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Biomedical subjects

A Bleich

Publications and source records attributed to A Bleich.

At least 55 records · Page 3Linked to original sources
PubMed1994

[Psycho-neuro-physiological assessment of post-traumatic stress disorder using event-related potentials].

To evaluate certain aspects of cognitive processing in posttraumatic stress disorder (PTSD), brain event-related potentials, primarily P300, to traumatic stimuli were recorded. 20 Israeli veterans with PTSD of combat origin and matched controls were studied. In a modification of the oddball paradigm, subjects were asked to react to target pictures of traumatic combat-related subjects while ignoring non-target pictures of irrelevant subjects. PTSD patients reacted with an accentuated P300 and prolonged reaction times to the traumatic pictures. In addition, P300 and reaction times to the target pictures were prolonged in PTSD patients as compared to controls. Event-related potentials (P300) to traumatic stimuli can serve as an objective and accurate brain parameter for characterization and diagnosis of PTSD. In addition, it contributes to understanding the pathogenesis of PTSD as a specific impairment in information processing.

Brain↗
PubMed1994

[Psychiatric morbidity following psychic trauma of combat origin].

Psychiatric morbidity following trauma of combat origin was studied in 60 Israeli veterans who applied for treatment 4-6 years after the war in Lebanon. Diagnostic tools were structured interviews for psychiatric disorders. In all subjects multiple psychiatric disorders had been diagnosed, most of which developed following the traumatic experience. Post-traumatic stress disorder (PTSD) was the most prevalent condition (100%-ever; 87%-present). Comorbidity included major depression with a very high prevalence (95%-ever; 50%-present) and anxiety disorders: phobic disorder, obsessive-compulsive disorder, panic attacks and generalized anxiety (prevalence range 12-25%-ever and 8-18%-present). The prevalence of minor affective disorders (specifically alcoholism or drug abuse) was considerably less. These findings suggest a possible link between PTSD and depressive and anxiety disorders, beyond a mere sharing of common symptoms. They also support the diagnostic validity of PTSD as an independent nosologic category. In addition, the lack of specific pharmacotherapy for PTSD on the one hand and the high prevalence of depressive and anxiety comorbidity on the other, support a special focus on antidepressive and anxiolytic medication for PTSD.

Anxiety Disorders↗
PubMed1994

Compensation and psychic trauma: a study of Israeli combat veterans.

The precursors and outcomes of compensation-seeking in Israeli war psychiatric casualties were examined. Findings suggest that compensation was sought by veterans who had experienced the most severe traumas and had subsequently developed the most severe symptoms and functional limitations. Reported range and severity of symptoms and functional limitations did not diminish with compensation.

Adaptation, Psychological↗
PubMed1994

Reactions to Stress During the Persian Gulf War: The Use of Structural Equations for Testing the Horowitz Model

In one of the few models specific to victims' reactions to traumatic events, it has been proposed that consequences typically include alternating patterns of intrusive and avoidance symptoms. The present exploratory investigation examined the responses of 120 victims who had been evacuated to a hotel after a SCUD missile attack on their home. Analyses using structural equation modeling showed that both psychological states follow stressful stimuli and perceived threat. In addition, results were found to be consistent with a model that posits intrusion as antecedent to anxiety which, in turn, was found to precede a latent outcome measure consisting of psychological, physical, and work functioning.

Journal Article↗
PubMed1993

[Secondary traumatization among wives of soldiers with combat stress reaction].

While the long-term effects of war-related psychic trauma on veterans have been studied extensively, the impact of the results of the trauma on wives has received only minimal attention. The implications of combat-induced stress reaction and post-traumatic stress disorder were examined in a sample of 212 wives of Israeli veterans of the 1982 Lebanon War. Both types of reaction in husbands were found to be associated with increased psychiatric and somatic symptoms in their wives.

Combat Disorders↗
PubMed1993

Death without warning? A clinical postmortem study of suicide in 43 Israeli adolescent males.

