Biomedical subjects

R A Bryant

Publications and source records attributed to R A Bryant.

At least 55 records · Page 3Linked to original sources

PubMed1999

Treating acute stress disorder: an evaluation of cognitive behavior therapy and supportive counseling techniques.

OBJECTIVE: Acute stress disorder permits an early identification of trauma survivors who are at risk of developing chronic posttraumatic stress disorder (PTSD). This study aimed to prevent PTSD by an early provision of cognitive behavior therapy. Specifically, this study indexed the relative efficacy of prolonged exposure and anxiety management in the treatment of acute stress disorder. METHOD: Forty-five civilian trauma survivors with acute stress disorder were given five sessions of 1) prolonged exposure (N = 14), 2) a combination of prolonged exposure and anxiety management (N = 15), or 3) supportive counseling (N = 16) within 2 weeks of their trauma. Forty-one trauma survivors were assessed at the 6-month follow-up. RESULTS: Fewer patients with prolonged exposure (14%, N = 2 of 14) and prolonged exposure plus anxiety management (20%, N = 3 of 15) than supportive counseling (56%, N = 9 of 16) met the criteria for PTSD after treatment. There were also fewer cases of PTSD in the prolonged exposure group (15%, N = 2 of 13) and the prolonged exposure plus anxiety management group (23%, N = 3 of 13) than in the supportive counseling group (67%, N = 10 of 15) 6 months after the trauma. Chronic PTSD in the supportive counseling condition was characterized by greater avoidance behaviors than in the prolonged exposure condition or the prolonged exposure plus anxiety management condition. CONCLUSIONS: These findings suggest that PTSD can be effectively prevented with an early provision of cognitive behavior therapy and that prolonged exposure may be the most critical component in the treatment of acute stress disorder.

Acute Disease↗

PubMed1999

A qualitative investigation of the organization of traumatic memories.

OBJECTIVE: Previous research has indicated that cohesive organization of traumatic memories may be necessary for the processing and resolution of post-trauma symptoms. The present study aimed to evaluate the qualitative features of memory organization, dissociation and perception of threat in traumatic memories recalled by individuals with and without acute stress disorder (ASD). DESIGN: Survivors of motor vehicle accidents (MVA) with either ASD or no ASD participated in a study on traumatic memories within 12 twelve days of the MVA. METHOD: Participants' audiotaped recollections of their memories of the MVA were coded in terms of disorganized structure, dissociative content and perception of threat. RESULT: The recollections of ASD participants were characterized by disorganization and dissociation more than those of non-ASD participants. CONCLUSION: The current findings suggest that disorganized memory structure may be one process that impedes access to, and modification of, trauma-related cognitive schema.

Adult↗

PubMed1998

Bulimia nervosa, restrained, and unrestrained eaters: a comparison of non-binge eating behavior.

OBJECTIVE: This study investigated non-binge eating behavior in bulimia nervosa, restrained and unrestrained eaters. METHOD: Nine females with bulimia nervosa, 12 female restrained eaters, and 13 female unrestrained eaters were administered the Eating Disorder Inventory-2 (EDI-2), the Body Shape Questionnaire, the Beck Depression Inventory, the Rosenberg Self-Esteem Scale, and the Revised Restraint Scale (RRS). All subjects were videotaped during a midday meal and their eating behavior was subsequently rated using the Eating Behaviour Rating Scale (EBRS). RESULTS: EBRS ratings were higher for bulimic than for unrestrained subjects. Restrained subjects' ratings did not differ from those of either bulimic or unrestrained subjects. EBRS scores were positively correlated with RRS and EDI-2 total scores. CONCLUSIONS: Bulimic subjects display aberrant eating behavior, and the extent to which subjects engage in maladaptive eating behavior is related to the degree of eating pathology. These results support the utility of the EBRS as a useful index of eating behaviors in clinical and nonclinical populations.

Adolescent↗

PubMed1998

The effect of attempted thought suppression in acute stress disorder.

