bluuebunny/crossref_metadata_2025 huggingface dataset:
Lactic acidosis in long‐chain fatty acid β‐oxidation disorders
Authors: Ventura F. V. , Ruiter J. P. N. , IJlst L. , Tavares de Almeida I. , Wanders R. J. A.
Published: December 2002

Among the many disorders of fatty acid β‐oxidation known today, the disorders of long‐chain fatty acid oxidation are the most severe and life‐threatening. One remarkable abnormality, not observed in, for instance, medium‐chain acyl‐CoA dehydrogenase deficiency, is the moderate to severe lactic acidaemia in long‐chain fatty acid β‐oxidation‐deficient patients, suggesting that oxidation of pyruvate is also compromised. In order to understand the underlying basis of the lactic acidaemia in these patients, we have studied the formation of L‐lactate and pyruvate in cultured skin fibroblasts incubated with D‐glucose. All long‐chain fatty acid β‐oxidation‐deficient cell lines studied were found to show a moderate elevation of lactate when compared with control and medium‐chain acyl‐CoA dehydrogenase‐deficient fibroblasts. Interestingly, differences were found between cells deficient in long‐chain 3‐hydroxyacyl‐CoA dehydrogenase and very‐long‐chain acyl‐CoA dehydrogenase, suggesting that saturated acyl‐CoA esters and their 3‐hydroxyacyl‐CoA derivatives affect pyruvate metabolism differently.
Tandem mass spectrometry — The potential
Authors: Bartlett K. , Pourfarzam M.
Published: December 2002

We summarize the current status of the use of tandem mass spectrometry for the detection of inherited metabolic disorders and the investigation of the pathophysiology of these conditions. We also indicate some of the more recent developments of this technology that have potential diagnostic applications.
Renal clearance of branched‐chain L‐amino and 2‐oxo acids in maple syrup urine disease
Authors: Schadewaldt P. , Hammen> H.‐W. , Ott A.‐C. , Wendel U.
Published: December 2002

In maple syrup urine disease (MSUD), branched‐chain L‐amino (BCAA) and 2‐oxo acids (BCOA) accumulate in body fluids owing to an inherited deficiency of branched‐chain 2‐oxo acid dehydrogenase complex activity. In MSUD, little information is available on the significance of urinary disposal of branched‐chain compounds. We examined the renal clearance of leucine, valine, isoleucine and alloisoleucine, and their corresponding 2‐oxo acids 4‐methyl‐2‐oxopentanoate (KIC), 3‐methyl‐2‐oxobutanoate (KIV), (S)‐ (S‐KMV), and (R)‐3‐methyl‐2‐oxopentanoate (R‐KMV), using pairs of plasma and urine samples (n=63) from 10 patients with classical MSUD. The fractional renal excretion of free BCAA was in the normal range (<0.5%) and indepen‐dent of the plasma concentrations. The excretion of bound (N‐acylated) BCAA was normal and not significantly dependent on the BCAA plasma concentrations. The fractional renal excretion of BCOA was in the order KIC≪KIV<R‐KMV≤S‐KMV (range (%): KIC 0.1–25; KIV 0.14–21.3; S‐KMV 0.26–24.6; R‐KMV 0.1–35.9), significantly correlated with the KIC plasma concentrations, and generally higher than that of the related BCAA. The results show that the renal excretion of free BCAA as well as of the acylated derivatives is negligible. The renal excretion of BCOA, however, to some extent counteracts increases in BCAA concentrations and thus contributes to the lowering of total BCAA pools in MSUD.
Glutaric aciduria type I: Pathomechanisms of neurodegeneration
Authors: Ullrich K. , Flott‐Rahmel B. , Schluff P. , Musshoff U. , Das A. , Lücke T. , Steinfeld R. , Christensen E. , Jakobs C. , Ludolph A. , Neu A. , Röper R.
Published: December 2002

