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PubMed2000

Ambulatory cardiovascular activity in Vietnam combat veterans with and without posttraumatic stress disorder.

The present study investigated the relationship between daily diary affect ratings and ambulatory cardiovascular activity in 117 male Vietnam combat veterans (61 with posttraumatic stress disorder [PTSD] and 56 without PTSD). Participants completed 12-14 hr of ambulatory monitoring and daily diary affect ratings. Compared with veterans without PTSD, veterans with PTSD reported higher negative affect and lower positive affect in daily diary ratings. No differences were detected for mean laboratory initial recordings or mean ambulatory heart rate (HR), systolic blood pressure (SBP), or diastolic blood pressure (DBP). However, compared with veterans without PTSD, veterans with PTSD demonstrated higher SBP and DBP variability and a higher proportion of HR activity (compared with initial recording values) during daily activity. There was a significant Time of Day x Group interaction for mean HR, with a trend for PTSD participants to maintain HR levels during evening hours.

Affect↗
PubMed1990

Rorschach structure of a hospitalized sample of Vietnam veterans with PTSD.

Rorschach structural summary data are presented for a group of 41 posttraumatic stress disorder (PTSD) patients who were being treated in a specialized inpatient PTSD treatment program. Results suggest that patients suffering from PTSD exhibit impaired reality-testing abilities and tend to utilize ineffective coping strategies. The group's structural summary factors are presented as incipient normative data for the Exner Comprehensive System on patients with PTSD. Implications that these protocols suggest a more severe and pervasive level of psychopathology than would be expected from theoretical descriptions of the disorder are discussed.

Adult↗
PubMed1982

Overview: clinical applications of the Amytal interview in psychiatric emergency settings.

The authors review the evidence for the efficacy of the sodium amytal interview with particular reference to psychiatric emergencies and rapid assessment and treatment. Amytal interviews have a valid role in the assessment and initial management of catatonia, hysterical stupor, and unexplained muteness as well as in distinguishing between depressive, schizophrenic, and organic stuporous states. Valid therapeutic indications include the abreaction of traumatic neurosis, recovery of memory in amnesic and fugue states, and recovery of function in conversion disorders. The authors offer a protocol for application of the amytal interview in emergency settings.

Adult↗
PubMed1992

Age-related psychiatric comorbidities and level of functioning in alcoholic veterans seeking outpatient treatment.

The relationship of age and of level of adaptive functioning to comorbidity of mental disorders among alcoholics was studied in a survey of all alcoholics seeking outpatient mental health treatment in the Veterans Affairs mental health care system during a one-month period in 1986 (N = 22,463). More than half of the alcoholic outpatients had one or more comorbid psychiatric diagnoses. Rates for comorbid substance abuse disorders, posttraumatic stress disorder, schizophrenia, and personality disorders peaked in younger alcoholics and then decreased with age. Age-related increases were observed for major depression, anxiety disorders, and organic brain syndrome or dementia. DSM-III axis V ratings of poor to grossly impaired functioning were consistent across age groups. More than half of alcoholics with a comorbid psychiatric disorder were rated as severely impaired, compared with less than a third of those with no comorbid mental disorder.

Activities of Daily Living↗
PubMed1992

Are panic attacks traumatic stressors?

Like typical stressors that produce posttraumatic stress disorder (PTSD), panic attacks are sudden, unpredictable, and often perceived as life-threatening. Structured interviews with 30 subjects with panic disorder revealed that five (17%) and two (7%) met lifetime and current DSM-III-R PTSD criteria, respectively, following their most terrifying panic attack. PTSD produced by panic is less severe than PTSD produced by either rape or combat.

Adolescent↗
PubMed1994

Self-report versus observer ratings of distress and pathology in Vietnam veterans with PTSD.

Few efforts have been made to examine the relationship between standard self-report measures and observer ratings of distress in veterans suffering from post-traumatic stress disorder (PTSD). In the present study correlations between self-report (verbal ratings and scores on the Brief Symptom Inventory) and observer ratings (scores on the Brief Hopkins Psychiatric Rating Scale) of pathology and distress were analyzed for 40 Vietnam combat veterans participating in a weekly outpatient PTSD therapy program. The relationship of these measures to the Mississippi PTSD scale and measures of combat exposure and duration was also examined. Results suggested that the self report and observer measures of distress were significantly correlated for this group. While written self report and observer ratings were correlated with scores on the Mississippi Scale, verbal self reports of distress were not. However, the verbal self reports of distress were most strongly related to reported combat exposure.