Attempted suppression of traumatic memories was investigated in survivors of motor vehicle accidents with acute stress disorder (ASD; n = 24) and without ASD (n = 24). Participants monitored their trauma-related thoughts for three 5-minute periods. In Period 1, participants were instructed to think about anything. For Period 2, participants were administered suppression or non-suppression instructions relating to thoughts of the trauma. In Period 3, participants were again instructed to think about anything. ASD participants reported higher ratings of anxiety, frequency of trauma-related thoughts, and attempted suppression of trauma-related thoughts than non-ASD participants. Participants who were given suppression instructions demonstrated a delayed increase in trauma-related thoughts in the period subsequent to suppression.

Accidents, Traffic↗

PubMed1998

Cognitive bias in acute stress disorder.

Cognitive bias was investigated in survivors of motor vehicle accidents with either acute stress disorder (ASD; n = 17) or no ASD (n = 17). Participants completed the acute stress disorder interview, the Beck depression inventory, the Beck anxiety inventory, the impact of event scale, and a probability questionnaire (PQ) and a cost questionnaire (CQ) within four weeks of their accident. ASD participants exaggerated both the probability of negative events occurring, and the adverse cost of those events more than non-ASD participants. IES-Avoidance scores were the only significant predictors of both PQ and CQ scores. Findings are discussed in terms of the role of cognitive errors in posttraumatic adjustment.

Accidents, Traffic↗

PubMed1998

Thought control strategies in acute stress disorder.

Intrusive trauma-related thoughts and the means to manage them are a central dynamic in posttraumatic stress. Thought control strategies were investigated in survivors of motor vehicle accidents with either acute stress disorder (ASD; n = 20) or no ASD (n = 20). Participants completed the Acute Stress Disorder Interview, the Beck Depression Inventory, the Beck Anxiety Inventory, the Impact of Event Scale, and the Thought Control Questionnaire (TCQ) within four weeks of their accident. Although distraction, social control, and reappraisal were the most common strategies in both groups, ASD participants engaged in punishment and worry more than non-ASD participants. Worry and punishment were also strongly associated with severity of intrusive, avoidance, arousal, and depressive symptoms. Findings are discussed in terms of the role of cognitive strategies in resolving posttraumatic stress.

Accidents, Traffic↗

PubMed1998

An analysis of calls to a Vietnam veterans' telephone counselling service.

The pattern of calls to an after-hours crisis telephone service for Vietnam veterans was surveyed over a 9-week period. Not including prank and administrative calls, 274 calls were made to the service. Domestic conflict, substance abuse, traumatic memories, depression, and anger at government represented the major problems requiring counselling. Crisis intervention was required for 18% of calls because of suicide threats or threatened violence to others. The survey findings indicate that telephone counselling can be an appropriate means to provide support for many veterans who may avoid conventional counselling agencies.

Adult↗

PubMed1998

Autobiographical memory in acute stress disorder.

Survivors of motor vehicle accidents with acute stress disorder (ASD) or with no ASD participated in a study on autobiographical memory within a week of their trauma. In Experiment 1, participants were provided cue words to elicit autobiographical memories of both an unconstrained time period and their trauma. Participants with ASD reported fewer specific memories to positive cue words than did non-ASD participants, even when the influence of depression was controlled. In Experiment 2, the same participants were assessed for posttraumatic stress disorder (PTSD) 6 months posttrauma. Poor recall of specific memories of the trauma in Experiment 1 accounted for 25% of the variance of PTSD severity. Accessibility of trauma memories in the acute posttrauma phase may have significant implications for longer term adjustment.

Accidents, Traffic↗

PubMed1998

The relationship between acute stress disorder and posttraumatic stress disorder: a prospective evaluation of motor vehicle accident survivors.

