bluuebunny/crossref_metadata_2025 huggingface dataset:
Coping with sexual assault: The roles of account‐making and confiding
Authors: Harvey John H. , Chwalisz Kathleen D. , Garwood Gail , Orbuch Terri L.
Published: June 2007

A study was conducted to evaluate the roles of account‐making (i.e., story‐like constructions involving explanations, reported memories, description, and emotional expression) and confiding in empathic others as facilitators of recovery for survivors of sexual assault. Twenty‐five women and one man anonymously participated in a questionnaire study that asked them to provide accounts of instances of sexual assault, their own and others' reactions to the assault, and their perceptions of the impact of the assault on aspects of their lives. Respondents' reactions were coded and classified by independent raters. Consistent with parts of the theoretical conception, included among the findings were the following: (1) account‐making was positively associated with successful coping and with helpful confidant reactions; (2) empathic confidant reactions occurring early after the assault led to more successful coping than did nonempathic reactions occurring either in the first twelve months or later after the assault; and (3) incest survivors indicated that they had more difficulty in coping and in their close relationships than did nonincest survivors. The data are discussed in terms of the value of story‐construction activities and confiding as vital to the recovery process.
Chronic combat‐related PTSD and concurrent substance abuse: Implications for treatment of this frequent “dual diagnosis”
Authors: Boudewyns Patrick A. , Hyer Lee , Albrecht J. William , Woods M. Gail
Published: June 2007

Vietnam combat veterans suffering from post‐traumatic stress disorder (PTSD) who had requested treatment through a special VA‐sponsored PTSD treatment program were evaluated using the Diagnostic Interview Schedule (DIS). Based on the DIS, 91.12% of the sample had a lifetime diagnosis of substance abuse or dependence and this was, by far, the most frequent co‐diagnosis in the sample. The most common reason for patients not completing the treatment program was for use of illegal substances or alcohol while in the program, even though they were aware that to do so meant that they would be either discharged or transferred to another unit. The percentage of other co‐diagnoses, and an estimate of currentness for all Axis I diagnoses were also presented on the sample of 102 patients. It was determined that for this population, the symptoms of substance abuse were chronic and were inextricably intertwined with PTSD symptoms and with the initial stressor (combat). Treatment process implications were discussed.
Learning about combat stress from Homer's Iliad
Authors: Shay Jonathan
Published: June 2007

Vietnam Veterans with severe post‐traumatic stress disorder often report the following combat experiences: a leader's betrayal of “what's right,” lost responsiveness to claims outside a tiny circle of combat‐proven comrades, grief and guilt for a dead special comrade, lust for revenge, renunciation of homecoming, feeling “already dead,” going berserk, dishonoring the enemy, and atrocities. These elements are all in Homer's Iliad account of Achilles, allowing the reader to witness them as they happen, so to speak. Homer's view of healing and regained humanity is discussed in relation to the Iliad's final scene. The Iliad offers a cross‐cultural look at men in battle, and raises questions about some assumptions in American military culture, particularly regarding grief and the need to degrade the enemy to make men fight. Betrayal of “what's right” and the berserk state are suggested as key pathogens for PTSD in combat soldiers.
Role players: A brief, intensive training program to portray acute psychological distress
Authors: McCaughey Brian G.
Published: June 2007

Role players can be used to help train medical personnel to deal with the victims of psychological trauma. An important aspect of this training process is to make the role player presentations as realistic as possible. A program was developed at the Uniformed Services University of the Health Sciences to teach role players how to portray one kind of psychological distress: battle fatigue. The following is a brief description of the methods that were used to train these role players. Key elements of the program were: (1) identify the psychological syndrome, (2) select role players, (3) educate the role players about the syndrome, (4) role players practice the role, (5) present the role to the medical students.
Work with traumatized children — psychological effects and coping strategies
Authors: Dyregrov Atle , Mitchell Jeffrey T.
Published: June 2007

Work with traumatized children has a profound effect on emergency personnel and other health care providers. It is hypothesized that work with seriously ill or injured children potentiates motivating factors in the helper's personality, brakes down natural defenses and leads to strong identification with the victims. In this paper various psychological effects on the rescuer are outlined Coping strategies used by health care personnel in the acute phase of an emergency are identified. Mental preparation, suppression of emotions, distancing from certain aspects of the event, and dehumanizing were frequently utilized coping strategies. Other coping mechanisms were regulating the amount of exposure, activities to restrict reflection, developing a sense of purpose, and self‐reassuring comments. Postexposure response to child trauma include helplessness, fear and anxiety, existential insecurity, rage, sorrow and grief, intrusive images, self‐reproach, shame and guilt, and changes in values. Emotional distancing and other self‐protective strategies seem important at the scene; self‐disclosure by talking about impressions and reactions is most helpful afterwards. However, carefully timed and executed interventions are necessary to break through the defensive barriers which are established by health care and other emergency personnel.
Illusions (and shattered illusions) of invulnerability: Adolescents in natural disaster
Authors: Greening Leilani , Dollinger Stephen J.
Published: June 2007