Forty-three consecutive Israeli male suicides, 18 to 21 years of age, that occurred during compulsory military service were studied using preinduction assessment data, service records, and extensive postmortem interviews with family and peers. At preinduction, subjects, as a group, appeared above average in intelligence, physical fitness, and measures predictive of successful adaptation to military service. Active duty performance was generally satisfactory. Ascertained post mortem, 53.5% met formal criteria for major depressive disorder; most cases, however, appeared recent and reactive. Narcissistic and/or schizoid traits were common. Substance abuse was absent and antisocial personality disorder was rare (4.7%). Furthermore, in eight patients (18.6%) no Axis I diagnosis could be made; half of these also lacked any significant Axis II pathology. These findings, at partial variance with US studies, suggest a complex relationship between suicide and mental disorder. The striking failure of intensive screening and preventive measures to prevent these suicides highlights unresolved questions of etiology and intervention.

Adaptation, Psychological↗
PubMed1993

An epidemiologic study of Gilles de la Tourette's syndrome in Israel.

OBJECTIVES: The goal of this study was to estimate the lifetime prevalence of Gilles de la Tourette's syndrome (GTS) in adolescents aged 16 to 17 years. DESIGN: Population-based epidemiologic study. SUBJECTS: Eighteen thousand three hundred sixty-four males and 9673 females aged 16 to 17 years screened for induction into the Israel Defense Force. RESULTS: Of the 28,037 individuals screened, 12 met diagnostic criteria for GTS. The point prevalence in this population was 4.3 +/- 1.2 (mean +/- SE) per 10,000. The 95% confidence interval for this estimate is 1.9 to 6.7 per 10,000. The point prevalence was 4.9 +/- 1.6 per 10,000 for males (95% confidence interval, 1.8 per 10,000) and 3.1 +/- 1.8 per 10,000 for females (95% confidence interval, 0 to 6.6 per 10,000). The rate of obsessive-compulsive disorder (OCD) was significantly elevated among the subjects with GTS (41.7%) compared with the population point prevalence of OCD (3.4) in those without GTS. In contrast, the rate of attention deficit hyperactivity disorder was only 8.3% compared with the population point prevalence of 3.9% in those individuals without GTS. CONCLUSIONS: The prevalence estimates from this population-based study are in agreement with previous results based on surveys of younger children. The sex ratio observed in this study is not as large as reported in previous studies and remains to be explored in other studies of adolescents and adults.

Adolescent↗
PubMed1993

A unique monthly distribution of suicide and parasuicide through firearms among Israeli soldiers.

The monthly distribution of completed suicide and parasuicide by Israeli soldiers was analyzed during the 7-year period of 1984-1990. Although parasuicide in general showed a constant incidence throughout the year, the monthly rate of suicide as well as parasuicide through firearms varied during the year in a similar way. The seasonal pattern of completed suicides, the vast majority of which occur with firearms, was correlated with the seasonal pattern of parasuicides through firearms. The combined variability of the two seasonal patterns was found to be significantly different from a pattern of a constant monthly incidence with a peak in December and a nadir in October. The monthly incidence of suicide and parasuicide through firearms was found to be negatively correlated with the duration of the daily photoperiod, when the latter was phase-advanced by 1-2 months. This unique pattern of seasonal incidence of suicide and parasuicide through firearms is different from most of the patterns reported in the Northern Hemisphere.

Firearms↗
PubMed1992

Psychiatric implications of missile attacks on a civilian population. Israeli lessons from the Persian Gulf War.

OBJECTIVE: To determine the proportion of hospitalized patients who had stress reactions as a result of missile attacks during the Persian Gulf War and evaluate the factors that influenced their evacuation. DESIGN: Review of medical records of patients hospitalized as a result of missile attacks. SETTING: During the Persian Gulf War in the winter of 1991, Israel received 18 missile attacks involving 39 surface-to-surface Scud missiles. The uncertainty in time, place, and type of warhead, conventional or chemical, was a source of chronic stress and the immediate cause for many traumatic stress reactions at or near the missile attack sites. PARTICIPANTS: Data from victims who were injured after each missile attack were available through a central hookup between 12 local hospitals and the Medical Corps of the Israeli Defence Force. MAIN OUTCOME MEASURE: The number of persons diagnosed in the hospital as psychological casualties after each missile attack. RESULTS: Approximately 43% of the 773 casualties evacuated to hospitals were diagnosed as psychological casualties, and an additional 27% had mistakenly injected themselves with atropine. Data also indicated that triage of psychological casualties to hospitals was more a function of the rescue team's training and preparation than the severity or extent of injury or damage. CONCLUSIONS: Optimal treatment during events that cause mass casualties requires proper preparation of rescue teams as well as reorganization of the hospital's psychiatric services. The threat of chemical warfare affected the number and nature of stress reactions.