In organotypic corticostriatal and hippocampal slice cultures from rat brain, 3‐hydroxyglutaric acid but not glutaric and glutaconic acids induced neurodegeneration by activation of NMDA receptors. Electrophysiological investigations (Xenopus laevis oocytes expressing glutamate receptors; rat mixed cortex culture) revealed no direct interaction of 3‐hydroxyglutaric acid with glutamate receptors. We speculate that 3‐hydroxyglutaric acid induces a mild energy deprivation that interferes with the voltage‐dependent Mg2+‐block of NMDA receptors.
Quantitative analysis of glucose‐6‐phosphate translocase gene expression in various human tissues and haematopoietic progenitor cells
Authors: Ihara K. , Nomura A. , Hikino S. , Takada H. , Hara T.
Published: December 2002

We investigated the quantitative expression of the human glucose‐6‐phosphate translocase gene (G6PT1) and its splicing variants in human tissues. The G6PT1 gene was strongly expressed in liver, kidney and haematopoietic progenitor cells, which might explain major clinical symptoms such as hepatomegaly, nephromegaly and neutropenia in glycogen storage diseases type Ib. Reverse transcriptase‐mediated PCR amplification of G6PT1 cDNA revealed several splicing variants in tissue‐specific manners. The brain‐specific isoform, which has an additional 22 amino acids between exons 6 and 8, was also identified in heart and skeletal muscle. A new splicing variant, although less prominent in quantity and lacking polypeptide loops corresponding to exons 2 and 3, may have a distinct substrate affinity or specificity in leukocytes and haematopoietic progenitors. In conclusion, the G6PT1 gene was expressed in various tissues, and alternative splicing variants exist in tissue‐specific manners.
Studies of the V94M‐substituted human UDPgalactose‐4‐epimerase enzyme associated with generalized epimerase‐deficiency galactosaemia
Authors: Wohlers T. M. , Fridovich‐Keil J. L.
Published: December 2002

Impairment of the human enzyme UDPgalactose 4‐epimerase (hGALE) results in epimerase‐deficiency galactosaemia, an inborn error of metabolism with variable biochemical presentation and clinical outcomes reported to range from benign to severe. Molecular studies of the hGALE loci from patients with epimerase deficiency reveal significant allelic heterogeneity, raising the possibility that variable genotypes may constitute at least one factor contributing to the biochemical and clinical heterogeneity observed. Previously we have identified a single substitution mutation, V94M, present in the homozygous state in all patients genotyped with the severe, generalized form of epimerase‐deficiency galactosaemia. We report here further studies of the V94M‐hGALE enzyme, overexpressed and purified from a null‐background yeast expression system. Our results demonstrate that the mutant protein is impaired relative to the wild‐type enzyme predominantly at the level of Vmax rather than of Km. Studies using UDP‐N‐acetylgalactosamine as a competitor of UDPgalactose further demonstrate that the Km values for these two substrates vary by less than a factor of 3 for both the wild‐type and mutant proteins. Finally, we have explored the impact of the V94M substitution on susceptibility of yeast expressing human GALE to galactose toxicity, including changes in the levels of galactose 1‐phosphate (gal‐1‐P) accumulated in these cells at different times following exposure to galactose. We have observed an inverse correlation between the level of GALE activity expressed in a given culture and the degree of galactose toxicity observed. We have further observed an inverse correlation between the level of GALE activity expressed in a culture and the concentration of gal‐1‐P accumulated in the cells. These data support the hypothesis that elevated levels of gal‐1‐P may underlie the observed toxicity. They further raise the intriguing possibility that yeast may provide a valuable model not only for assessing the impact of given patient mutations on hGALE function, but also for exploring the metabolic imbalance resulting from impaired activity of GALE in living cells.
Coping with domestic violence: Control attributions, dysphoria, and hopelessness
Authors: Clements Caroline M. , Sawhney Daljit K.
Published: December 2002

