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Biomedical subjects

S Southwick

Publications and source records attributed to S Southwick.

At least 19 recordsLinked to original sources
PubMed2001

Scoring accuracy using the comprehensive system for the Rorschach.

The Comprehensive System (CS; Exner, 1974, 1978) for scoring Rorschach responses is the most widely taught and most widely accepted system in use today. The complexity and labor- intensive nature of the CS makes the issue of scoring accuracy a central concern. Twenty-one graduate psychology students and 12 professionals scored 20 Rorschach responses drawn from normal and clinical protocols. In general. accuracy scores for both students and professionals were below acceptable levels. Accuracy scores were clearly better for the code categories of Location, DQ, Pairs, Popular, and Z than for Determinants, FQ, Content, and Special Scores. Responses from clinical protocols were subject to more error. The results suggest that high levels of scoring errors may exist in the field use of the CS. Training standards may need to be devised to insure scoring competence.

Clinical Competence↗
PubMed2001

The affective and memorial components of distinctiveness-based illusory correlations.

Two studies were conducted to test a model of the distinctiveness-based illusory correlation (IC) phenomenon that suggests there are two components operating with ICs: cognitive memorial, and affective. In Expt 1 (N = 118), two stimulus arrays were developed that were equivalent in regards to valence (good or bad extremity) but differed in regards to the affect dimension (high or low emotional intensity). Consistent with predictions drawn from the proposed model, the magnitude of the IC effect was higher in the high emotional intensity than in the low emotional intensity condition, but only significantly so on the measures (estimation and general evaluation) that have been hypothesized to be most sensitive to the affective component. In Expt 2 (N = 52), the affective qualities were matched and the valence properties varied in two stimulus arrays. As predicted, the IC effect differed significantly between conditions only on the measure (assignment) thought to be most sensitive to the memorial component. The results are discussed in terms of the implications of the findings for the proposed mechanisms of illusory correlation.

Adult↗
PubMed1999

No association between D2 dopamine receptor (DRD2) "A" system alleles, or DRD2 haplotypes, and posttraumatic stress disorder.

BACKGROUND: Association studies between marker alleles at the D2 dopamine receptor gene (DRD2) and various psychiatric illnesses have produced conflicting results. Reports of allelic associations were originally made with alcoholism, but were then extended to other psychiatric disorders, including posttraumatic stress disorder (PTSD). METHODS: We studied allele frequency of the DRD2 TaqI "A," "B," and "D" system markers in 52 European-American subjects with diagnoses of PTSD (based on structured interviews). RESULTS: Frequency of the A1 allele in this sample was .15, not significantly different from the .19 allele frequency seen in 87 control subjects. We were thus unable to replicate the previous reports of allelic association between the DRD2 TaqI "A1" allele and PTSD. There were also no significant differences in allele frequency for the "B" or "D" systems. We then computed three marker (TaqI "A," "B," and "D" system) haplotypes for the sample; DRD2 haplotype frequencies also did not differ between control subjects and subjects with PTSD. CONCLUSIONS: We conclude that DRD2 alleles are not associated with PTSD in this sample, and that genetic variation at the DRD2 locus is not likely to be an important contributor to risk for this disorder.

Adult↗
PubMed1999

Comparison of outcome between homogeneous and heterogeneous treatment environments in combat-related posttraumatic stress disorder.

This study compared treatment outcome at discharge, and 4, 8, and 12 month follow-up between an inpatient program consisting of a mixture of Vietnam combat veterans with posttraumatic stress disorder (PTSD) and general psychiatric patients (N = 42), and the same program at a later period, consisting of only Vietnam combat veterans with PTSD (N = 33). Veterans rated the homogeneous environment higher in satisfaction, support, order, clarity, and amount of discussion of combat, and lower in hostility, than the heterogeneous condition. However, veterans showed no improvement in condition at 12 month follow-up, with the exception of decreased violence, replicating earlier studies. No differences in outcome were found between homogeneous or heterogeneous treatment environments. This study underscores the enduring nature of chronic posttraumatic stress disorder in the veteran population.

Adult↗
PubMed1997

Relationships between hormonal profile and novelty seeking in combat-related posttraumatic stress disorder.