Adult↗
PubMed2006

Quality-adjusted health status in veterans with posttraumatic stress disorder.

This study evaluated the quality-adjusted health status in veterans with posttraumatic stress disorder (PTSD). In a cross-sectional study veterans diagnosed with PTSD completed a quality-adjusted health status measure (Quality of Well-Being Self-Administered [QWB-SA] scale), PTSD symptom severity measures (Mississippi Scale for Combat-Related PTSD and Clinician-Administered PTSD Scale), and a depression severity measure (Beck Depression Inventory). Significant inverse relationships were identified between the QWB-SA and PTSD severity measures as well as between the QWB-SA and depression severity measures in this sample. Demonstration of these relationships suggests that greater symptom severity is associated with lower quality-adjusted health status in veterans with PTSD. More importantly, the QWB-SA was designed for use in cost-effectiveness analyses and may be useful in assessing the relative value of PTSD interventions compared with other mental and physical health interventions.

Combat Disorders↗
PubMed1993

Long-term traumatic stress reactions in British Falklands War veterans.

This brief report summarizes the first available findings on long-term traumatic stress syndromes among ex-servicemen who are veterans of the Falklands War. The results reveal a correlation between physical injury during the War and post-traumatic stress disorder, indicating the need for a long-term follow-up survey incorporating treatment evaluations and welfare rights.

Adult↗
PubMed1999

Psychopharmacology and posttraumatic stress disorder.

Posttraumatic Stress Disorder (PTSD) is a complex and challenging psychiatric disorder. Its more severe manifestations will require psychopharmacologic intervention. This paper offers guidance in the psychopharmacologic management of PTSD.

Arousal↗
PubMed1996

A profile of help-seeking Australian veterans.

While considerable information is available regarding American Vietnam veterans, surprisingly little has appeared concerning veterans of other nationalities who served in the Vietnam war. This paper provides a preliminary profile of help-seeking Australian veterans in order to afford a comparison with the available American data. Collected in the context of a review of the Vietnam Veterans Counselling Service (VVCS), demographic data suggest that the client population is similar in many ways to that of the American posttraumatic stress disorder (PTSD) Clinical Teams. Problems commonly reported by clients of VVCS included posttraumatic stress, relationship difficulties, anxiety, depression, and problems with pensions and benefits. A postal survey of a sub-sample of current clients revealed a mean score on the Combat Exposure Scale of 19.27 and a mean score on the Mississippi Scale for PTSD of 118.43. Again, these findings are broadly comparable with those of American help-seeking veterans.

Adaptation, Psychological↗
PubMed2006

External-cause mortality after psychologic trauma: the effects of stress exposure and predisposition.

Research suggests that exposure to psychologic trauma is associated with mortality from external causes, including homicide, suicide, drug overdoses, and unintended injury. However, the etiology of this association is unclear. We examined the survival time and cause of death among a national sample of 15288 US Army veterans by posttraumatic stress disorder (PTSD) status 30 years after military service. In these analyses, we included demographic (age, race, marital status, service entry age, and birthplace), predisposing (army volunteer status, discharge status, history of drug abuse, early-age alcohol use, and intelligence), and combat exposure variables. After adjusting for demographic and predisposing factors, all-cause mortality was associated with PTSD for all veterans combined (hazards ratio [HR] = 2.1, P < .001), as well as for era veterans without Vietnam service (HR = 2.0, P = .001) and theater veterans with Vietnam service (HR = 2.1, P < .001). For theater veterans, PTSD remained significant for all-cause mortality, even after controlling for demographic, predisposition, and combat exposure measures (HR = 2.1, P < .001). For external mortality, the adjusted results indicated that PTSD was associated with death for all veterans combined (HR = 2.3, P < .001) and for theater veterans separately (HR = 2.2, P = .002). For era veterans, the adjusted external mortality results also approached statistical significance (HR = 2.2, P = .068). Among theater veterans, PTSD remained significant for external mortality, even after controlling for all variables and combat exposure (HR = 2.2, P = .002). Combat exposure was not associated with external mortality once all variables were controlled. In addition, theater veterans who volunteered for Vietnam and those with dishonorable discharges were at increased risk for external-cause mortality.

Adult↗
PubMed1996

Baseline startle amplitude and prepulse inhibition in Vietnam veterans with posttraumatic stress disorder.