We investigated the influence of control judgments and coping style on emotional reactions to domestic violence utilizing the framework of hopelessness theory. We assessed abuse severity, control attributions, coping, dysphoric symptoms, and hopelessness in 70 battered women recruited from 12 domestic violence agencies. Respondents reported dysphoria but not hopelessness. Increased reports of dysphoria were associated with higher levels of self‐blame and avoidance coping and lower levels of problem‐focused coping. Increased problem‐focused coping was associated with decreased hopelessness. Perceived control over current abuse was not related to dysphoria. High expectations for control over future events were associated with decreased dysphoria. We discuss our results in terms of their application to attributional accounts of emotional reactions to battering.
An investigation of the impact of posttraumatic stress disorder on physical health
Authors: Wagner Amy W. , Wolfe Jessica , Rotnitsky Andrea , Proctor Susan P. , Erickson Darin J.
Published: December 2002

In a large sample of Gulf War veterans (N = 2301) we examined the relations between PTSD symptoms assessed immediately upon returning from the Gulf War and self‐reported health problems assessed 18–24 months later. PTSD symptomatology was predictive of self‐reported health problems over time for both men and women veterans, even after the effects of combat exposure were removed from the analysis. Female veterans reported significantly more health problems than male veterans, however, there was no interactive effect of gender and PTSD on health problems. These findings provide further support for the theory that psychological response to stressors impacts health outcome.
PTSD severity and health perceptions in female victims of sexual assault
Authors: Zoellner Lori A. , Goodwin Melanie L. , Foa Edna B.
Published: December 2002

In women with chronic posttraumatic stress disorder (PTSD), poor physical health may be related to their PTSD symptoms through an underlying negative affect or distress that accompanies the disorder, through the PTSD symptoms in general, or specifically through the chronic hyperarousal present in the disorder. The current study examined the relative contribution of these factors to reported physical symptoms in female victims of sexual assault. Seventy‐six women with chronic PTSD were assessed, using measures of stressful life events, psychological difficulties, and perceived health. Negative life events, anger, depression, and PTSD severity were all related to self‐reported physical symptoms; however, PTSD severity predicted self‐reported physical symptoms beyond these other variables. Contrary to our hypothesis, the reexperiencing cluster of PTSD, and not the hyperarousal cluster, was related to self‐reported physical symptoms.
A controlled study of imagery rehearsal for chronic nightmares in sexual assault survivors with PTSD: A preliminary report
Authors: Krakow Barry , Hollifield Michael , Schrader Ron , Koss Mary , Tandberg Dan , Lauriello John , McBride Leslie , Warner Teddy D. , Cheng Diana , Edmond Tonya , Kellner Robert
Published: December 2002

Imagery‐rehearsal therapy for chronic nightmares was assessed in a randomized, controlled study of sexual assault survivors with posttraumatic stress disorder (PTSD). Nightmares, sleep quality, and PTSD were assessed at baseline for 169 women, who were randomized into two groups: treatment (n = 87) and wait‐list control (n = 82). Treatment consisted of two 3‐hr sessions and one 1‐hr session conducted over 5 weeks. Of 169 participants, 91 women (Treatment, n = 43, Control, n = 48) completed a 3‐month follow‐up and 78 did not. At follow‐up, nightmare frequency and PTSD severity decreased and sleep quality improved in the treatment group with small to minimal changes in the control group. Treatment effects were moderate to high (Cohen's d ranged from 0.57 to 1.26). Notwithstanding the large dropout rate, imagery‐rehearsal therapy is an effective treatment for chronic nightmares in sexual assault survivors with PTSD and is associated with improvement in sleep quality and decreases in PTSD severity.
BRCA1 Testing and Informed Consent in a Woman with Mild Retardation
Authors: Schneider Katherine A. , Kieffer Stephanie A. , Patenaude Andrea F.
Published: December 2002

