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The implications of life events and social integration in the course of combat-related post-traumatic stress disorder.

This study examined the relationships of life events and social integration with combat-related Post-traumatic stress disorder. The sample consisted of 255 Israeli soldiers who suffered a combat stress reaction episode during the 1982 Lebanon War and were followed one and two years after their participation in combat. Statistical analyses yielded significant effects of positive and negative life events and social integration on the diagnosis of post-traumatic stress disorder. Changes in the diagnosis of post-traumatic stress disorder from time 1 to time 2 were associated with life events and social integration. Theoretical and methodological implications of the findings were discussed.

Adult↗

Smoking withdrawal symptoms in response to a trauma-related stressor among Vietnam combat veterans with posttraumatic stress disorder.

This study investigated the relationship between a trauma-related stressor and smoking withdrawal symptoms in 25 male Vietnam combat veterans with posttraumatic stress disorder (PTSD) using a within-subjects design. All subjects were smokers. The stressor involved a modified Stroop task, in which the veterans color-named either anxiety-related or neutral control words. Anxiety-related words produced more withdrawal symptoms than neutral control words, including increased craving, negative affect symptoms, somatic symptoms, and lack of alertness.

Adult↗

Disordered society.

Explore the source record for details and available documents.

Combat Disorders↗

Posttraumatic stress disorder and comorbidity in Australian Vietnam veterans: risk factors, chronicity and combat.

OBJECTIVE: The objective of this study was to examine the relationship between combat-related posttraumatic stress disorder (PTSD) and comorbid DSM-III-R psychiatric diagnoses to determine commonalities in risk factors, relative onsets and the role of combat exposure. METHOD: An epidemiological cohort study using standardised psychiatric, social and health interviews was undertaken with a national random sample of male Australian Army Vietnam veterans. Interviews and searches of military records yielded risk factors for PTSD, which were examined for association with each psychiatric diagnosis. Relative onsets of PTSD and each Diagnostic Interview Schedule diagnosis were compared. Comorbidity odds ratios were adjusted for combat exposure effects using logistic regression, and the relation between each diagnosis and combat was assessed after controlling for PTSD. RESULTS: Commonality of risk factor profile was evident for several diagnoses, and for many their onset preceded PTSD onset. Combat was independently related to only a few diagnoses after controlling for PTSD, and PTSD remained strongly associated with several conditions after controlling for combat exposure. CONCLUSIONS: The analysis suggests that the disorders that may constitute risk factors or vulnerabilities for PTSD comprise depression and dysthymia, antisocial personality disorder, agoraphobia and simple phobia, while those that may be consequent on PTSD are panic and generalised anxiety disorder, drug use disorders and somatoform pain disorder. Alcohol and drug use disorders and social phobia may have a mixed aetiology, while obsessive-compulsive disorder may be serendipitously related to PTSD through an association with risk of combat. Gambling disorder is unrelated.

Adult↗

Combat, dissociation, and posttraumatic stress disorder in Australian Vietnam veterans.

The specificity of various wartime stressors for different posttraumatic stress disorder (PTSD) symptoms is inconsistently reported in the literature. Combat, wounding, and peritraumatic dissociation have not been assessed together in their effects on each of the various PTSD symptom clusters. This cohort study of a random sample of male Australian Army Vietnam veterans yielded psychiatric assessments of 641 subjects. PTSD measures comprised symptom criteria for reexperiencing, numbing and avoidance, hyperarousal, and PTSD diagnosis both lifetime and current within the past month. Logistic regression is used to examine the effects of combat, wounding, and peritraumatic dissociation together on PTSD. Combat experiences comprised four components derived from a principal components analysis of combat experiences: direct combat exposure, exposure to death and injury, exposure to civilian death and injury, and exposure to mutilation. Each was differentially related to reexperiencing, avoidance, hyperarousal, and PTSD diagnosis. Being wounded was not related to lifetime or current PTSD and peritraumatic dissociation was related to all diagnostic components of PTSD in the presence of other variables.

Australia↗

Quetiapine for treatment of refractory symptoms of combat-related post-traumatic stress disorder.

To assess the effects of adjunctive quetiapine for treatment of refractory symptoms of combat-related post-traumatic stress disorder (PTSD), charts of Vietnam veterans with war-connected PTSD who had been prescribed quetiapine were reviewed. Only patients with symptoms that had not responded to adequate therapy with two or more psychotropic medications prior to quetiapine treatment were analyzed. Addition of quetiapine to ongoing therapy resulted in further symptomatic improvements in DSM-IV PTSD criterion B (re-experiencing) for 35%, criterion C (avoidance/numbing) for 28%, and criterion D (arousal) for 65% of study subjects. Low doses of quetiapine (mean = 155 +/- 130 mg) were associated with minimal side effects. These results, although retrospective, suggest that augmentative quetiapine may benefit some refractory symptoms of PTSD in combat veterans.