It is suggested that, even in the absence of emotional sequelae, victims of trauma continue to feel vulnerable to similar future victimization. We hypothesized this to be true even for adolescents who, theoretically, tend to view themselves as invulnerable to death itself. Subjects were 455 adolescents sampled from 12 high schools, most located in communities where known weather disasters occurred (i.e., flood, tornado, and/or lightning‐strike). Subjects estimated the likelihood of dying from 24 lethal events including weather events, accidents, diseases, and acts of human agency. Results showed that personal experience with weather disasters was predictive of elevated subjective risks for death from future respective events. Group differences were not found to be attributable to differences in general perceived riskiness, gender, tendencies toward thrill seeking or attention to the news media. Analyses of a subgroup of lightning subjects suggest that such effects can last as long as 7 years.
Fluoxetine reduces explosiveness and elevates mood of vietnam combat vets with PTSD
Authors: Shay Jonathan
Published: June 2007

Thirteen of 18 depressed Vietnam War combat veterans who had frequent, explosive outbursts of rage enjoyed reduced explosiveness when treated with fluoxetine, They displayed and reported a greater ability to think rather than act. Duration of anger also diminished; and mood improved.
The prevalence of post‐traumatic stress disorder in the Vietnam generation: A multimethod, multisource assessment of psychiatric disorder
Authors: Schlenger William E. , Kulka Richard A. , Fairbank John A. , Hough Richard L. , Kathleen Jordan B. , Marmar Charles R. , Weiss Daniel S.
Published: June 2007

Findings from the Congressionally mandated National Vietnam Veterans Readjustment Study indicate that nearly one‐half million Vietnam veterans —15.2% of the men and 8.5% of the women who served in Vietnam—suffer from post‐traumatic stress disorder (PTSD) fifteen or more years after their military service. Current PTSD prevalence rates for Vietnam veterans are significantly and substantially higher than the rates for their comparable Vietnam generation peers, which range from 0.3% to 2.5%. Additionally, the current prevalence rate among male Vietnam veterans was found to differ significantly among race/ethnicity subgroups: 27.9% among Hispanic men, 20.6% among black men, 13.7% among white/other men. Multivariate analyses indicated that although background factors are significantly related to the current prevalence of PTSD, the current prevalence is much higher among Vietnam veterans than among era veteran and civilian counterpart comparison groups even after background differences are taken into account. These analyses also demonstrated the important role of exposure to combat and other types of war zone stress in the current prevalence of the disorder.
Trauma reactivation assessment and treatment: Integrative case examples
Authors: Hiley‐Young Bruce
Published: June 2007

A framework for differentiating between subtypes of trauma reactivation is presented as a guide to client‐treatment matching. Case examples are given to illustrate uncomplicated reactivation, complicated reactivation, and respective treatment implications. The rationale for utilizing a psychoeducational approach for treatment of uncomplicated reactivation and a psychodynamic approach for treatment of complicated reactivation is presented. Treatment implication for short‐term disaster counseling services are discussed.
Shame and its contribution to PTSD
Authors: Wong Martin R. , Cook David
Published: June 2007

Post‐traumatic stress disorder is a legacy of the Vietnam War. Perhaps as many as a half‐million U.S. veterans suffer from the problem to some degree. Hospitalized U.S. veterans, diagnosed as suffering from PTSD were given the Internalized Shame Scale, the Beck Depression Inventory, and the Rosenberg Self‐Esteem Scale. Hospitalized veterans suffering from (1) depression and (2) substance abuse were also given these instruments and the resulting data were compared. Veterans suffering from PTSD scored higher on Internalized Shame and on Depression than did the Substance Abuse group and scored higher numerically on Depression than did the Depression group itself. All groups were compared on factors related to Shame, Inferiority and Alienation. Data indicated that the PTSD group scored numerically highest on both factors. Results are discussed in accordance with current Shame induction theory.
Alexithymia as a predictor of treatment response in post‐traumatic stress disorder
Authors: Kosten Thomas R. , Krystal John H. , Giller Earl L. , Frank Julia , Dan Elisheva
Published: June 2007

Fifty‐seven veterans with post‐traumatic stress disorder (PTSD) completed the Alexithymia Provoked Response Questionnaire (APRQ) upon entering an 8‐week randomized trial comparing phenelzine, imipramine, and placebo. Low alexithymia on the APRQ significantly predicted improvement on the avoidance items of the Impact of Events Scale (IES) particularly among patients treated with placebo, but was not associated with changes in the intrusion items of the scale.
Adolescent survivors of massive childhood trauma in cambodia: Life events and current symptoms
Authors: Realmuto George M. , Masten Ann , Carole Linda Flies , Hubbard Jon , Groteluschen Andrea , Chhun Bunkhean
Published: June 2007