Cancer predisposition testing can pose complex genetic counseling issues. This casereport discusses whether it is appropriate to provide BRCA1 testing to a woman withlimited intellectual capacity and documented psychological distress. This case is one ofseveral cancer counseling cases presented to our Genetic Counseling Supervision Groupover the past three and a half years. The Supervision Group provided valuable feedback and supportto proceed with this challenging case.
Identifying subtypes of women survivors of childhood sexual abuse: An MMPI‐2 cluster analysis
Authors: Elhai Jon D. , Flitter Jill M. Klotz , Gold Steven N. , Sellers Alfred H.
Published: December 2002

This paper investigated subtypes of women childhood sexual abuse (CSA) survivors through a cluster analysis of their Minnesota Multiphasic Personality Inventory‐2 (MMPI‐2) clinical and validity scales. Participants were 117 women in outpatient treatment for CSA aftereffects at a university‐affiliated community mental health center. Three well‐fitting MMPI‐2 cluster solutions were evaluated with discriminant analyses and MANOVAs; a 5‐cluster solution was deemed optimal. Follow‐up analyses demonstrated significant between‐cluster differences on the Impact of Event Scale, Beck Depression Inventory, Dissociative Experiences Scale, and nearly all Symptom Checklist‐90‐Revised subscales. No differences emerged when comparing clusters on the Family Environment Scale and their CSA characteristics. Implications were considered for research and clinical practice, using the MMPI‐2 with CSA survivors.
An Opportunity for Genetic Counseling Intervention: Depression in Parents of Individuals with Proteus Syndrome
Authors: Peters Kathryn F. , Biesecker Leslie G.
Published: December 2002

Depression is common, affecting 2–5% of the general population. Parental depression can confound adjustment to, and caring for, a child with a genetic condition. As part of a study on psychosocial issues of parents caring for children with Proteus syndrome, 31 parents (20 mothers and 11 fathers) completed a depression screening tool, the Beck Depression Inventory. Approximately 23% (4/20 mothers and 3/11 fathers) scored positive on the tool. Pessimism, sense of failure, general lack of satisfaction, sense of punishment, self‐dislike, social withdrawal, indecisiveness, work inhibition, somatic preoccupation, and loss of libido were reported more frequently by the group of parents with positive screen results than those with normal results. These data suggest that symptoms of depression may be prevailing among parents of individuals with Proteus syndrome. Because effective interventions for depression are readily available, genetic counselors working with families affected with rare, overgrowth disorders should specifically assess parents for physical and affective symptoms of depression and refer them for appropriate clinical treatment.
Supervision for Practicing Genetic Counselors: An Overview of Models
Authors: Kennedy Annette L.
Published: December 2002

Supervision has traditionally been a concept that refers primarilyto a means by which to train genetic counseling students. However, supervision—redefined—can afford anextraordinary opportunity for practicing genetic counselors to regularly update and enhancetheir counseling skills. This paper provides a new definition of supervision for experiencedgenetic counselors and discusses the process and advantages of different types ofsupervision. The leader‐led peer supervision group will be highlighted as especiallyamenable to the needs of genetic counselors for a collegial forum in which to discuss thepsychosocial components of their work. Immediately following, in a separate paper, will bea description of a currently ongoing supervision group for practicing genetic counselors.
An evaluation of stress symptoms associated with academic sexual harassment
Authors: McDermut Jennifer Fine , Haaga David A. F. , Kirk Lindsey
Published: December 2002

It is clear that sexual assault can precipitate posttraumatic stress disorder. Some theorists have suggested that less severe sexually harassing behaviors may also have trauma‐like sequelae. In a study evaluating this hypothesis, 69 female participants completed self‐report measures of instances of sexual harassment, basic beliefs, psychological distress/symptoms, and PTSD symptoms. Participants watched videotapes depicting sexual harassment, emotional arousal (not sexual in nature), and a neutral interaction while their heart rate was monitored, and they were interviewed using the SCID for PTSD. Results revealed that those who had been sexually harassed reported more negative basic beliefs, more general distress, and more negative state mood after watching the sexual harassment video, relative to those who had not been harassed. The severity of sexual harassing behaviors experienced was positively correlated with PTSD symptoms. Heart rate reactivity to the videotapes did not differ across groups defined by sexual harassment status.
Posttraumatic stress disorder symptoms in Korean conflict and World War II combat veterans seeking outpatient treatment
Authors: McCranie Edward W. , Hyer Leon A.
Published: December 2002