This study examines relationships between hormonal levels and novelty seeking in a group of 27 Vietnam veterans with combat-related posttraumatic stress disorder (PTSD). Novelty seeking in the veteran sample, measured by the Cloninger Tridimensional Personality Questionnaire (TPQ), was almost twice as high as previously published norms. A distinctive pattern of significant positive correlations was found between novelty seeking scores and serum total triiodothyronine (T3), free T3, the T3/free thyroxine (FT4) ratio, urinary norepinephrine and the norepinephrine/cortisol ratio, while a negative correlation was found between novelty seeking scores and urinary cortisol levels. The findings were confirmed by t test analyses of high vs low novelty seeking subgroups and do not appear to be related simply to the severity of PTSD. These preliminary findings indicate the need to include measures of characterological traits in psychoendocrine studies of PTSD and to investigate their possible usefulness in subtyping this disorder.

Adult↗
PubMed1997

The impact of the homecoming reception on the development of posttraumatic stress disorder. The West Haven Homecoming Stress Scale (WHHSS).

This study reports on the development of a self-report measure of the homecoming experience among Vietnam veterans with posttraumatic stress disorder (PTSD). The West Haven Homecoming Stress Scale (WHHSS), measuring Frequency of Events, Intensity of Feelings, and Level of Support during the first 6 months after return from overseas, and within the past 6 months, was collected from 247 veterans who were receiving inpatient treatment for PTSD. Homecoming Stress was the most significant predictor of current PTSD symptomatology superseding combat exposure, childhood and civilian traumas, and stressful life events. A factor analysis resulted in four orthogonal factors: Shame, Negative Interpersonal Interaction, Social Withdrawal, and Resentment. Homecoming Stress was unchanged over the course of a 4 month inpatient program.

Adult↗
PubMed1996

Outcome of intensive inpatient treatment for combat-related posttraumatic stress disorder.

OBJECTIVE: This study analyzed the outcome of a 4-month intensive inpatient program for combat-related posttraumatic stress disorder (PTSD) among Vietnam veterans. METHOD: The subjects were 51 male veterans with PTSD who completed the inpatient treatment program. Comprehensive measures of PTSD and psychiatric symptoms, as well as social functioning, were assessed at admission, discharge, and 6, 12, and 18 months after discharge. RESULTS: The overall study group showed an increase in symptoms from admission to follow-up and a decrease in violent actions and thoughts and legal problems. Family and interpersonal relationships and overall morale were improved at discharge but then returned to pretreatment levels at 18 months. Patient evaluations also indicated that the program affected morale and interpersonal relationships but not symptoms. CONCLUSIONS: The chronic nature of combat-related PTSD among Vietnam veterans is evident. The study raises the possibility that long-term intensive inpatient treatment is not effective, and other forms of treatment should be considered after rigorous study of such variables as length of stay, trauma versus rehabilitation focus, and patient characteristics.

Adaptation, Psychological↗
PubMed1994

Elevation of serum free triiodothyronine, total triiodothyronine, thyroxine-binding globulin, and total thyroxine levels in combat-related posttraumatic stress disorder.

BACKGROUND: This study was designed to assess both central and peripheral aspects of thyroid function in combat-related posttraumatic stress disorder (PTSD), with the particular purpose of finding a mechanistic explanation for an imbalance between serum levels of free thyroxine (T4) and total T4 previously observed in pilot work. METHODS: A total of 96 male combat veterans with PTSD diagnosed by DSM-III-R (72 from the West Haven, Conn, Veterans Affairs Medical Center and 24 from the Menlo Park, Calif, Veterans Affairs Medical Center) were compared with 24 male control subjects. One or more serum samples were analyzed by radioimmunoassays for levels of total T4, free T4, total triiodothyronine (T3), free T3, T4-binding globulin, and thyrotropin. RESULTS: The pilot observation of moderately elevated total T4 levels with no elevation in free T4 levels in patients with PTSD was confirmed, suggesting the hypotheses that (1) there may be an increased peripheral conversion of free T4 by deiodination to T3 or (2) there may be an increased binding of T4 secondary to elevated T4-binding globulin levels. Our findings support both hypotheses. The PTSD groups all showed a marked and sustained elevation in levels of both total T3 and free T3, as well as elevated T3/T4 ratios, supporting the increased T3 conversion hypothesis. The PTSD groups also showed a marked and sustained increase in T4-binding globulin levels, supporting the increased binding hypothesis. Thyrotropin levels did not differ between PTSD and control groups. CONCLUSIONS: These findings demonstrate an unusual pattern of thyroid alterations, featuring substantial elevations in total T3, free T3, and T4-binding globulin levels, in combat-related PTSD that differs from established endocrinopathies, such as classic hyperthyroidism, T3 thyrotoxicosis, or chronic T4-binding globulin elevation.