Aged↗

What does the Keane et al. PTSD scale for the MMPI measure?

The correlations of the Keane, Malloy, and Fairbank (1984) MMPI PTSD scale with DSM-III-based post-traumatic stress disorder symptom, section, and factor score ratings, and with combat history, were studied to determine what aspects of the disturbance it measures (N = 61). The scale's correlations with the various symptom criteria were both substantial and strikingly consistent. However, its relationships with trauma history measures were modest and frequently nonsignificant. The data suggest that the scale is a moderately strong measure of the various PTSD symptoms, but is related only weakly to trauma history.

Adult↗

MMPI configural interpretation as applied to posttraumatic stress disorder in Vietnam veterans.

This study investigated the systems of Minnesota Multiphasic Personality Inventory (MMPI) configural interpretation of Skinner and Jackson (1978) and Kunce (1979) with Vietnam veterans with posttraumatic stress disorder (PTSD). MMPI profiles of four groups differing in combat exposure were compared on four MMPI configural variables from Kunce (1979) and Skinner and Jackson (1978). The four groups were (a) PTSD sufferers, (b) Vietnam combat veterans without PTSD, (c) Vietnam noncombat veterans, and (d) Vietnam era veterans. All groups were further divided into hospitalized versus nonhospitalized subgroups. Dependent variables were Skinner and Jackson's (a) sociopathic modal profile, (b) neurotic profile, (c) psychotic profile, and (d) Kunce's emotional expression (enthusiastic-reserved) dimension. Results indicated that hospitalized PTSD subjects had significantly higher scores on Skinner and Jackson's neurotic profile; both hospitalized and nonhospitalized PTSD subjects had higher scores on the psychotic profile and were more "reserved" on Kunce's emotional expression dimension. Results were interpreted in terms of configural MMPI interpretation systems and the adjustment of Vietnam veterans with PTSD. PTSD was viewed as exhibiting cognitive, somatic, and affective features.

Adult↗

Baclofen treatment for chronic posttraumatic stress disorder.

OBJECTIVE: Previous studies have shown the efficacy of gamma-aminobutyric acid B (GABA(B)) receptor agonists in treating anxiety in patients with panic disorder and in treating depression and anxiety in alcoholic patients. We hypothesized that baclofen, a GABA(B) agonist, would be an effective treatment in the symptomatic management of veterans with chronic posttraumatic stress disorder (PTSD). METHODS: Fourteen male veterans with chronic, combat-related PTSD were enrolled in an open-label, 8-week, monotherapy trial of baclofen titrated to a maximum of 80 mg/d in 3 divided doses. The primary outcome measure was the Clinician-Administered PTSD Scale (CAPS), and secondary outcome measures included the Hamilton Rating Scale for Anxiety, the Hamilton Rating Scale for Depression, the Global Assessment of Functioning Scale, and the Clinical Global Impressions. RESULTS: In the 11 patients who completed the 8-week trial, the mean total CAPS score decreased significantly from baseline (from 82.9 +/- 16.1 to 63.5 +/- 21.2). The avoidance and hyperarousal subscales showed significant decreases (from 36.2 +/- 6.2 to 26.5 +/- 9.6 and from 31.9 +/- 6.5 to 22.1 +/- 7.1, respectively), whereas the re-experiencing subscale remained unchanged. Significant improvements were also noted on all secondary outcome measures. Treatment response was noted within the first 4 weeks of treatment and was maintained throughout the trial. Baclofen therapy was well tolerated, as only 1 patient dropped out due to adverse effects. CONCLUSIONS: Baclofen therapy was effective in treating both the PTSD symptoms and accompanying depression and anxiety in patients with chronic PTSD due to combat. Larger, double-blind, placebo-controlled studies are needed to confirm the efficacy of baclofen in the treatment of PTSD.

Adult↗

War-related mental health problems of today's veterans: new clinical awareness.

1. Veterans of the military conflicts in Iraq and Afghanistan may have been exposed to significant psychological stressors, resulting in mental and emotional disorders. 2. Posttraumatic stress disorder (PTSD) is characterized by symptoms in three domains: reexperiencing the trauma, avoiding stimuli associated with the trauma, and symptoms of increased autonomic arousal. 3. Treatment of PTSD often requires both psychological and pharmacological interventions. 4. In addition to PTSD, other mental disorders may be precipitated or worsened by exposure to combat, including depression, anxiety, psychosis, and substance abuse.

Adaptation, Psychological↗

Metric development and score reporting in Rasch measurement.

This article: 1) describes problems in score reporting with the True-Score Model, 2) presents a definition of the Rasch measurement unit, the logit, 3) reviews various transformations of the logit metric, and 4) provides examples of score reporting procedures. Two data sets are used. The first contains dichotomous data drawn from responses to a multiple-response statistics examination taken by Ph.D. students; the second contains polychotomous data from a self-efficacy assessment given to war veterans suffering from Post Traumatic Stress Disorder.

Adult↗