Motor vehicle accident survivors (n = 92) were assessed for acute stress disorder (ASD) within 1 month of the trauma and reassessed (n = 71) for posttraumatic stress disorder (PTSD) 6 months posttrauma. ASD was diagnosed in 13% of participants, and a further 21% had subclinical levels of ASD. At follow-up, 78% of ASD participants and 60% of subclinical ASD participants met criteria for PTSD. The strong predictive power of acute numbing, depersonalization, a sense of relieving the trauma, and motor restlessness, in contrast to the low to moderate predictive power of other symptoms, indicates that only a subset of ASD symptoms is strongly related to the development of chronic PTSD. Although these findings support the use of the ASD diagnosis, they suggest that the dissociative and arousal clusters may require revision.

Accidents, Traffic↗

PubMed1998

Treatment of acute stress disorder: a comparison of cognitive-behavioral therapy and supportive counseling.

Acute stress disorder (ASD) is a precursor of chronic posttraumatic stress disorder (PTSD). Twenty-four participants with ASD following civilian trauma were given 5 sessions of either cognitive-behavioral therapy (CBT) or supportive counseling (SC) within 2 weeks of their trauma. Fewer participants in CBT (8%) than in SC (83%) met criteria for PTSD at posttreatment. There were also fewer cases of PTSD in the CBT condition (17%) than in the SC condition (67%) 6 months posttrauma. There were greater statistically and clinically significant reductions in intrusive, avoidance, and depressive symptomatology among the CBT participants than among the SC participants. This study represents the 1st demonstration of successful treatment of ASD with CBT and its efficacy in preventing chronic PTSD.

Accidents↗

PubMed1998

Predictors of acute stress following mild traumatic brain injury.

The aim of this study was to investigate the predictors of acute stress disorder (ASD) following mild traumatic brain injury (MTBI). Patients who sustained MTBI following a motor vehicle accident (n = 48) were assessed with a structured interview within 18 days of the trauma for the presence of ASD and administered the Beck Depression Inventory (BDI), Coping Style Questionnaire, Dissociative Experiences Scale, and the Eysenck Personality Inventory. ASD was diagnosed in 14.6% of patients and 4.2% were diagnosed with sub-syndromal ASD. BDI scores and avoidant coping were significant predictors of ASD and acute stress severity. This study provides further evidence that traumatic stress reactions occur following MTBI and highlights the possibility of identifying those who may benefit from early intervention.

Accidents, Traffic↗

PubMed1998

Acute stress disorder after mild traumatic brain injury.

The debate continues over whether a posttraumatic response occurs in those who have sustained a traumatic brain injury (TBI). The aim of this study was to investigate the incidence of acute stress disorder (ASD) in the mild TBI population. Patients who sustained a mild TBI after a motor vehicle accident (N = 79) were assessed for the presence of ASD. ASD was diagnosed in 13.9% of patients, and 5.1% were diagnosed with subsyndromal ASD. Dissociative, reexperiencing, and avoidance symptoms were found to have moderate to high predictive power. This study highlights the significant number of patients who experience an acute trauma response after TBI and raises the possibility that those with ASD denote those for whom an early intervention may prevent longer-term psychopathology. Diagnostic difficulties in defining ASD after TBI are discussed.

Accidents, Traffic↗

PubMed1998

Relationship between acute stress disorder and posttraumatic stress disorder following mild traumatic brain injury.

OBJECTIVE: The aim of this study was to index the frequency of occurrence of acute stress disorder following mild traumatic brain injury and to determine its utility in predicting posttraumatic stress disorder (PTSD). METHOD: Consecutive adult patients who sustained a mild traumatic brain injury following a motor vehicle accident (N = 79) were assessed for acute stress disorder within 1 month of their trauma with the Acute Stress Disorder Inventory, a structured clinical interview based on DSM-IV criteria. Patients were followed up 6 months after the trauma (N = 63) and were administered the PTSD module of the Composite International Diagnostic Interview. RESULTS: Acute stress disorder was diagnosed in 14% of patients, and at follow-up 24% satisfied criteria for PTSD. Six months after the trauma PTSD was diagnosed in 82% of patients who had been diagnosed with acute stress disorder and in 11% of those who had not been diagnosed with acute stress disorder. CONCLUSIONS: These findings point to the frequency of PTSD following mild traumatic brain injury. While the criteria for acute stress disorder are useful in identifying those individuals who are at risk of developing chronic PTSD, the findings suggest that current criteria require modification in order to optimally predict PTSD following mild traumatic brain injury.