Adult↗
PubMed1992

Urinary catecholamine excretion and severity of PTSD symptoms in Vietnam combat veterans.

In the present study, we replicated and extended our previous findings of increased 24-hour urinary catecholamine excretion in posttraumatic stress disorder (PTSD). Dopamine, norepinephrine, and epinephrine concentrations were measured in 22 male patients with PTSD (14 inpatients and eight outpatients) and in 16 nonpsychiatric normal males. The PTSD inpatients showed significantly higher excretion of all three catecholamines compared with both outpatients with PTSD and normal controls. Dopamine and norepinephrine, but not epinephrine, levels were significantly correlated with severity of PTSD symptoms in the PTSD group as a whole. In particular, these catecholamines seemed related to intrusive symptoms. None of the catecholamines were correlated with severity of depression. The findings support the hypothesis of an enhanced sympathetic nervous system activation in PTSD, and suggest that increased sympathetic arousal may be closely linked to severity of certain PTSD symptom clusters.

Ambulatory Care↗
PubMed1992

Dissociation and posttraumatic stress disorder in Vietnam combat veterans.

OBJECTIVE: This study compared current dissociative symptoms and dissociation at the time of specific traumatic events in Vietnam combat veterans with posttraumatic stress disorder (PTSD) and Vietnam combat veterans without PTSD. METHOD: Vietnam combat veterans who sought treatment for PTSD (N = 53) were compared to Vietnam combat veterans without PTSD (N = 32) who sought treatment for medical problems. Dissociative symptoms were evaluated with the Dissociative Experiences Scale. Dissociation at the time of a combat-related traumatic event was evaluated retrospectively with the modified Dissociative Experiences Questionnaire. The Combat Exposure Scale was used to measure level of combat exposure. RESULTS: There was a significantly higher level of dissociative symptoms, as measured by the Dissociative Experiences Scale, in patients with PTSD (mean = 27.0, SD = 18.0) than in patients without PTSD (mean = 13.7, SD = 16.0). This difference persisted when the difference in level of combat exposure was controlled with analysis of covariance. PTSD patients also reported more dissociative symptoms at the time of combat trauma, as measured retrospectively by the Dissociative Experiences Questionnaire (mean = 11.5, SD = 1.6) than non-PTSD patients (mean = 1.8, SD = 2.1). CONCLUSIONS: Dissociative symptoms are an important element of the long-term psychopathological response to trauma.

Adult↗
PubMed1991

Cerebral laterality, symptoms, and diagnosis in psychotic patients.

A dichotic nonsense test and a dichotic word test were used to assess cerebral laterality in 100 acutely symptomatic inpatients. Schizophrenic patients had significantly lower right ear advantages (REAs) than healthy controls, depressed patients, or schizoaffective patients. Manic patients did not differ from any other group, but manics with lower REAs were likely to have more symptoms of thought disorder than of mood disturbance while the reverse was likely to be true for manic patients with higher REAs. A subset of patients tested after symptom remission showed recovery-related increases in REA on the nonsense test and decreases on the word test, replicating previous findings. Those schizophrenics with evidence of greater disease-related decreases in REA on the nonsense than on the word test had predominantly negative symptoms whereas those with similar changes on the two tests had predominantly positive symptoms. These observations suggest the hypothesis that positive symptoms are related to overactivation of a dysfunctional left hemisphere by right hemisphere input while negative symptoms reflect a left hemisphere deficit state.

Adult↗
PubMed1991

The Pain Behavior Check List (PBCL): factor structure and psychometric properties.