Given important differences in the Korean conflict and World War II, samples of treatment‐seeking combat veterans from these wars (30 Korea, 83 World War II) were compared on the prevalence and severitv of posttraumatic stress disorder (PTSD). With age, ethnicity, and combat exposure taken into account, the Korean veterans reported significantly more severe symptoms on both interview and self‐report PTSD measures. Group differences in the prevalence of current PTSD were in a similar direction but not significant. These results are generally consistent with other studies that have found Korean combat veterans to exhibit higher rates of psychosocial maladjustment than World War II combat veterans. Based on related research with Vietnam veterans, one direction for future investigation is to examine what role stressful postmilitary homecoming experiences may have played in influencing the development and course of combat‐related PTSD in the aging cohort of “forgotten” Korean conflict veterans.
The children's PTSD inventory: Development and reliability
Authors: Saigh Philip A. , Yasik Anastasia E. , Oberfield Richard A. , Green Bonnie L. , Halamandaris Phill V. , Rubenstein Hilary , Nester Jeanne , Resko Jody , Hetz Batia , McHugh Margaret
Published: December 2002

Information involving the development of the DSM‐IV version of the Children's PTSD Inventory is described. Independent ratings by highly experienced judges denote that the instrument encompassed the universe of definition that it was intended to measure (i.e., the DSM‐IV criteria for PTSD). The instrument was administered to 82 traumatized and 22 nontraumatized youths at Bellevue Hospital. Moderate to high Cronbach alphas (.53–.89) were evident at the subtest level. An alpha of .95 was evident at the diagnostic level. In terms of inter‐rater reliability, 98.1% agreement was evident at the diagnostic level. Inter‐rater intraclass correlation coefficients (ICCs) ranged from .88 to .96 at the subtest level and .98 at the diagnostic level. Cood to excellent kappas (.66–1.00) were reported for inter‐rater reliability at the subtest level. An inter‐rater reliability kappa of .96 was evident at the diagnostic level. In terms of test‐retest reliability, 97.6% agreement was evident at the diagnostic level. Good to excellent test‐retest kappas (.66–1.00) and ICCs (.66–.94) were observed. A test‐retest kappa of .91 and an ICC of .88 was observed at the diagnostic level.
Comparison of the PTSD symptom scale–interview version and the clinician‐administered PTSD scale
Authors: Foa Edna B. , Tolin David F.
Published: December 2002

The Clinician‐Administered PTSD Scale (CAPS) is one of the most frequently used measures of posttraumatic stress disorder (PTSD). It has been shown to be a reliable and valid measure, although its psychometric properties in nonveteran populations are not well known. One problem with the CAPS is its long assessment time. The PTSD Symptom Scale–Interview Version (PSS‐I) is an alternative measure of PTSD severity, requiring less assessment time than the CAPS. Preliminary studies indicate that the PSS‐I is reliable and valid in civilian trauma survivors. In the present study we compared the psychometric properties of the CAPS and the PSS‐I in a sample of 64 civilian trauma survivors with and without PTSD. Participants were administered the CAPS, the PSS‐I, and the Structured Clinical Interview for DSM‐IV (SCID) by separate interviewers, and their responses were videotaped and rated by independent clinicians. Results indicated that the CAPS and the PSS‐I showed high internal consistency, with no differences between the two measures. Interrater reliability was also high for both measures, with the PSS‐I yielding a slightly higher coefficient. The CAPS and the PSS‐I correlated strongly with each other and with the SCID. Although the CAPS had slightly higher specificity and the PSS‐I had slightly higher sensitivity to PTSD, overall the CAPS and the PSS‐I performed about equally well. These results suggest that the PSS‐I can be used instead of the CAPS in the assessment of PTSD, thus decreasing assessment time without sacrificing reliability or validity.
Death notification education: A needs assessment study
Authors: Stewart Alan E. , Lord Janice Harris , Mercer Dorothy L.
Published: December 2002