Cambodian adolescents who survived massive trauma as children were studied to examine the relation of current trauma symptoms to sex, age, trauma exposure, and other current symptoms. Exposure to traumatic life events was expected to be very high, to relate to age and to other symptoms of current psychological functioning. Questionnaires assessed traumatic life events, post‐traumatic stress disorder (PTSD) and other psychiatric symptoms, and current functioning. Results document high levels of stress exposure and current trauma symptoms. Based on self‐reports of PTSD symptoms, 37% of the subjects were estimated to fulfill DSM‐III‐R criteria for PTSD. Trauma symptoms were correlated with exposure (r =.31), although not with symptoms of depressed mood, anxiety, or dissociation. Age was related to high levels of recollected trauma exposure (r =.56). Further studies are needed to identify factors associated with better outcomes and to plot the differential course of PTSD symptom clusters over time.
Recall of traumatic memories following cerebral vascular accident
Authors: Cassiday Karen L. , Lyons Judith A.
Published: June 2007

We present a case of delayed post‐traumatic stress disorder (PTSD) in a WWII combat veteran who developed symptoms following medical retirement. Following a subsequent cerebral accident (CVA) Mr. J experienced intrusive thoughts, recalled forgotten war memories, began avoiding reminders of war (e.g., stopped teaching marksmanship), and experienced dissociative episodes in which he felt as though he was in hand‐to‐hand combat. Mr. J's example suggests that the disinhibiting sequelae of CVA's, and other neuropsychological deteriorations that are likely to occur with poor health and advancing age, may influence expression of PTSD symptoms.
Assessment of intrusive cognition in PTSD: Use of the modified Stroop paradigm
Authors: McNally Richard J. , English George E. , Lipke Howard J.
Published: June 2007

In this article, we review research supporting the modified Stroop color‐naming paradigm as a means for assessing intrusive cognition in patients with posttraumatic stress disorder (PTSD). Because Stroop interference reflects involuntary semantic activation, delayed color‐naming of trauma‐related words can provide an objective index of intrusive cognition that is not based on self‐report. In a replication and extension of previous research, we found that Vietnam combat veterans with PTSD exhibited Stroop interference for trauma‐related words but not for other threat words, positive words, or neutral words. Also, we provide reliability and validity data on the paradigm.
The evolution of mental health responses and research in Australian disasters
Authors: Raphael Beverley , Meldrum Lenore
Published: June 2007

This paper overviews the development of Australian mental health services during disasters as well as recording research conducted and outcomes published. A comprehensive review of disaster research conducted on the Australian continent over the past 15 years has been undertaken. This includes “natural disasters” of flood, bushfire, cyclone, and earthquake; as well as “man‐made” disasters of rail accident, bus crash, shipwreck, and mass shootings. The Australian mental health response to disasters has evolved progressively through a changing focus from broad evaluations in early studies to systematic exploration of the mental health impact. Ongoing research should consider prevention at every level, further exploration of etiology, and the issues of service provision across the diverse nature of Australian society.
Patterns of positive readjustment in Vietnam combat veterans
Authors: Wolfe Jessica , Keane Terence M. , Kaloupek Danny G. , Mora Catherine A. , Wine Pamela
Published: June 2007

This study examines readjustment patterns in 152 Vietnam combat veterans. Subjects were nontreatment‐seeking volunteers who felt that they had made an adequate life adjustment since Vietnam. Using a set of self‐report instruments, data were obtained on background characteristics, military experiences (including combat), exposure to war trauma, current day PTSD symptomatology, and types of coping strategies. A subset of well‐functioning veterans with substantial combat exposure was identified. Results indicated that these veterans suffered considerable distress during wartime but that they dealt with current recollections of this experience in a fashion that was significantly different from more symptomatic cohorts. Nonavoidant coping styles characterized the functioning of well‐adjusted veterans; furthermore, type of coping strategy predicted current adjustment better than combat exposure. Implications of different approaches to coping are discussed, particularly as they relate to the long‐term integration of traumatic war experiences.
Effect of family role on response to disaster
Authors: Solomon Susan D. , Bravo Milagros , Rubio‐Stipec Maritza , Canino Glorisa
Published: June 2007

This study hypothesized that family role (marital and parental status) would moderate the effect of disaster exposure on the mental health of victims. The study included St. Louis residents exposed to floods and dioxin, as well as Puerto Rican respondents exposed to floods and mudslides. In St. Louis, worst outcomes were found for single and married parents exposed to disaster, substantially exceeding the symptomatology of all unexposed respondents except non‐victim single parents. In Puerto Rico, victims without families had higher levels of alcohol abuse symptoms than did any other subgroup. Perceived emotional support was found to be an important moderator of disaster's effect on psychiatric distress in this site, generally overriding the effect of family role. Single parents in both sites who were exposed to disaster had substantially reduced levels of emotional support available to them, as compared to unexposed single parents, suggesting that single parents are at particularly high risk for losing access to emotional support following a disaster. This study suggests that both single and married parents constitute important high‐risk victim groups. The findings also suggest that those perceiving they lack adequate emotional support, regardless of family role, may be in special need of services.
Evaluation of psychological debriefings
Authors: Robinson Robyn C. , Mitchell Jeffrey T.
Published: June 2007

