 60 years of age. Clinical features are almost identical to those observed in younger patients. However there are various types of PTSD: PTSD de novo, occurring after exposure to extreme trauma in old age; chronic PTSD when symptoms persist since the time of the trauma; delayed-onset PTSD when patients exhibit signs of the disorder decades after the trauma; complex PTSD, generated by exposure to repeated traumatisms in early development, who could be linked up to changes in personality in older exposed to repeated traumatisms. Pharmacological and psychotherapic interventions used in younger populations can be applied for treatment to older adults, when taking into account the pharmacodynamic and psychic changes associated with aging.

Aged↗