Atropine↗
PubMed1992

An epidemiological study of obsessive-compulsive disorder and related disorders in Israeli adolescents.

Five hundred and sixty-two, 16- to 17-year-old consecutive inductees into the Israeli Army, constituting a random sample of their cohort, were screened for obsessive-compulsive disorder (OCD), Tourette's syndrome, transient tics (TT), chronic multiple tics (CMT), and attention-deficit hyperactive disorder (ADHD). Two child psychiatrists interviewed the subjects, using screening items from structured interviews that implement DSM-III-R diagnostic criteria. For OCD, a point prevalence of 3.6% was found, 3.9% for ADHD, 1.8% for CMT, and 1.6% for TT. For ADHD, TT, and CMT, but not for OCD, there was a significantly higher prevalence for males than for females. Among the OCD individuals, there was an elevation of TT, CMT, and Tourette's syndrome relative to the population rates.

Adolescent↗
PubMed1992

From front line to home front: a study of secondary traumatization.

While the long-term effects of combat trauma on veterans have been studied extensively, its impact on veterans' wives has yet to be investigated. This study examined the implications of combat-induced psychopathology--wartime combat stress reaction (CSR) and current posttraumatic stress disorder (PTSD)--in a sample of 205 wives of Israeli combat veterans of the 1982 Lebanon war. Results show that both CSR and PTSD were associated with increased psychiatric symptoms in the wives. In addition, current PTSD was particularly found to contribute to impaired social relations among veterans' wives in a broad range of contexts, from inner feelings of loneliness, through impaired marital and family relations, and extending to the wider social network. Implications of these findings for treatment and further research are discussed.

Analysis of Variance↗
PubMed1992

Structural equation modelling of some of the determinants of suicide risk.

Much of the psychological research with suicidal patients has examined, individually or in combination, correlates and predictors of the various measures in the suicide process. The present study investigated suicidal risk as an outcome measure. Several questionnaires were administered to a sample of 94 soldiers, 61 of whom had manifested some suicidal symptoms. Using LISREL analysis, the data showed that the best model had suicide risk as directly influenced by depression and indirectly by impulsivity.

Adult↗
PubMed1992

Acute transient stress-induced hallucinations in soldiers.

Three cases of stress-induced hallucinations in young soldiers are described. The hallucinatory experience was not accompanied by gross psychopathology. The phenomenology and psychopathological implications of hallucinations following exposure to environmental stress are discussed.

Adolescent↗
PubMed1992

The factor structure and criterion validity of the short form of the Eating Attitudes Test.

One of the more frequently used measures of eating disorders is the 40-item Eating Attitudes Test (EAT) developed by Garner and Garfinkel (1979). Although originally designed to diagnose anorexia nervosa, the test has recently been applied to nonclinical populations also. In this study, we examined psychometric and validity data for a short version of the scale, the EAT-26. Using a sample of 809 female soldiers in their late teens, results showed that the EAT-26 is reliable, the factor structure is different from that obtained in clinical groups, and the EAT-26 is significantly correlated with body image, weight, and diet.

Adolescent↗
PubMed1992

Clinicians' assessments of suicide risk: can self-report measures replace the experts?

This study examined the possibility of using standardized self-report measures as "stand-ins" for clinicians' assessments of suicide risk. Subjects were 252 new applicants to a military mental health clinic who completed a battery of questionnaires and underwent clinical interviews. The self-report measures of psychiatric symptomatology (general and depression), personality (impulsivity, anger), and cognitions (hopelessness, attitudes toward life and death) were not highly correlated with clinicians' assessments of suicide risk and some showed a non-linear association. These findings suggest that the two methods of assessment are not interchangeable and that clinicians base their assessments of suicide risk, at least in part, on factors not assessed by the above questionnaires.

Adolescent↗