This paper describes the impact of critical incidents and psychological debriefings on 172 emergency service, welfare and hospital personnel in Australia. Experience of trauma at work was found to reactivate prior trauma in one in two personnel. Psychological debriefing was reported to reduce stress symptoms in almost all personnel who reported stress response. The effectiveness of the debriefing was found to derive, in large part, from talking and in particular from talking with others who had experienced the same situation.
Do child sexual abuse experts hold pro‐child beliefs?: A survey of the international society for traumatic stress studies
Authors: Kovera Margaret Bull , Borgida Eugene , Gresham April W. , Swim Janet , Gray Ellen
Published: June 2007

As psychologists become increasingly involved in child sexual abuse cases, professional concerns have been expressed about their partisan orientation as child advocates. A survey was administered to examine the beliefs about child sexual abuse and children's capabilities as witnesses held by a sample (N = 340) from the International Society for Traumatic Stress Studies (ISTSS). Multivariate analyses of variance suggest that female ISTSS members generally have stronger beliefs in the credibility of child witnesses than male members. Additionally, ISTSS members who work with victims of sexual assault generally have stronger beliefs in the credibility of children than members who work with veterans or other sufferers of traumatic stress reactions. Moreover, ISTSS members from southern geographical regions are less likely than respondents from other regions to endorse items in a manner that has favorable implications for a child witness. Beliefs of ISTSS respondents do not differ as a function of their educational background. Implications for the role of child sexual abuse experts in the legal system are discussed.
Avoidant symptoms cloaking the diagnosis of PTSD in patients with severe accidental injury
Authors: Epstein Richard S.
Published: June 2007

In a pilot study of seriously injured accident victims, 15 patients selected in initial intake interviews were followed at 9‐ to 10‐week intervals for 9 months after admission to a community shock‐trauma center. Psychiatric diagnoses were based on a structured psychiatric interview. A total of six patients met criteria for PTSD. In two cases, PTSD was not diagnosed until 3 to 6 months after injury, primarily because of severe avoidant symptomatology. In another case, intrusive and arousal symptoms were not immediately explainable as a manifestation of PTSD, because it was mistakenly believed that the patient had been unconscious during the accident. Diagnosis in two of these would probably have been missed without frequent follow‐up interviews. Findings suggest that avoidant symptoms of PTSD can interfere with diagnosis. This has important consequences for outcome studies. It is suggested that frequent follow‐up after a traumatic event may reduce the level of false negatives in population studies.
Post‐traumatic stress disorder among the injured of the intifada
Authors: Khamis Vivian
Published: June 2007

The current study aimed to assess the prevalence of PTSD among Palestinians who sustained serious bodily injuries during the intifada, as well as to delineate factors having an effect on the development and attenuation of PTSD symptomatology. Results indicated evidence of high prevalence of PTSD among the injured. No significant differences in PTSD prevalence for demographic, situational, and trauma‐related variables were found except for the age factor. Prevalence of PTSD among adolescents was significantly higher than among adults. It seemed that the injury itself was so intensely overwhelming that the other variables were overshadowed. Implications for further research and stress management techniques were discussed.
A cognitive model of guilt typology in combat‐related PTSD
Authors: Kubany Edward S.
Published: June 2007

Dysfunctional guilt is a prominent feature of combat‐related, post‐traumatic stress disorder (PTSD). The present article describes a model of combat‐related guilt that distinguishes guilt types on the basis of specific false assumptions and errors of logic that are frequently associated with different kinds of traumatic circumstances. Two common types of combat‐related guilt based on this conceptualization are described and cognitive relabeling treatment strategies which have a “type” specific focus are outlined. The needs for research on guilt assessment among trauma survivors and for interventions that focus explicitly on guilt management are discussed.
Childhood abuse experiences and combat‐related PTSD
Authors: Zaidi Lisa Y. , Foy David W.
Published: June 2007

Current literature on the etiology of combat‐related PTSD strongly implicates combat trauma exposure as a primary etiological factor. However, studies of premilitary variables have produced conflicting results, perhaps in part due to methodological inconsistencies and failure to employ standardized measures. The present study examines one premilitary variable, childhood physical abuse history. Using a standardized measure developed by child abuse researchers, forty‐five percent of veterans with PTSD were identified as recipients of abusive physical punishment during childhood. A positive correlation between physical abuse history and severity of combat‐related PTSD was found. These preliminary findings set the stage for further investigation of the child abuse variable and underscore the need for treatment of veterans with combat‐related PTSD which addresses developmental traumagenic events.
A nation's response to attack: Israelis' depressive reactions to the gulf war
Authors: Lomranz Jacob , Eyal Nitza , Hobfoll Stevan E. , Johnson Robert , Zemach Mina
Published: June 2007

We examined Israelis' reactions to the Gulf War and SCUD missile attacks. Four national samples of Israelis (n = 3,204) were interviewed as to depressive mood on four occasions—prior to the Gulf Crisis, as the war approached, during the SCUD missile attacks, and after cessation of hostilities. There was an expected increase in depressive mood during the period of SCUD missile attacks and a quick return to base‐line levels following the hostilities. Less educated and older individuals reported higher base‐line levels of depressive mood and were at higher risk for clinical depression. Women and men did not differ in depressive mood before or after the SCUD missile attacks. However, women experienced a marked increase in depressive mood when the SCUD missile attacks occurred.
The relationship between traumatic exposure, family dysfunction, and post‐traumatic stress symptoms in male juvenile offenders
Authors: Burton Douglas , Foy David , Bwanausi Chenga , Johnson Jim , Moore Larry
Published: June 2007