A survey of 245 death notifiers (i.e., law enforcement officers, emergency medical technicians, victim advocates, coroners, clergy, health care professionals, and others who had performed death notification in the past) was conducted to examine their death notification experience and their needs for education. The survey also assessed the benefits the notifiers received by attending a death notification seminar developed by Mothers Against Drunk Driving. Forty one percent of the notifiers had received neither classroom training nor experiential training in death notification before the seminar. Respondents' reported needs for education included (a) specific detail on how to deliver a notification, (b) how to manage survivor reactions, and (c) how to manage their own emotional reactions. The respondents indicated that the seminars substantially enhanced their death notification skills.
Recommendations for Telephone Counseling
Authors: Ormond Kelly E. , Haun Jody , Cook Lola , Duquette Debra , Ludowese Carol , Matthews Anne L.
Published: December 2002

Telephone counseling can provide a convenient, accessible, and valuable source of information to the general public, health care providers, and other professionals. In the genetic counseling profession, telephone counseling is often associated with teratogen information services. However, genetic counselors routinely utilize the telephone in a number of different counseling encounters. Nevertheless, the literature provides very little guidance to how that encounter might be conducted, what information should be obtained and provided, or how the encounter should be documented. We present a brief overview of the history of telephone counseling, a description of the major differences between telephone counseling and a face‐to‐face counseling session, and a framework to optimize a telephone counseling session.
Nocturnal re‐experiencing more than forty years after war trauma
Authors: Schreuder Bas J. N. , Kleijn Wim Chr. , Rooijmans Harry G. M.
Published: December 2002

The aim of this study was the examination of Posttraumatic Nightmares (PTNM) and Posttraumatic Anxiety Dreams (PTAD) in Dutch combat veterans and World War II victims. Participants (outpatients; n = 223) were administered a standardized psychiatric interview, the Impact of Event Scale, the SCL‐90, the Clinician Administered PTSD Scale, and an interview on posttraumatic nocturnal re‐experiencing. Prevalence of PTNM was 56%. Patients with PTNM, even those who were not diagnosed with PTSD, had significantly more psychiatric complaints than patients with no PTNM. Analysis of PTNM demonstrated that they were often experienced as exact replications of the original traumatic events. Replicative PTNM often implicated dream recurrence. Traumatic experiences before the age of 5 resulted in nonreplicalive PTNM only. Unlike nonreplicative PTNM, replicative PTNM seemed to be correlated with several intrusion subscales.
Fear, helplessness, and horror in posttraumatic stress disorder: InvestigatingDSM‐IVCriterion A2 in victims of violent crime
Authors: Brewin Chris R. , Andrews Bernice , Rose Suzanna
Published: December 2002

A DSM‐IV diagnosis posttraumatic stress disorder (PTSD) required for the first time that individuals must report experiencing intense fear, helplessness, or horror at the time of the trauma. In a longitudinal study of 138 victims of violent crime, we investigated whether reports of intense trauma‐related emotions characterized individuals who, after 6 months, met criteria for PTSD according to the DSM‐III‐R. We found that intense levels of all 3 emotions strongly predicted later PTSD. However, a small number of those who later met DSM‐III‐R or ICD criteria for PTSD did not report intense emotions at the time of the trauma. They did, however, report high levels of either anger with others or shame.
Trauma exposure and psychological reactions to genocide among Rwandan children
Authors: Dyregrov Atle , Gupta Leila , Gjestad Rolf , Mukanoheli Eugenie
Published: December 2002

