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PubMed1996

Stress, suicide, and military service during Operation Uphold Democracy.

The initial weeks of Operation Uphold Democracy were marked by a high rate of major axis I disorders among soldiers presenting for treatment at the 528th Combat Stress Center. The mission to Haiti was also marked by three suicides during the first 30 days. The author explores psychodynamic sources of stress that may have contributed to the high level of psychiatric acuity observed during that first month. Then, distinctions are made between psychiatric conditions that present in combat and those that occur on peacekeeping missions.

Combat Disorders↗
PubMed2003

Clinical presentations in combat veterans diagnosed with posttraumatic stress disorder.

This article investigated subtypes of symptom patterns among male combat veterans diagnosed with posttraumatic stress disorder (PTSD) through a cluster analysis of their Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Graham, Ben-Porath, Tellegen, Dahlstrom, & Kaemmer, 2001) clinical and validity scales. Participants were 126 veterans seeking outpatient treatment for combat-related PTSD at a Veterans Affairs Medical Center. Two well-fitting MMPI-2 cluster solutions (a four-cluster solution and a three-cluster solution) were evaluated with several statistical methods. A four-cluster solution was determined to best fit the data. Follow-up analyses demonstrated between-cluster differences on MMPI-2 "fake bad" scales and content scales, the Beck Depression Inventory (BDI; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961), Dissociative Experiences Scale (DES; Bernstein & Putnam, 1986), Mississippi Combat PTSD scale (M-PTSD; Keane, Caddall, & Taylor, 1988), and Clinician-Administered PTSD Scale (CAPS-1; Blake et al., 1990). Clusters also were different in disability-seeking status, employment status, and income. Implications for research and clinical practice using the MMPI-2 with combat veterans presenting with PTSD are briefly addressed.

Adult↗
PubMed1993

Effects of the Persian Gulf War on veterans with combat-related post-traumatic stress disorder.

The authors prospectively studied 32 male veterans with combat-related post-traumatic stress disorder (PTSD) during the Persian Gulf War. The veterans were enrolled in a Veterans Affairs mental health clinic and met the DSM-III-R criteria for PTSD. The purpose of the study was to evaluate exacerbation and reactivation of PTSD symptomatology utilizing the Mississippi Scale and the Impact of Event Scale, two widely used self-report inventories for assessment of PTSD symptoms. Results did not support an increase in the PTSD symptoms of avoidance and intrusion during the actual combat period. Possible reasons for this finding are discussed.

Adult↗
PubMed2000

Platelet monoamine oxidase activity, ego strength, and neuroticism in soldiers with combat-related current posttraumatic stress disorder.

AIM: To assess possible differences in platelet monoamino oxidase-B (MAO-B) activity, ego strength, and neuroticism in combat-experienced soldiers with or without current posttraumatic stress disorder (PTSD). METHOD: The soldiers with current PTSD (N=36) and a control group of 34 healthy soldiers were matched in combat experience, time passed between combat experience and the study, demographic variables (age, marital status, education), and smoking status. Platelet MAO-B was assayed fluorometrically, ego strength was measured by the Croatian version of the Ego Identity Scale, and neuroticism by the N-scale from Eysenck's EPQ-R questionnaire. RESULTS: Soldiers with combat-related current PTSD had lower platelet MAO-B activity than the control group (9.1+/-3.9 vs. 11.9+/-4.0; p<0.05), as well as lower ego-strength (86.3+/-8.3 vs. 108.6+/-13.4; p<0.05) and higher neuroticism (23.5+/-13.2 vs. 5. 9+/-4.7; p<0.05). There was no association of ego strength or neuroticism with platelet MAO-B activity. CONCLUSION: Ego identity strength and emotional stability are associated with successful coping with combat trauma. The involvement of platelet MAO-B activity in biological basis of ego strength and neuroticism could not be demonstrated.

Adult↗
PubMed1994

[Implication of compensation in recovery from combat-induced post-traumatic stress disorder].

The effect of compensation payment on long-term adjustment of soldiers with war-induced psychic trauma was studied. 2 groups of combat stress reaction casualties of the 1982 Lebanon War were examined: 109 casualties had been recognized by the Ministry of Defence as eligible for benefits, while 111 casualties had not applied for compensation benefits. Data were collected from their IDF medical charts and computerized personal records, from clinical data collected by IDF clinicians, and by mail and telephone surveys. Results indicated that the groups were quite similar in social functioning before the war. However, in those compensated there was more distress and impaired functioning following the war and at follow-up. The role of compensation in recovery from war-induced psychic trauma is discussed.

Adaptation, Psychological↗
PubMed1981

Survivors of the holocaust and their children: current status and adjustment.

A group of 52 concentration camp and other survivors of World War II were compared with a control group of 29 persons of similar European and religious background. Forty-seven children of these survivors and 16 children from the comparison group were also evaluated. The psychological adjustment of both group of adults and their children was within the normal range. Cultural rather than specific survivor influences were noted in the present attitudes and behaviors of the parents. There were no significant differences between the survivor and control group children on any of the psychological variables or in thier attitudes and behaviors toward their parents. Based on these findings, we questioned notions of survivor guilt, the manifestation of emotional blunting in the survivors, and the extremely maladaptive psychological influence of their parents' experiences on the children of survivors.

Adjustment Disorders↗
PubMed2001

The adjustment of children of Australian Vietnam veterans: is there evidence for the transgenerational transmission of the effects of war-related trauma?

