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Biomedical subjects

R S Pynoos

Publications and source records attributed to R S Pynoos.

13 recordsLinked to original sources
PubMed1991

Stress responses after pediatric bone marrow transplantation: preliminary results of a prospective longitudinal study.

This paper reports the preliminary findings of a longitudinal prospective study of young children undergoing bone marrow transplantation. Symptoms of post-traumatic stress were seen in these children up to 12 months after transplant. The bone marrow transplantation survivors demonstrated more denial and avoidance and fewer arousal symptoms than has been noted in children traumatized by a violent life threat, such as a sniper attack. These data suggest the use of post-traumatic stress as a model in understanding some of the symptoms of pediatric bone marrow transplantation survivors and may be applicable to other children exposed to the double life threat of serious illness and intensive medical intervention.

Adaptation, Psychological↗
PubMed1989

Children's memory and proximity to violence.

The study examined 133 school-age children's memory of a sniper attack at their elementary school. Researchers analyzed the role that spatial representation, memory markers, inner plans of action, and strategies of recall played in the memory process. In recalling the event, exposed children reduced their degree of life threat, while nonexposed children increased their proximity to the violence. Clinical and forensic implications are discussed.

Anxiety↗
PubMed1989

Startle modulation in children with posttraumatic stress disorder.

Startle responses to bursts of white noise were recorded as blink reflexes 17-21 months after a traumatic event in six children with posttraumatic stress disorder (PTSD) and in six normal control children. A seventh child with PTSD was studied on four occasions during the 2 years following a stressful event. The startle responses were modulated by nonstartling acoustic prestimulation in order to study the inhibitory and facilitatory modulation of startle reaction by brainstem mechanisms. The children with PTSD experienced a significant loss of the normal inhibitory modulation of startle response, suggesting that the traumatic experience had induced a long-lasting brainstem dysfunction.

Acoustic Stimulation↗
PubMed1987

Life threat and posttraumatic stress in school-age children.

One hundred fifty-nine children (14.5% of the student body) were sampled after a fatal sniper attack on their elementary school playground. Systematic self-reports of posttraumatic stress disorder (PTSD) symptoms were obtained by use of a child PTSD Reaction Index. Analysis of variance revealed significant differences by exposure but not by sex, ethnicity, or age. Additional analyses were conducted of individual item response, overall severity of PTSD reaction, symptom grouping, and previous life events. The results provide strong evidence that acute PTSD symptoms occur in school-age children with a notable correlation between proximity to the violence and type and number of PTSD symptoms. Sampling at approximately one month after the trauma provided adequate delineation among exposure groups. The symptom profile of highly exposed children lends validity to the diagnosis of acute PTSD in childhood.

Acute Disease↗
PubMed1987

Death notification.

Death notification--informing the deceased's family of an unexpected death--is a singularly stressful task common to medical personnel, clergy, and police. We surveyed by questionnaire a group of 50 Los Angeles Police Department homicide detectives, 21 of whom were subsequently interviewed by telephone. The detectives stated that their initial apprehension stemmed from feeling unprepared. Identification with victims' families was common and compounded the stress. One prevalent worry concerned the possible reactions of the family upon hearing the news, especially the risk of a violent attack on the police officer. Several coping styles were recognized. Our findings suggest that the repetitive performance of this continuously stressful task may be a prominent and underappreciated contribution to occupational burnout.

Death↗
PubMed1986

The inpatient psychiatric unit as consultation service.

In response to the changing role of the hospital in the mental health care system, the authors propose a new model for inpatient psychiatric units--that of consultants to outpatient therapists and community and mental health agencies. They discuss key aspects of an inpatient hospitalization that facilitate the tasks of expanded diagnostic evaluation and treatment assessment, and present several cases to illustrate how information and perspectives gleaned from the evaluation can be effectively conveyed to both patient and outpatient therapist, so that it optimizes care of the patient after discharge.

Adult↗
PubMed1985

Mental health consultation to a preschool following the murder of a mother and child.

The murder of a five-year-old boy and his mother disrupted the entire small community of the pre-school he had attended. A two-stage mental health intervention consisting of separate group sessions with the preschoolers, teachers, and parents was initiated to help them work through their grief and fear and to reverse their increasing isolation from one another. The reassuring presence of adults who were not struggling with the crisis and the creation of a supportive milieu relieved the children's anxiety, enabling them to discuss their fears and fantasies about the deaths, and alleviated the anxious mistrust and sense of lost personal security of the teachers and parents. The teachers were able to resume their professional functioning, and the parents were better able to assist their affected children.

Attitude to Death↗
PubMed1984

An unusual case of self-inflicted death in childhood.

The authors report the details of the case of a ten year old boy whose self-inflicted death by gunshot featured the involvement of a nine year old companion. The authors examine the material from the viewpoints of a possible case of suicide, of a certain case of violent death, and of a case with repercussions on the other child and the community.

Adaptation, Psychological↗
PubMed1983

Use of joint consultations in inpatient psychiatry.

The coexistence of medical and psychiatric problems in psychiatric inpatients often causes compliance difficulties, based on either irrational and distorted fears of medical treatment or more rational concerns that proposed psychiatric treatment could adversely affect a preexisting medical condition. The authors propose the use of joint consultations, in which both the psychiatrist and the other medical specialist meet together with the patient, as a way of ameliorating such distortions and conflicts and thereby improving compliance with both medical and psychiatric treatment.

Adult↗
PubMed1981

Cancer in a parent: the impact on mother and child. A consultation-liaison clinical case conference.

The following case presents a 31-year-old woman medically hospitalized during a relapse of acute myelocytic leukemia. A consultation-liaison clinical conference focused on the patient's concerns about the effects of her illness on her relationship with her young daughter and its impact on the child's development. The discussion illustrates the consultation-liaison psychiatrist's role in alerting parents to their child's needs and in providing them with tools for effective parenting in a crisis situation such a cancer.

Adult↗