A total of 3030 children age 8–19 years from Rwanda was interviewed about their war experiences and reactions approximately 13 months after the genocide that started in April 1994. Rwandan children had been exposed to extreme levels of violence in the form of witnessing the death of close family members and others in massacres, as well as other violent acts. A majority of these children (90%) believed that they would die; most had to hide to surive, and 15% had to hide under dead bodies to surive. A shortened form of the Impact of Event Scale used in a group of 1830 of these children documented high levels of intrusion and avoidance. While children living in shelters were exposed to more trauma, they evidenced less posttraumatic reactions. Analyses showed that reactions were associated with loss, violence exposure, and, most importantly, feeling their life was in danger.
Relations between coercive strategies and MMPI‐2 scale elevations among women survivors of childhood sexual abuse
Authors: Lucenko Barbara A. , Gold Steven N. , Elhai Jon D. , Russo Stephen A. , Swingle Janine M.
Published: December 2002

The relationship between coercion strategies used by perpetrators of childhood sexual abuse (CSA) and elevations of CSA survivors on the Minnesota Multiphasic Personality inventory‐2 (MMPI‐2) was investigated. Participants were 151 women survivors of CSA in outpatient treatment at a university‐based community mental health center. Scores on the MMPI‐2 clinical scales and the Keane posttraumatic stress disorder (PTSD) scale were examined. Main effects were found for promised or received rewards on several clinical scales and the PTSD scale of the MMPI‐2, independent of the presence of force. Specifically, the presence of such rewards was associated with significantly higher levels of symptomatology on Paranoia (Pa), Psychasthenia (Pt), Schizophrenia (Sc), and PTSD (Pk). There were no main or interaction effects noted for the presence of actual or threatened force on any of the scales.
Behavioral treatment of PTSD in a perpetrator of manslaughter: A single case study
Authors: Rogers Paul , Gray Nicola S. , Williams Tegwyn , Kitchiner Neil
Published: December 2002

Studies of posttraumatic stress disorder (PTSD) have predominantly focused on victims of trauma. Some studies have examined the after‐effects of a person's own violent actions in combat or police situations. However, there is a sparsity of literature examining the development of PTSD in convicted perpetrators of violent crime, and there is no literature concerning the treatment of PTSD in such perpetrators. This single‐case study presents the outcome of behavioral treatment in one case in which the patient had PTSD consequential to being a perpetrator of manslaughter. The theoretical implications of this case are briefly discussed.
Cognitive strategies and the resolution of acute stress disorder
Authors: Bryant Richard A. , Moulds Michelle , Guthrie Rachel M.
Published: December 2002

Information processing theories propose that resolution of posttraumatic stress is mediated by activation of traumatic memories and modification of threat‐based beliefs. It is argued that this adaptive response is associated with reduced cognitive avoidance. Thought control strategies were assessed in civilian trauma survivors with acute stress disorder (N = 45) prior to and following either cognitive behavior therapy or supportive counseling. Participants completed the Acute Stress Disorder Interview, the Beck Depression Inventory, the State Trait Anxiety Inventory, the Impact of Event Scale, and the Thought Control Questionnaire within 2 weeks of their trauma and 6 months following treatment. Receiving cognitive behavior therapy was associated with reductions in the use of punishment and worry, and increases in the use of reappraisal and social control strategies. Further, reduced posttraumatic stress symptoms were associated with increased use of social control strategies and reappraisal strategies, and decreased use of worry. Findings are discussed in terms of the cognitive strategies that may mediate acute posttraumatic stress.
Reports of prior exposure to potentially traumatic events and PTSD in troops poised for deployment
Authors: Bolton Elisa E. , Litz Brett T. , Britt Thomas W. , Adler Amy , Roemer Lizabeth
Published: December 2002

Exposure to potentially traumatic events (PTEs), posttraumatic stress disorder (PTSD) symptomatology, and the mental health status of 2,947 military personnel were assessed prior to deployment on a peacekeeping mission. Approximately 74% of the soldiers reported being exposed to at least one PTE. The mean number of PTEs reported was 2.38, most of which did not occur during previous deployments. Approximately 6% of the participants exceeded our screening criteria for PTSD and 43% endorsed elevated levels of psychological distress. These findings document a high rate of exposure to PTEs in soldiers prior to their deployment. These results also highlight the need to screen for PTEs when attempting to isolate the rates of PTSD following a specific traumatic event and to examine the effects of cumulative exposure to PTEs.
The Process of Family Reconstruction after DNA Testing for Huntington Disease
Authors: Sobel Susan , Cowan D. Brookes
Published: December 2002

