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[Hormonal function of the thymus gland in melanoma of the skin: relation to functional disorders of other endocrine glands].

The analysis of correlations between levels of epiphyseal, hypophyseal, adrenocortical and gonadal hormones suggested functional disorders developing in these glands to be interdependent and account for dysfunction of the thymus and immune system in patients suffering malignant melanoma. The degree of relationship between pituitary-adrenal system and thymus function disorders increased with tumor size; it was more pronounced in males. The rationale for application of pineal gland preparations in melanoma patients aimed at combatting neuroendocrine disorders is discussed.

Endocrine Glands↗

Media triggers of post-traumatic stress disorder 50 years after the Second World War.

Post-traumatic stress disorder (PTSD) may present many years after the original trauma. Case studies of two elderly patients are described. Both had experienced life-threatening combat situations and witnessed intense suffering during the Second World War. Marked distress was triggered by the media commemorating the fiftieth anniversary of the end of the war. PTSD patients often avoid talking of their traumatic experiences because of associated distress. Without taking a military and trauma history from elderly patients the diagnosis is likely to be missed.

Aged↗

Psychometric evaluation of post-traumatic stress disorder: the Multidimensional Personality Questionnaire as an adjunct to the MMPI.

Two groups of Vietnam veterans--Post-traumatic stress disorder (PTSD, n = 17) and non-PTSD (n = 80)--were developed from a sample of treatment-seeking alcohol abusers. The subjects completed a Combat Experiences Questionnaire, a PTSD Symptom Scale, the MMPI, and the Multidimensional Personality Questionnaire (MPQ). The MPQ proved to be a useful adjunct to the MMPI in describing the major manifestations of PTSD among alcohol-abusing veterans.

Adult↗

Post-traumatic stress disorder: a psychiatric defense.

Post-traumatic stress disorder (PTSD) is one of the anxiety disorders recently included in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III).(1) The disorder refers to the psychological sequelae that may follow a significant stressor. The military has previously referred to PTSD as "war neurosis," "shell shock," and "combat neurosis."PTSD has recently gained attention as a means of legal defense. As a defense, it may exist separately from "innocence by reason of insanity." The authors review the literature, provide case vignettes exemplifying the clinical features, and present three additional cases that gained local and national notoriety because of their defense motions. The senior author served as an expert witness in these cases. Recommendations are given to readers who may in the future serve as expert witnesses or consultants in similar cases.

Adult↗

Differentiating overreporting and extreme distress: MMPI-2 use with compensation-seeking veterans with PTSD.

This purpose of this study was to examine overreporting on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) in compensation-seeking veterans with posttraumatic stress disorder (PTSD). A sample of veterans tested during a V.A. hospital compensation and pension exam were given the MMPI-2 and measures of PTSD, depression, and combat exposure. Veteran's MMPI-2s were only included in the analyses if their profile was extremely exaggerated, as measured by an F scale T score above 80, did not elevate the MMPI-2 VRIN and TRIN scales, and had a primary diagnosis of PTSD (n = 127). Using the Infrequency-Psychopathology, F(p), scale to distinguish overreporting from distress, it was found that 98 veterans elevated profiles due to distress, whereas 29 elevated due to overreporting, F(p) below and above 7, respectively. Differences between groups on MMPI-2 clinical scales and the other measures were assessed. Implications of these findings for assessing veteran response style and using the MMPI-2 with a PTSD population are discussed.

Analysis of Variance↗

Cellular and molecular aspects of monoamine neurotransmitter transporters.

Neurotransmitter transporters terminate synaptic neurotransmission by accumulating neurotransmitters once again after release in a sodium- and chloride-dependent fashion. The availability of the cloned neurotransmitter transporters has allowed investigation into the roles of these transporters in neuronal function. Molecular biological and protein engineering studies including in vitro site-directed mutagenesis, chimera formation of several transporter clones, or epitope-tagging various regions of transporter proteins, have revealed the topology and functionally mapped the transporter proteins. Monoamine neurotransmitter transporters such as those for dopamine, norepinephrine and serotonin are of interest, since they are a target of drugs of abuse and are involved in neuronal disorders including Parkinson's disease and depression. Therefore, elucidating the molecular basis of these transporters may clarify these problems and help develop treatments with which to combat these disorders and drug abuse.

Binding Sites↗

Quantitative electroencephalogram (qEEG) in combat veterans with post-traumatic stress disorder (PTSD).

Only a small number of studies have used quantitative electroencephalography (qEEG) in research of the post-traumatic stress disorder (PTSD). The results are not consistent. The aim of the present investigation was to compare qEEG in combat veterans with and without PTSD. The hypothesis is that differences among qEEG characteristics will be found regarding the presence/absence of PTSD. Seventy-nine combat veterans with PTSD comprised the experimental group and 37 veterans without PTSD were included as controls. After the informed consent, they were investigated by the resting EEG recordings. The results demonstrate that PTSD veterans had decreased alpha power and increased beta power. These results suggest an altered neurobiology in PTSD. Various explanations have been offered for alpha activity decrease observed in PTSD veterans. Increased beta rhythm may play a role as a potential marker in differentiating subtypes of PTSD.

Adult↗

Diagnosing and managing posttraumatic stress disorder.