This study examined some chronic, stressful conditions and some acute traumatic events which may place youths at risk for specific types of psychopathology. Ninety one delinquent adolescents with histories of serious and repeated crimes were assessed for their exposure to 11 different types of trauma. The subjects were also tested using measures which assess family functioning, and frequency and intensity of Post‐Traumatic Stress Disorder (PTSD) symptoms. Results indicated that 24% of the subjects tested met full DSM III‐R criteria for PTSD. Both exposure to violence and family dysfunction were significantly associated with PTSD symptomatology. These findings suggest that juvenile offenders may constitute a high risk group for exposure to multiple types of trauma and the development of post‐traumatic stress symptoms related to such exposure. This study provides a rationale for future cross‐trauma research both within the juvenile offender population and between it and other identified trauma groups.
Violence and the homeless: An epidemiologic study of victimization and aggression
Authors: North Carol S. , Smith Elizabeth M. , Spitznagel Edward L.
Published: June 2007

The present study is a random, systematic study of 900 homeless subjects in St. Louis that describes violence in their lives, both in terms of victimization, by specific violent traumatic events, and victimizing with recognized aggressive behaviors. Many subjects had experienced a traumatic event, and post‐traumatic stress disorder was very common. Substance abuse and other Axis I disorders were associated with a history of a traumatic event. The majority of men and a substantial proportion of women also had a history of physically aggressive behaviors, often beginning in childhood. Aggressive adult behavior was associated with substance abuse and major depression. The aggressive behaviors usually predated homelessness, and about half continued after the individual had become homeless. Therefore, it is seen that violence is very much a part of the lives of the homeless, and it seems to be part of a broader picture of problems associated with risk for and experience of homelessness.
The psychological impact of sexual abuse: Content analysis of interviews with male survivors
Authors: Lisak David
Published: June 2007

Autobiographical interviews with 26 adult male survivors of childhood sexual abuse were audiotaped, transcribed verbatim and content analyzed to identify common psychological themes. Approximately equal numbers of men were abused by male and female perpetrators, almost half came from disrupted or violent homes and a majority had a history of substance abuse. Fifteen psychological themes were identified: Anger, Betrayal, Fear, Homosexuality Issues, Helplessness, Isolation and Alienation, Legitimacy, Loss, Masculinity Issues, Negative Childhood Peer Relations, Negative Schemas about People, Negative Schemas about the Self, Problems with Sexuality, Self Blame/Guilt and Shame/Humiliation. The themes are discussed and illustrated with examples drawn from the transcripts.
Traumatic responses among battered women who kill
Authors: Dutton Mary Ann , Hohnecker Laura C. , Halle Paulin M. , Burghardt Kimberly J.
Published: June 2007

This study compared levels of violence, social support, and post‐traumatic stress between battered women charged with a violent crime against an abusive partner and those seeking help from a mental health clinic. Results indicated that forensic battered women were more likely than clinical battered women to report experiencing severe violence, including sexual abuse, in their relationships. Women in the forensic sample also reported less social support and greater post‐traumatic stress than women in the clinical sample. However, when social support and level of violence were accounted for, levels of general post‐traumatic stress indicators (MMPI‐PTSD, CR‐PTSD, GSI) were no longer different between groups, although levels of specific post‐traumatic stress indicators (intrusion, avoidance) remained higher for battered women in the forensic sample. Implications for understanding battered women's response to violence and their post‐traumatic reactions to it are discussed.
Emergency work experience and reactions to traumatic incidents
Authors: Moran Carmen , Britton Neil R.
Published: June 2007

The present study examined the association between volunteer emergency work experience, personality, and reactions to a past traumatic incident. Participants from randomly selected State Emergency Services and Volunteer Bushfire Brigade Units in New South Wales (Australia) completed four questionnaires. The data did not support the idea that emergency workers are hardier than most, or have particular coping styles. Length of volunteer emergency service was associated with both severity and length of reaction to a past traumatic incident. The number of emergency callouts and current general symptom severity were associated with severity of reaction to a past incident.
Post‐traumatic stress disorder: Evaluation of a behavioral treatment program
Authors: Richards David A. , Lovell Karina , Marks Isaac M.
Published: June 2007

The relative values of imaginal and real‐life exposure exercises were tested in this study by randomizing 14 patients who met DSM‐III‐R criteria for PTSD at least 6 months after the initiating trauma to one of two groups. Group 1 (n = 7) had four, weekly, hour‐long sessions of imaginal exposure followed by four, weekly, hour‐long sessions of live exposure. Group 2 (n = 7) had the reverse order of four live exposure sessions followed by four imaginal exposure sessions. Both groups improved significantly on both PTSD‐specific measures and measures of general health post‐treatment, and significantly further on 7 out of 12 measures at follow up 12 months post‐treatment. Clinical improvement was in the order of 65–80% reduction in target symptoms. On one measure only (problem 2—phobic avoidance), live exposure yielded more improvement than imaginal exposure whether given first or second. The importance of both live and imaginal exposure to all relevant cues, behavioral and cognitive, is discussed, together with the value of self‐exposure homework for patients with PTSD.
The reported prevalence of physical and sexual abuse among a sample of children and adolescents at a public psychiatric hospital
Authors: Randall Elizabeth J. , Chowanec Gregory , Thyer Bruce A. , Josephson Allan M.
Published: June 2007