Accidents, Traffic↗

PubMed1997

Acute stress disorder: a critical review of diagnostic issues.

Acute stress disorder (ASD) is a recently developed diagnosis that describes posttraumatic stress reactions that occur in the first month following a trauma. Diagnostic criteria include dissociative, intrusive, avoidance, and arousal symptoms. ASD was driven by the proposal that trauma leads to dissociative reactions, and these are predictive of longer-term psychopathology. This paper reviews a series of anomalies in the diagnostic criteria, highlights discrepancies between criteria for ASD and posttraumatic stress disorder (PTSD), and illustrates the lack of empirical evidence for some assumptions inherent in the conceptualization of ASD. It is argued that future revisions of ASD criteria need to be based on empirical evidence of acutely traumatized individuals.

Acute Disease↗

PubMed1997

Attentional bias in posttraumatic stress disorder.

This study investigated preferential encoding of threat material in subjects with posttraumatic stress disorder (PTSD) with a modified dot-probe paradigm. This paradigm indexes attentional bias by measuring response latency to name neutral target words that are presented adjacent to or distant from threat words. Motor vehicle accident survivors with PTSD (n = 15), subclinical PTSD (n = 15), and low anxiety (n = 15) were required to name target words that were presented either adjacent to or distant from strong threat, mild threat, positive, and neutral words. PTSD subjects named targets faster when they were in close proximity to mild threat words. Results suggested that PTSD subjects' attention was drawn to the mild threat stimuli and are discussed in the context of network models of PTSD.

Adult↗

PubMed1997

Folie à familie: a cognitive study of delusional beliefs.

JASPERS (1913/1959) initially differentiated between primary and secondary delusions. Whereas primary delusions were conceptualized as changes in experience or mood that were not comprehendible by the individual, secondary delusions were those beliefs that possessed an understandable cognitive content (Walker 1991). Cognitive theories have recently focused on these delusional beliefs and, to varying degrees, conceptualized them as the products of attempted explanations of anomalous experiences (Bentall et al. 1994). For example, an individual experiencing depersonalization may attribute this experience to witches controlling his or her body, and will thereafter interpret perceptual experiences that are consistent with this belief. In this sense, Maher (1988) has conceptualized delusions as normal cognitions that account for abnormal perceptual experiences.

Adult↗

PubMed1996

Visual imagery in posttraumatic stress disorder.

Visual imagery is reported to play a central role in posttraumatic stress disorder (PTSD). This pilot investigation examined visual imagery ability in patients with varying degrees of posttraumatic stress. Eighty one survivors of motor vehicle accidents with either (a) diagnosed PTSD, (b) diagnosed Specific Phobia, or (c) no psychiatric diagnosis and low anxiety were assessed on a measure of vividness of visual imagery. Low Anxiety subjects displayed superior visual imagery compared to PTSD and Specific Phobic subjects. Incidence of flashbacks and nightmares, however, was associated with visual imagery ability in PTSD subjects. Findings suggest that visual imagery ability may be associated with PTSD flashbacks. These results are discussed in terms of use of imagery-based treatments with traumatized patients, and of the need for further investigation of the role that imagery plays in posttraumatic adjustment.

Accidents, Traffic↗

PubMed1996

Posttraumatic stress disorder, flashbacks, and pseudomemories in closed head injury.

Posttraumatic stress disorder (PTSD) is rarely diagnosed in patients with significant head injury. This paper reviews two patients who were amnesic for events surrounding their motor vehicle accidents (MVAs) but developed delayed-onset PTSD. Symptoms included vivid images of the MVAs that were based on information learnt following the trauma. These cases indicate that amnesic head injured patients can suffer pseudomemories that are phenomenologically similar to flashbacks observed in PTSD. Implications for understanding the nature of flashbacks are discussed.

Accidents, Traffic↗