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Biomedical subjects

P A Boudewyns

Publications and source records attributed to P A Boudewyns.

At least 19 recordsLinked to original sources
PubMed1996

Modes of long-term coping with trauma memories: relative use and associations with personality among Vietnam veterans with chronic PTSD.

Little is known about how individuals who develop chronic posttraumatic stress disorder (PTSD) cope with recurring trauma memories, or how enduring personality characteristics influence such coping. Focusing on 110 hospitalized Vietnam combat veterans with chronic PTSD, this exploratory study assessed the relative frequency of using eight ways of coping with war memories, and associations between relative use of these strategies and eight dysfunctional personality styles. As a secondary issue, associations between coping strategies, combat exposure, and PTSD severity were also examined. Consistent with prior findings, these veterans predominantly used emotion-focused and avoidant strategies to cope with war memories. Differing personality styles and relative use or nonuse of particular coping strategies were also associated in psychologically coherent ways. These preliminary findings are discussed in relation to methodologic and future research issues.

Adaptation, Psychological↗
PubMed1996

Periodic limb movements of sleep in combat veterans with posttraumatic stress disorder.

Twenty-five veterans suffering from combat-related posttraumatic stress disorder were studied for 1-4 nights with all-night polysomnography. All subjects had sleep complaints. Analysis reveals that nineteen (76%) of the patients were found to have clinically significant periodic limb movements of sleep (PLMs) by the second night of study. PLMs are associated with sleep complaints in normals. For this reason the common assumption that sleep complaints in posttraumatic stress disorder are related only to the psychiatric disorder itself are challenged.

Adult↗
PubMed1996

Posttraumatic stress disorder: conceptualization and treatment.

After a long history of both scientific and political debate, the notion that extreme psychological traumatic experiences, in and of themselves, could result in a severe, even malignant, psychiatric disorder is now established. In 1980 posttraumatic stress disorder finally became an officially classified anxiety disorder. Since then, the few controlled treatment outcome studies that have been carried out appear to indicate that the most effective treatment for PTSD is some form of exposure therapy. This is not surprising in light of the fact that several other types of anxiety disorders respond well to this form of behavioral treatment. However, PTSD may be more complex than the other types of anxiety disorders, especially with regard to the variety of symptoms involved. In its chronic form or in combat-related PTSD, no one type of treatment tested so far has been successful in reducing all the symptoms of the disorder. Psychophysiological overarousal to imaginal facsimiles of the traumatic event is especially difficult to influence with treatment. Identifying techniques that reduce or at least control this arousal will likely be grist for the research mill for many years. Theoretical and conceptual formulations regarding both the etiology and treatment of the disorder are in early stages of development. It is hoped that these efforts will eventually mature our understanding of the disorder as researchers explore important issues such as (1) predisposing factors; (2) how the nature and intensity of the stressor relates to the severity of the disorder; and (3) how biological, psychological, social, and cultural variables interact to result in PTSD and to either ameliorate or exacerbate its symptoms.

Adult↗
PubMed1994

MMPI profiles in PTSD as a function of comorbidity.

A sample of 135 Vietnam veteran inpatients with combat-related PTSD was sorted into three groups, depending upon the presence of concurrent psychiatric disorders: Depression (n = 68), Psychosis (n = 31), and Other (n = 36). Pairwise comparisons were made on the MMPI with respect to the validity indicators, clinical scales, four relevant Harris-Lingoes subscales, the Psychoticism content scale, and the MMPI-PTSD subscale. Results indicate variations in scale elevations as a function of comorbid diagnosis. Various items and scales appear to differentiate the Psychosis group due to greater psychopathology. In general, the results spotlight the heterogeneous aspects that comorbidity brings to PTSD assessment.

Adult↗
PubMed1994

A comparison of MMPI and MMPI-2 in PTSD assessment.