In this retrospective analysis of inpatient charts, a total of 298 children and adolescents admitted to a public psychiatric hospital over a 1‐year period were examined for the prevalence of reported histories of physical or sexual abuse. Physical abuse was reported in 15% of the cases, while sexual abuse occurred in 13%. A variety of comparisons were made examining possible differences in gender, age, race, diagnosis, and personality trait disturbance among the abused and nonabused patients. Relative to known prevalence rates as reported to child protective agencies, physical or sexual abuse occurred much more frequently among our sample of patients, suggesting the need for careful assessment of such histories upon admission and during treatment.
Hearing people through their pain
Authors: Egendorf Arthur
Published: June 2007

The first goal in this clinical and theoretical essay is to specify what it means to hear people through their pain, by articulating intuitions that are seldom put in formal terms. “What” and “how” and “whom” we hear shift depending on whether we are (1) uncovering the facts, (2) appreciating their meaning with another's life, (3) drawing out and enlivening the one who has to live with and make sense of traumatic experience, or (4) engendering, by having others hear that they are heard, enough relatedness to establish a meaningful precedent for their lives. A second goal here is to show how the meaning of trauma changes as hearing deepens. Accordingly, we may hear in people's trauma (1) psychophysical reactions to events; (2) the playing out of themes from a lifetime; (3) violations whose inner message is a demand to awaken beyond self‐protective ways of being; and (4) a uniquely powerful opening for communion.
When disaster strikes, acute stress disorder may follow
Authors: Koopman Cheryl , Classen Catherine , CardeN¯ta Etzel , Spiegel David
Published: June 2007

During and immediately following a traumatic event, people may manifest a pattern of dissociative and anxiety symptoms and other reactions, referred to as Acute Stress Disorder. A review of the empirical literature on psychological reactions to trauma suggest that this pattern of symptoms has often been identified across different kinds of traumatic events. It is likely to constitute a psychological adaptation to a stressful event, limiting painful thoughts and feelings associated with the event and allowing the person to function at least minimally. Continuation of these symptoms, however, may impair the person's quality of life and disrupt social and other functioning. If symptoms last beyond a month following the traumatic event, Post Traumatic Stress Disorder (PTSD) may ensue, continuing for months or even years after the precipitating event. Hence, it is important to be able to identify this pattern of reactions that may be manifested in reaction to trauma, so that appropriate intervention can be provided. Although it was not officially recognized in the 3rd edition Diagnostic and Statistical Manual (DSM‐III‐R), Acute Stress Disorder is included as a separate diagnosis in the DSM‐IV.
Psychological adaptation among residents following restart of Three Mile Island
Authors: Prince‐Embury Sandra , Rooney James F.
Published: June 2007

Psychological adaptation is examined in a sample of residents who remained in the vicinity of Three Mile Island following the restart of the nuclear generating facility which had been shut down since the 1979 accident. Findings indicate a lowering of psychological symptoms between 1985 and 1989 in spite of increased lack of control, less faith in experts and increased fear of developing cancer. The suggestion is made that reduced stress might have been related to a process of adaptation whereby a cognition of emergency preparedness was integrated by some of these residents as a modulating cognitive element. Findings also indicate that “loss of faith in experts” is a persistently salient cognition consistent with the “shattered assumptions” theory of victimization.
Differential effects of trauma on spouses of traumatized households
Authors: Baker Ahmad M. , Kevorkian Nadera S.
Published: June 2007

The responses of 60 households subjected to varying degrees of traumatic events were examined. Specific attention was given to the differential effect that traumatic events have on spouses, especially in terms of general anxiety, state anxiety, trait anxiety, depression, and other symptoms related to trauma. The findings showed that degree of traumatization was proportional to number and intensity of stress related symptoms. Mothers, however, manifested depression and anxiety levels twice as high as fathers. The validity of these results was discussed in terms of cultural beliefs and practices.
The development of a clinician‐administered PTSD scale
Authors: Blake Dudley David , Weathers Frank W. , Nagy Linda M. , Kaloupek Danny G. , Gusman Fred D. , Charney Dennis S. , Keane Terence M.
Published: June 2007