Although an exaggerated startle response is a symptom of posttraumatic stress disorder (PTSD), empirical support for elevated baseline startle in PTSD has been weak. The present study investigated the eyeblink component of the acoustic startle reflex and prepulse inhibition (PPI) in 21 unmedicated Vietnam veterans with PTSD and in 17 civilian and 10 combat veteran comparison subjects. Patients with PTSD exhibited normal acoustic startle amplitude, but showed a significant reduction in PPI relative to the civilian subjects. There was only a trend toward a reduction in PPI in the PTSD group compared with the combat control group. The study does not support the hypothesis of exaggerated baseline startle in Vietnam veterans with PTSD but suggests abnormal startle modulation by a prepulse (i.e., PPI). Discrepancies between studies concerning the amplitude of startle in PTSD are discussed.

Acoustic Stimulation↗
PubMed1992

Posttraumatic stress disorder: a review.

In this article, I have reviewed posttraumatic stress disorder with Vietnam veterans, soldiers in other wars, and in victims of natural and civilian disasters. A discussion of measurement and therapy approaches is included.

Combat Disorders↗
PubMed1982

A psychophysiological study of post traumatic stress disorder in Vietnam veterans.

Comparisons were made between a group of male Vietnam veterans suffering from Post-Traumatic Stress Disorder (PTSD) (n = 11) and an age and sex matched group of non-veteran controls (n = 11) on their psychophysiological responding (heart rate (HR), blood pressure (BP), forehead EMG, skin resistance level, and peripheral temperature) to mental arithmetic and an audiotape of combat sounds played at gradually increasing volume levels. The two groups responded differently to the combat sounds in terms of HR, systolic BP, and forehead EMG. The HR response could correctly classify 95.5% of the combined sample. Implications of these findings for the basis of PTSD are discussed.

Adult↗
PubMed1984

An assessment of the treatment needs of Vietnam-era veterans.

A needs assessment was conducted to determine the existence and extent of differences between Vietnam-era veterans and other veterans residing within the catchment area of the Northport Veterans Administration Medical Center. The results of a questionnaire completed by 486 veterans indicated that, compared with World War II and Korean War veterans, a greater percentage of Vietnam-era veterans reported experiencing the symptoms of posttraumatic stress disorder. They also reported more situational adjustment problems. A great number of Vietnam-era veterans expressed a need for psychotherapy and anger-control therapy, and they generally preferred to be treated with other Vietnam-era veterans who have had similar combat experience.

2,4,5-Trichlorophenoxyacetic Acid↗
PubMed1998

Measurement of dissociative states with the Clinician-Administered Dissociative States Scale (CADSS).

The purpose of this study was to develop an instrument for the measurement of present-state dissociative symptoms, the Clinician Administered Dissociative States Scale (CADSS). Reported here are interrater reliability and internal consistency of the CADSS, validity as assessed by comparisons with other instruments for the assessment of dissociation, and sensitivity of the CADSS to discriminate patients with dissociative disorders from patients with other psychiatric disorders and healthy subjects. Initial analyses indicated good interrater reliability and construct validity for the CADSS. Scores on the CADSS discriminated patients with dissociative disorders from the other groups.

Adult↗
PubMed1990

Adapted character styles of Vietnam veterans with Posttraumatic Stress Disorder.

A total of 189 male Vietnam veterans who were admitted to a specialized inpatient treatment program were evaluated using the Millon Clinical Multiphasic Personality Inventory to assess character styles. The veterans were assessed for Posttraumatic Stress Disorder by using a subscale of the Minnesota Multiphasic Personality Inventory (MMPI) and 72% of the patients were classified as having Posttraumatic Stress Disorder. The character styles of passive-aggressive, schizoid, avoidant, and borderline were significantly associated with these patients. The most common 2-point profile was passive-aggressive and avoidant (8-2 or 2-8) and was significantly related to the diagnosis. While drug and alcohol abuse were common problem areas for the entire sample, the profile of patients with Posttraumatic Stress was different from those of substance abusers. These results indicate that treating Vietnam veterans with this disorder requires adopting strategies which include a character style focus as well as a symptom focus.

Adaptation, Psychological↗
PubMed2001

Posttraumatic stress disorder among survivors of a kamikaze attack.

26 sailors who survived a Kamikaze attack during the battle for Okinawa in World War II were given two adapted forms of the Posttraumatic Stress Disorder Checklist-Civilian to assess the psychological reactions they had to the sinking of their ship. Depending on the assessment criteria used, their responses indicated significant stress reactions ranging from 8.3% to 44% of the sample. The findings provide evidence that a single combat experience can have lifelong, averse psychological effects.

Accidents, Aviation↗