In addition to being associated with combat, posttraumatic stress disorder (PTSD) also occurs in civilians exposed to severe trauma or serious illness. Manifestations of PTSD are varied and commonly include nonspecific physical symptoms, sleep disturbances, and psychological problems. Treatment with selective serotonin reuptake inhibitors (SSRIs) is usually effective.

Diagnosis, Differential↗

A cross-validation of the Keane and Penk MMPI scales as measures of post-traumatic stress disorder.

The scores of DSM-III-diagnosed post-traumatic stress disorder (PTSD) patients (N = 116), psychiatric patients who did not meet the criteria, and normals (N = 19) on the Keane, Malloy, and Fairbank (1984) PTSD and Penk Combat scales for the MMPI were compared. The Keane scale discriminated PTSD-positive patients from normals at a substantial level of accuracy (omega 2 = .23; mean hit rate = 80.5%) and PTSD-positive from PTSD-negative patients at a more modest level (omega 2 = .09; mean hit rate = 64%). The scores of the PTSD-positive and PTSD-negative patients were considerably lower than those of Keane et al.'s (1984) samples, which suggests that local norms may be needed to facilitate their interpretation. The Penk Combat Intensity scale, which was correlated highly with the Keane scale, differentiated the PTSD-positive patients from both the normals and the PTSD-negative patients, but with less differentiating power (omega 2'S = .07 and .08). The Penk Combat Exposure scale did not separate the groups.

Combat Disorders↗

Physiologic responses to loud tones in Israeli veterans of the 1973 Yom Kippur War.

Eyeblink and autonomic components of the acoustic startle response were evaluated in a community sample of Israeli veterans of the Yom Kippur war. Individuals were solicited by mail and telephone to participate in the study; they were not seeking treatment or compensation. Nineteen Israeli veterans with current posttraumatic stress disorder (PTSD) and 74 veterans without PTSD were exposed to 15 consecutive 95-dB, 500-msec, 1000-Hz tones with 0-msec rise and fall times, while orbicularis oculi electromyogram, skin conductance, and heart rate responses were measured. Individuals with PTSD produced larger averaged heart rate responses, and a slower decline in skin conductance responses, across the 15 tone presentations compared to non-PTSD subjects. There was no group difference in the magnitude of the averaged electromyogram response. Results of this study replicate previous findings of increased autonomic responses to loud tone stimuli in this disorder.

Acoustic Stimulation↗

Cortisol regulation in posttraumatic stress disorder and major depression: a chronobiological analysis.

The aim of the present study was to evaluate the pattern of basal cortisol release in PTSD and major depression using a chronobiological analysis. Plasma for cortisol determination was obtained from 15 combat veterans with PTSD, 14 subjects with major depression, and 15 normal men every 30 min during a 24-hour period of bed rest. Raw cortisol data were modeled using standard and multioscillator cosinor models to determine the best fitting functions for circadian, hemicircadian, and ultradian components of cortisol release. PTSD subjects had substantially lower cortisol levels, and displayed a pattern of cortisol release that was better modeled by circadian rhythm. PTSD subjects also showed a greater circadian signal-to-noise ratio than the other groups. In contrast, depressed patients displayed a less-rhythmic, more chaotic pattern of cortisol release. The pattern of cortisol secretion and regulation observed in the PTSD group under baseline conditions may reflect an exaggerated sensitization, whereas the chronobiological alterations in depression may reflect dysregulation, of the hypothalamic-pituitary-adrenal (HPA) axis.

Adult↗

Posttraumatic stress disorder and the MCMI-II.

This study investigated the MCMI-II profile characteristics of 39 veterans diagnosed with Posttraumatic Stress Disorder. Characteristics of the mean group profile were similar to prior findings reported in the literature on the MCMI and Posttraumatic Stress Disorder with highest mean elevations found on the Avoidant, Passive-Aggressive, Schizoid, and Antisocial basic personality scales, the Borderline and Schizotypal pathological personality scales, and with elevations on the Anxiety, Dysthymia, Alcohol Dependence, Drug Dependence, and Major Depression clinical syndrome scales. A multivariate analysis of variance comparing the group with Posttraumatic Stress Disorder with a non-PTSD comparison group of 39 on the basic personality, pathological personality, and the clinical syndrome scales of the MCMI-II was not statistically significant. Nonetheless, univariate analyses of variance comparing the two groups on the individual modifier scales and the individual personality and clinical syndrome scales of the MCMI-II using a Bonferroni adjusted probability indicated significant differences on the Desirability and Histrionic scales. Response-style bias as a possible factor in MCMI-II profiles for the group with Posttraumatic Stress Disorder is also discussed.

Adult↗

The Keane PTSD Scale extracted from the MMPI: sensitivity and specificity with Vietnam veterans.

A study was conducted to further investigate whether the Keane Posttraumatic Stress Disorder (PTSD) Scale of the Minnesota Multiphasic Personality Inventory (MMPI) can be employed as a separate instrument administered outside the context of the full MMPI. A group of Vietnam combat veterans with diagnosed PTSD and two comparison groups of veterans without PTSD (Vietnam combat and era veterans) were diagnosed by clinical interviews. Over 84% of the 64 veterans in the study were accurately classified by the Keane PTSD Scale into their original diagnostic groups. Excellent test sensitivity was demonstrated, with 90% of combat veterans with PTSD being properly classified by the Keane PTSD Scale when the recommended cutoff score of 30 was utilized. The clinical and research implications are discussed.

Adult↗