A sample of 47 Vietnam veterans with the diagnosis of combat-related Post-Traumatic Stress Disorder (PTSD) was administered the MMPI and MMPI-2. Pairwise comparisons were performed on the clinical scales, Harris Lingoes subscales, and scales relevant to the assessment of PTSD. Correlational analyses were performed as well. Hit rates of high-point pairs were compared across the tests. The results suggest a high degree of congruence between tests. Differences were seen on evaluations of some scales between tests that may influence interpretation and treatment.

Adult↗
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↗
PubMed1993

Dissociative experiences of Vietnam veterans with chronic posttraumatic stress disorder.

Interest in dissociation has been renewed, and its relationship to Post-traumatic Stress Disorder is especially intriguing. In this study 57 consecutively admitted chronic, combat-related Posttraumatic Stress Disorder sufferers were grouped by scores on a dissociative scale (Dissociative Experiences Scale). The three groups (high, medium, and low) were compared on personality measures (MMPI basic scales and subscales, and Millon's MCMI), Posttraumatic Stress Disorder measures, and a psychophysiological index of heart rate under baseline trauma conditions. The results showed that the survivors with more dissociative experiences show distinctive and higher symptom levels--excessive fearfulness, symptoms of strange experiences, and high tonic psychophysiological states--as well as greater severity of ratings of Posttraumatic Stress Disorder (on the Mississippi Scale). The discussion addressed the possible role of dissociation in Posttraumatic Stress Disorder.

Adult↗
PubMed1992

Negative parenting behavior, combat exposure, and PTSD symptom severity. Test of a person-event interaction model.

The "personal characteristics" and "extreme event" hypotheses have been proposed as alternative explanations for the development of posttraumatic stress disorder (PTSD) among combat veterans. The person-event interaction model attempts to integrate both perspectives by hypothesizing that premilitary individual vulnerability characteristics play a greater role in influencing risk of PTSD or PTSD symptom severity at lower than at higher levels of exposure to traumatic combat stressors. Focusing on a sample of 57 Vietnam veterans undergoing inpatient treatment for diagnosed PTSD, we assessed this model by examining interactions between negative parenting behaviors in childhood (e.g., inconsistent love) and degree of combat exposure in predicting PTSD symptom severity. Hierarchical regression analyses supported the model, indicating that the father's negative parenting behaviors were more predictive of PTSD symptom severity at relatively lower levels of combat exposure. Implications of the findings for further research on multivariate, interactional models of PTSD etiology among Vietnam combat veterans are discussed.

Adaptation, Psychological↗
PubMed1991

Hidden PTSD in substance abuse inpatients among Vietnam veterans.

Alcohol use patterns among Vietnam combat veterans is an area with little research. This study evaluated three groups of Vietnam subjects on a chemical dependency unit who had a current Axis I diagnosis of alcohol abuse. No subject possessed a PTSD diagnosis. Two groups involved in-country veterans divided by presence or absence of PTSD based on the MMPI-PTSD scale (In-country and PTSD). The third group did not experience combat and was below the mean on the MMPI-PTSD scale (Noncombat). These groups were compared on the MMPI and the Alcohol Use Inventory (AUI), a measure of alcohol use patterns. Results showed that the PTSD Group had significantly higher scores on the MMPI and AUI reflective of deteriorated and binge drinking patterns. Discussion focused on the "hidden" dimension of PTSD among chemically dependent Vietnam veteran inpatients. The Relapse Prevention model was endorsed.

Alcohol Drinking↗
PubMed1990

Suicidal behavior among chronic Vietnam theatre veterans with PTSD.

Suicidal behavior among Vietnam veterans with chronic Post-traumatic Stress Disorder (PTSD) was evaluated. Sixty chronic PTSD vets admitted to a Specialized PTSD Unit were divided into two groups based on the presence of suicidal behavior: 29 patients in a Suicide Group and 31 in a Non-suicide Group. Subjects were evaluated on symptoms, psychometric measures, military variables, adjustment factors, and pre-military parental patterns of discipline. Results showed that the Suicide Group possessed problems in paternal child-rearing patterns, current adjustment difficulties, and the PTSD symptoms of survival guilt and crying. In a regression analysis, paternal inconsistency of love, survivor guilt, and tendency to cry, in addition to age and sex, accounted for the significant variance of suicidal behavior.