The construct of "pain behaviors" as observable and measurable manifestations of pain occupies a central role in Fordyce's operant model of pain. The present study was designed to evaluate the multidimensional nature of the construct and to explore the psychometric properties of a newly developed self-report instrument called the Pain Behavior Check List (PBCL). Subjects were 126 chronic pain patients who completed an initial version of the PBCL and other standardized questionnaires as part of their evaluation by the West Haven VAMC. Factor analysis identified four factors labeled Distorted Ambulation, Affective Distress, Facial/Audible Expressions, and Seeking Help. Substantial reliability and stability estimates for the total PBCL and the subscales support the potential clinical and theoretical utility of the instrument.

Affect↗
PubMed1990

The role of marital interaction in chronic pain and depressive symptom severity.

Several investigators have noted the moderating role of the spouse in determining the severity and disability associated with the experience of chronic pain. In this study, pain-contingent responses from spouses, but not global marital satisfaction, accounted for a significant proportion of the variance in reported pain severity. Global marital satisfaction predicted depressive symptom severity. The interaction between global marital satisfaction and the reported frequency of punishing responses to pain behavior added significantly to the prediction of depressive symptoms. Similarly, the interaction between marital satisfaction and degree of spouse solicitousness significantly predicted pain severity. These results are consistent with evolving literatures on the important relationship between marital distress, aversive communication and depression on the one hand, and the potentially deleterious role of the solicitous spouse in the maintenance of chronic pain on the other.

Adult↗
PubMed1989

Serum thyroxine change and clinical recovery in psychiatric inpatients.

Serum free thyroxine (FT4), total thyroxine (TT4), and Brief Psychiatric Rating Scale (BPRS) measurements were obtained following hospital admission and at 2-week intervals during hospitalization in 80 male psychiatric inpatients with a variety of major psychotic and affective disorders. A strong correlation between the range values for BPRS sum and for FT4 (p less than 0.005) and TT4 (p less than 0.001) levels indicated that change in overall symptom severity was linked to change in thyroxine levels during clinical recovery. We found the relationship not to be a simple one, but to require definition of criteria for three patient subgroups for each hormone, taking into account the initial absolute thyroxine level, as well as the direction and magnitude of hormonal change during recovery. The hormonally defined "good recovery" subgroup included patients with high initial thyroxine levels that then fell substantially, patients with low initial thyroxine levels that then rose substantially, and patients with initial thyroxine levels in the middle range that subsequently changed substantially. The hormonally defined "poor recovery" subgroup included those patients not meeting these criteria. The degree of clinical improvement in the hormonally defined good recovery group was significantly greater by almost twofold than the poor recovery group both for FT4 (p less than 0.04) and TT4 (p less than 0.02). These findings suggest that a "normalizing" principle underlies the relationship between clinical recovery and thyroxine levels and that both FT4 and TT4 levels within the normal range appear to have clinical significance in either reflecting or contributing to the course of a variety of psychiatric disorders and possibly having a role in pathogenesis.

Adolescent↗
PubMed1988

Use of imipramine for attention deficit disorder in a borderline patient.

A subcategory of patients with borderline personality disorder (BPD) who also meet criteria for attention deficit disorder (ADD) has recently been described. The present case involves a young man with BPD and ADD who failed to respond to methylphenidate but experienced a marked reversal of anxiety, explosiveness, restlessness, and affective lability when treated with imipramine. Tricyclics may prove to be helpful in borderlines who also meet criteria for ADD.

Adult↗
PubMed1981

Antagonism of reserpine rigidity without inducing sedation.

The effects of pretreatment with chlorpromazine, promethazine or SKF 7265 on the severity of reserpine-induced rigidity were evaluated using a series of behavioral responses. Chlorpromazine (10 mg/kg) reduced the severity of the syndrome, particularly the tremor, but only at doses that also produced marked sedation. SKF 7265 was more effective than chlorpromazine and produced no detectable sedation or other motor impairment. Promethazine was ineffective in protecting against the effects of reserpine. These studies demonstrate that motor and behavioral abnormalities induced by high doses of reserpine can be blocked without inducing generalized sedation. This would suggest that it is possible to separate pharmacologically the motor pathways responsible for reserpine rigidity and those responsible for sedation.

Acridines↗