Several interviews are available for assessing PTSD. These interviews vary in merit when compared on stringent psychometric and utility standards. Of all the interviews, the Clinician‐Administered PTSD Scale (CAPS‐1) appears to satisfy these standards most uniformly. The CAPS‐1 is a structured interview for assessing core and associated symptoms of PTSD. It assesses the frequency and intensity of each symptom using standard prompt questions and explicit, behaviorally‐anchored rating scales. The CAPS‐1 yields both continuous and dichotomous scores for current and lifetime PTSD symptoms. Intended for use by experienced clinicians, it also can be administered by appropriately trained paraprofessionals. Data from a large scale psychometric study of the CAPS‐1 have provided impressive evidence of its reliability and validity as a PTSD interview.
Post‐traumatic stress disorder and the MMPI‐2
Authors: Munley Patrick H. , Bains Dharm S. , Bloem William D. , Busby Rebecca M.
Published: June 2007

This study compared the MMPI‐2 profiles of 27 veterans diagnosed with post‐traumatic stress disorder with a non‐PTSD comparison group of 27 veteran patients receiving inpatient treatment for other mental disorders. Three multivariate analyses of variance were conducted comparing the two groups on the 10 traditional clinical scales, the 12 supplemental scales and the 15 new content scales on the MMPI‐2. The PTSD group obtained a mean profile with peak elevations on the F validity scale and on clinical Scales 2 (D) and 8 (Sc). The multivariate analysis of variance comparing the PTSD and non‐PTSD groups across the 10 traditional clinical scales was not significant. The multivariate analyses of variance comparing the two groups on the 12 supplemental scales and the 15 content scales were significant. Significant univariate supplemental scale differences were found on the Keane PTSD scale (PK) and the Post‐Traumatic Stress Disorder (PS) scale with the PTSD group scoring higher on PK and PS. Significant univariate content scale differences were found for the Anger (ANG) scale with the PTSD group scoring higher. A cut‐off score of 28 on the PK scale correctly classified 76% of the overall sample, 67% of the PTSD group and 85% of the non‐PTSD‐comparison group.
Adult trauma survivors and post‐traumatic stress sequelae: An analysis of reexperiencing, avoidance, and arousal criteria
Authors: Ullman Sarah E.
Published: June 2007

The relationship of traumatic events to DSM‐III criteria symptoms for post‐traumatic stress disorder was examined in a randomized community survey (N = 2,364) of Los Angeles residents. Multivariate analysis of covariance revealed that both demographic factors and the type of traumatic event influenced respondents' reports of reexperiencing, avoidance, and arousal symptoms after the event.
Posttraumatic stress disorder, flashbacks, and pseudomemories in closed head injury
Authors: Bryant Richard A.
Published: June 2007

Posttraumatic stress disorder (PTSD) is rarely diagnosed in patients with significant head injury. This paper reviews two patients who were amnesic for events surrounding their motor vehicle accidents (MVAs) but developed delayed‐onset PTSD. Symptoms included vivid images of the MVAs that were based on information learnt following the trauma. These cases indicate that amnesic head injured patients can suffer pseudomemories that are phenomenologicalfy similar to flashbacks observed in PTSD. Implications for understanding the nature of flashbacks are discussed.
Traumatic events and physical health in a community sample
Authors: Oilman Sarah E. , Siegel Judith M.
Published: June 2007

The relationship of traumatic events to physical health was examined in a randomized community survey (N = 2,364) of Los Angeles residents, 16% of whom had experienced a lifetime traumatic event. This study tested hypotheses that individuals experiencing traumatic events have poorer physical health and that the negative impact of traumatic events on physical health is greater among disadvantaged sociodemographic groups. Regression analyses showed that respondents with a traumatic event history indicated poorer perceptions of their physical health, more chronic limitations in physical functioning, and more chronic medical conditions compared with respondents without such a history, while controlling for demographics, psychiatric history, and other stressful life events. The association of traumatic events with poorer physical health among vulnerable sociodemographic groups was partially supported.
Factors in the cycle of violence: Gender rigidity and emotional constriction
Authors: Lisak David , Hopper Jim , Song Pat
Published: June 2007

A sample of 595 men were administered self‐report assessments of childhood sexual and physical abuse, perpetration history, gender rigidity and emotional constriction. Including noncontact forms of sexual abuse, 11% of the men reported sexual abuse alone, 17% reported physical abuse alone, and 17% reported both sexual and physical abuse. Of the 257 men in the sample who reported some form of childhood abuse, 38% reported some form of perpetration themselves, either sexual or physical; of the 126 perpetrators, 70% reported having been abused in childhood. Thus, most perpetrators were abused, but most abused men did not perpetrate. Both sexually and physically abused men who perpetrated manifested significantly more gender rigidity arid emotional constriction than abused nonperpetrators. Men who reported abuse but not perpetration demonstrated significantly less gender rigidity, less homophobia and less emotional constriction than nonabused men.
Crisis support following the Herald of free‐enterprise disaster: A longitudinal perspective
Authors: Dalgleish Tim , Joseph Stephen , Thrasher Sian , Tranah Troy , Yule William
Published: June 2007