Chronic Disease↗
PubMed1987

MMPI overreporting by Vietnam combat veterans.

The MMPI-PTSD scale is the only psychometric measure that has been cross-validated on Vietnam veterans for the determination of PTSD. Despite this, there may be problems with this scale related to symptom exaggeration. Three groups of Vietnam inpatients (N = 75) were defined carefully by both clinical and actuarial methods--PTSD combat, Non-PTSD combat, and Non-combat. This study applied symptom exaggeration methods based on the MMPI obvious/subtle items and on the F scale to these groups. Results show that all the items of this scale are either obvious or neutral, that a carefully distinguished PTSD group differentially responds to these obvious and neutral items relative to other inpatient Vietnam groups, and that the F scale is exaggerated by the PTSD group. In addition, a separate analysis on an independent sample of 50 combat and 50 non-combat Vietnam veterans showed that the combat group endorsed the obvious items on selected scales by 20 T score points at higher rates than other groups. Caution in the use of the MMPI-PTSD scale is discussed.

Humans↗
PubMed1987

Key determinants of the MMPI-PTSD subscale: treatment considerations.

Seventy-five "in country" Vietnam combat psychiatric inpatients were given a battery of measures upon admission to the medical center. These included the MMPI, VETS Adjustment Scale, State-Trait Anxiety Scale, Rotter Locus of Control, Profile of Mood Scale, and a variation of the Figley Stress Scale that measures current stress. Post-traumatic stress disorder (PTSD) was determined by the MMPI-PTSD subscale. Ten of the battery variables were used as predictors for a multiple regression analysis on the MMPI-PTSD subscale. Results yielded a multiple R of .89 for two predictors, Figley Stress Scale and Rotter Locus of Control (external). Patients with PTSD, therefore, suffer most from perceived and experienced current stressors and a low sense of control. Arguments are made for more present-centered and interpersonal strategies in the treatment of PTSD combat veterans.

Adult↗
PubMed1985

Evaluating finger-temperature data.

Data are presented to support the hypothesis that finger temperature is distributed in a bimodal manner. It is empirically demonstrated that using conventional parametric inferential statistics to evaluate absolute changes in finger temperature is at least misleading and may result in invalid conclusions. Alternative statistical procedures to assess the finger-temperature response are suggested. Also, using a smaller homogeneous sample of subjects, it is shown that lengthy, presession baseline recordings (a standard procedure in temperature research designed to allow subjects to stabilize hand temperature) may serve only to increase the distance between the two modes or distributions. Finally, a suggestion as to why finger temperature is distributed in a bimodal manner is offered and some ideas about how these findings might affect clinical practice are discussed.

Adolescent↗
PubMed1985

Prospective payment: its impact on psychology's role in health care.

This article describes the new Medicare payment system based on diagnosis-related groups (DRGs) and its impact on professional psychology. DRGs represent medically oriented notions about how many inpatient days a prudent physician needs to effectively treat a patient who suffers from a specified disease. However, for the most part, DRGs ignore the behavioral variables that moderate entry into the tertiary care system and the subsequent use of hospital resources. Under DRGs, the development and use of behavioral treatments for somatic disorders could be discouraged. For example, many newer behavioral medicine techniques may be more time-consuming and/or expensive than traditional treatment options (e.g., bed rest vs. biofeedback for low back pain) and thus not fall within the time period or "trim points" alloted for such disorder, regardless of comparative effectiveness. Also, under the new system, psychologists can no longer bill separately for their inpatient services. It is argued that the framers of health care policies should recognize and support health psychologists in light of the fact that many of their techniques can reduce the cost and consumption of health care through programs that: reduce behavioral risk factors, increase compliance with medical regimens, and prepare patients psychologically for stressful medical procedures.

Diagnosis-Related Groups↗