OBJECTIVE: The presence of posttraumatic stress disorder (PTSD) in trauma survivors has been linked with family dysfunction and symptoms in their children, including lower self-esteem, higher disorder rates and symptoms resembling those of the traumatized parent. This study aims to examine the phenomenon of intergenerational transfer of PTSD in an Australian context. METHOD: 50 children (aged 16-30) of 50 male Vietnam veterans, subgrouped according to their fathers' PTSD status, were compared with an age-matched group of 33 civilian peers. Participants completed questionnaires with measures of self-esteem, PTSD symptomatology and family functioning. RESULTS: Contrary to expectations, no significant differences were found between the self-esteem and PTSD symptomatology scores for any offspring groups. Unhealthy family functioning is the area in which the effect of the veteran's PTSD appears to manifest itself, particularly the inability of the family both to experience appropriate emotional responses and to solve problems effectively within and outside the family unit. CONCLUSION: Methodological refinements and further focus on the role of wives/mothers in buffering the impact of veterans' PTSD symptomatology on their children are indicated. Further effort to support families of Veterans with PTSD is also indicated.

Adaptation, Psychological↗
PubMed1999

Image control and symptom expression in posttraumatic stress disorder.

Despite the devastating impact of affective dysregulation in posttraumatic stress disorder (PTSD), there has been little research on how trauma relates to affect regulation. This study examines the relationship between the cognitive capacity to control mental images and symptoms of individuals with (N = 23) and without (N = 23) PTSD after exposure to SCUD missile attacks during the Gulf War. The capacity to control mental images, symptoms of posttrauma, anxiety, and anger were assessed. PTSD subjects with a high image control reported a higher capacity to control anger, lower levels of anger state and expression, and lower levels of intrusive symptoms compared with PTSD subjects with low image control. In individuals without PTSD, results show that the better the image control, the lower the control of anger and the higher the expression of anger. Image control seems to play different functions in the emotional regulation of normal subjects (facilitatory) and PTSD patients (protective).

Affect↗
PubMed1992

Use of hypnosis in the military.

This chapter will describe the use of clinical hypnosis in the military. As a result of the studies that were done during the Vietnam conflict, the relationship between post traumatic stress disorder and hypnotize ability was made. The author concludes that combat traumas enhance hypnotic potential in some veterans, and that veterans with excellent hypnotic potential begin to problem solve better preparing for a healthier post-war transition.

Combat Disorders↗
PubMed1989

Utility: Sensitivity and specificity in developing diagnostic tests of combat-related post-traumatic stress disorder (PTSD).

This paper summarizes strengths and weaknesses of clinical utility of tests that diagnose Vietnam combat-related Post-Traumatic Stress Disorder (PTSD). Weaknesses reviewed are: excessive reliance upon one kind of measure of Index Diagnosis; failure to control for varying prevalence rates across samples; failure to compare accuracy across response modalities. Strengths that emerge from the review are that self-report measures have proven to be highly sensitive, and psychophysiological measures have been demonstrated as highly specific. Whereas one single "gold standard" measure of PTSD has yet to be devised, clinical researchers can continue to have confidence in the use of multiple measures.

Combat Disorders↗
PubMed1989

Psychometric detection of fabricated symptoms of combat-related post-traumatic stress disorder: a systematic replication.

Vietnam veterans with post-traumatic stress disorder (n = 11) and two other groups of Vietnam veterans (n = 24) instructed to fabricate symptoms of post-traumatic stress disorder completed the MMPI. A discriminant function analysis that used scale F and the post-traumatic stress disorder subscale correctly classified 91% of the subjects. This systematic replication supports the utility of the MMPI as a component in evaluating the validity of self-reported symptoms of post-traumatic stress disorder in Vietnam veterans.

Adult↗
PubMed1998

Polysomnographic sleep is not clinically impaired in Vietnam combat veterans with chronic posttraumatic stress disorder.

BACKGROUND: Because sleep is typically disturbed in posttraumatic stress disorder (PTSD), this study was undertaken to evaluate a group of Vietnam combat veterans with the disorder using clinical polysomnographic techniques. METHODS: Eighteen Vietnam combat veterans with PTSD and 10 healthy non-combat-exposed Vietnam era veterans participated in 2 nights of polysomnographic study and a multiple sleep latency test. RESULTS: No significant differences between subjects and controls were noted except for greater sleep onset latency to stage 2 (p < .03), and lower arousals/hour from stages 3 & 4 (p < .04) on night 2, and lower subjectively estimated total sleep time on night 1 (p < .005) in the case of PTSD subjects. Otherwise, results from the second night served to replicate those from the first, and no significant differences appeared on 2 successive nights for any polysomnographic variable. No daytime hypersomnolence was detected. CONCLUSIONS: Polysomnographically recorded sleep was notably better than expected in the presence of clinically significant PTSD with typical histories of disrupted sleep. In these subjects, there is no clinically significant sleep disorder or typical pattern of sleep disturbance detectable by standard polysomnography.

Adult↗
PubMed1990

Naloxone-reversible analgesic response to combat-related stimuli in posttraumatic stress disorder. A pilot study.

We tested the hypothesis that exposure to a stimulus resembling the original traumatic event would induce naloxone-reversible analgesia in patients with posttraumatic stress disorder (PTSD). Eight medication-free Vietnam veterans with PTSD and eight veterans without PTSD, matched for age and combat severity, viewed a 15-minute videotape of dramatized combat under naloxone hydrochloride and placebo conditions in a randomized double-blind crossover design. In the placebo condition, the subjects with PTSD showed a 30% decrease in reported pain intensity ratings of standardized heat stimuli after the combat videotape. No decrease in pain ratings occurred in the subjects with PTSD in the naloxone condition. The subjects without PTSD did not show a decrease in pain ratings in either condition. The results are consistent with the induction of opioid-mediated stress-induced analgesia in the patients with PTSD.

Adult↗