Crisis support was assessed with survivors of the Herald of Free Enterprise ferry sinking at 3 and 6 years postdisaster. It was found that reported levels of support received from family and friends decreased over the first 3 years after the event but increased over the subsequent 3 years. In addition, higher retrospective ratings of crisis support received in the immediate aftermath of the disaster were found to predict lower levels of posttraumatic symptomatology as assessed by the Impact of Event Scale, the Beck Depression Inventory and the State‐Trait Anxiety Inventory at a later period. The results replicate earlier findings following the Jupiter Cruise ship disaster and are thought to have implications for the assessment and treatment of survivors at high risk of disturbance.
Posttraumatic stress, mental health professionals, and the clergy: A need for collaboration, training, and research
Authors: Weaver Andrew J. , Koenig Harold G. , Ochberg Frank M.
Published: June 2007

This article addresses the need for improved clergy‐mental health professional collaboration in the assessment and treatment of posttraumatic stress disorder (PTSD). Tens of millions of North Americans with personal problems seek the counsel of clergy. There is an absence of research on the function of clergy as helpers with the traumatized and on the psychological dynamics of religious coping among the traumatized. Psychological trauma presents the mental health and religious communities with unique opportunities to work together in the best interest of those they serve.
The use of anticonvulsants in posttraumatic stress disorder: Case study and overview
Authors: Ford Nicholas
Published: June 2007

A case of posttraumatic stress disorder is described in which a favorable response to the anticonvulsants carbemazepine and sodium valproate occurred. The literature on the use of anticonvulsants in this disorder is reviewed.
Modification of CAPS‐1 for diagnosis of PTSD in Afghan refugees
Authors: Samad Malekzai A. Bazger , Niazi John M. , Paige Stephen R. , Hendricks Shelton E. , Fitzpatrick Denis , Leuschen M. Patricia , Millimet C. Raymond
Published: June 2007

A DSM‐III‐R based instrument for the assessment of posttraumatic stress disorder (PTSD), the Clinician‐Administered PTSD Scale (CAPS‐1), was modified to accommodate cultural differences and translated into the Afghan languages Pushto and Farsi (Dari) and administered to 30 Afghan refugees living in the United States. The modified CAPS‐1 was found to be practical and reliable. Inter‐item correlations were calculated on the frequency and intensity scores for the 17 cardinal symptoms and the eight associated features items of the modified CAPS‐1. The four reexperiencing items demonstrated significant independence from the avoidance and arousal symptom clusters. However, the avoidance and arousal symptom clusters were not found to be independent cardinal components of PTSD in our participants. The CAPS‐1 criteria for diagnosis of PTSD were met by 50% of the subjects evaluated.
PTSD: How frequently should the symptoms occur? The effect on epidemiologic research
Authors: Karam Elie G. , Noujeim Jina C. , Saliba Sabah E. , Chami Adel H. , Rached Sana Abi
Published: June 2007

The definition of posttraumatic stress disorder (PTSD), like most other psychiatric disorders, relies on descriptive methodology; the formulation of the criteria needed to establish a diagnosis is based on clinical and research findings. We used our data from a community study in Beirut, Lebanon to look at the effect that the frequency of occurrence of individual PTSD symptoms might have on the total PTSD prevalence. We found that the prevalence of PTSD decreased by half if symptoms were required to have occurred at least twice per week. This phenomenon was true whether we considered war or nonwar traumata and was true for the DSM‐III‐R and the DSM‐IV definitions of PTSD.
Trauma‐related dissociative states and long‐term psychopathology in posttraumatic stress disorder
Authors: Bremner J. Douglas , Brett Elizabeth
Published: June 2007

Dissociative responses to trauma have been hypothesized to be associated with long‐term increases in psychopathology. The purpose of this study was to examine dissociative responses to premilitary, combat‐related and postmilitary traumatic events and long‐term psychopathology in Vietnam combat veterans with (n = 34) and without (n = 28) posttraumatic stress disorder (PTSD). PTSD patients reported higher levels of dissociative states at the time of combat‐related traumatic events than non‐PTSD patients. Higher levels of dissociative states persisted in PTSD patients in the form of higher levels of dissociative states in response to postmilitary traumatic events. In addition, dissociative responses to combat trauma were associated with higher long‐term general dissociative symptomatology as measured by scores on the Dissociative Experience Scale, as well as increases in the number of flashbacks since the time of the war. These findings are consistent with previous formulations that dissociation in the face of trauma is a marker of long‐term psychopathology.
The impact of Hurricane Andrew on deviant behavior among a multi‐racial/ethnic sample of adolescents in Dade County, Florida: A longitudinal analysis
Authors: Khoury Elizabeth L. , Warheit George J. , Hargrove Mary C. , Zimmerman Rick S. , Vega William A. , Gil Andres G.
Published: June 2007

Findings from a longitudinal study are presented on the relationships between the problems and stresses resulting from Hurricane Andrew and posthurricane minor deviant behavior. The sample (N = 4,978) included Hispanic, African‐American, and White non‐Hispanic middle school students enrolled in Dade County, Florida public schools. Two waves of data were collected prior to the hurricane; a third was obtained approximately 6 months following the storm. Results indicated that females were likely to report higher levels of hurricane‐related stress symptoms than males. After controlling for prehurricane levels of minor deviance, family support, and race/ethnicity, hurricane stress symptom level remained a significant predictor of posthurricane minor deviant behavior. The findings lend support to stress theories of social deviance.