The needs of families to reconstruct their relationships in response to the DNA testing for Huntington disease of one or more of their asymptomatic members are presented. Data were collected from family interviews with 18 families, and from their responses on a post interview questionnaire. Findings are that families need to (a) address “unfinished business” associated with the decision for testing; (b) bring family members, peripheral in the decision for testing, into the loop; (c) reorganize patterns of communication and roles altered by the testing and heal ruptures in family membership; and (d) revise family stories about illness to provide a meaning for HD and explain the test results in a way that leaves them with a sense of mastery. Findings suggest that families should be more involved in the initial decision for testing of a member and that protocols should be established to provide help for their ongoing adjustment.
Update and Review: Supernumerary Marker Chromosomes
Authors: Ungerleider Sharon
Published: December 2002

Supernumerary marker chromosomes (SMCs) are found in individuals with normal and abnormal clinical phenotypes. Correlations between karyotype and phenotype have been made in only a few circumstances. This article summarizes the most recent information regarding supernumerary marker chromosomes, including genetic counseling issues.
Patient Motivation, Satisfaction, and Coping in Genetic Counseling and Testing for BRCA1 and BRCA2
Authors: Clark Shelly , Bluman Leslie G. , Borstelmann Nancy , Regan Katherine , Winer Eric P. , Rimer Barbara K. , Skinner Celette Sugg
Published: December 2002

Women with a strong family history of breast and/or ovarian cancer can now have genetic testing, that may identify mutations associated with increased cancer predisposition. Within the context of a clinical trial evaluating printed educational materials, we examined motivation, satisfaction, coping, and perceptions of genetic counseling and testing among 159 women who underwent pretest counseling and made a testing decision. Ninety‐six percent of the participants elected to have BRCA1/2 testing. When making a decision about genetic testing, study participants were concerned less about the potential negative effects that could result from testing than the potential benefits. After counseling, participants said that they felt better able to make decisions that were right for them and that their questions and concerns were adequately addressed during the session. Ninety‐five percent of the women were satisfied with their test decision. Participants used a range of strategies to cope with thoughts and feelings about cancer and/or genetic testing immediately following test decision. Results suggest that the genetic counseling session helped women make decisions about testing for BRCA1 and BRCA2, even in the setting of a trial in which all women also received detailed educational materials. Further, the results indicate that future research focusing on perceptions of risks and benefits of testing and of coping strategies immediately following test decision may be warranted.
Perception of Genetic Risk Among Genetic Counselors
Authors: Roggenbuck Jennifer , Olson Janet E. , Sellers Thomas A. , Ludowese Carol
Published: December 2002

A mailed survey of female prenatal genetic counselors, obstetric nurses, and high school biology teachers was conducted to determine if these groups hold different attitudes toward genetic risk and to investigate the extent to which any differences result from the effect of different professional experiences. In this study, the participants were 166 genetic counselors, 116 obstetric nurses, and 78 biology teachers (n = 360). Survey participants completed a written questionnaire designed to assess their numeric estimate of the empiric risk for birth defects/genetic problems, their subjective perception of this risk, and their personal use of prenatal diagnosis. Genetic counselors were found to be less likely than the other groups to consider the frequency of birth defects/genetic problems as rare and were 10 times more likely than nurses and 8 times more likely than teachers to have had prenatal diagnosis. Furthermore, more than half of the prenatal diagnosis procedures had by genetic counselors were not medically indicated. These results suggest that genetic counselors have an increased perception of genetic risks relative to nurses or teachers. Possible explanations for this finding are discussed, and the potential role of discordant risk perception in creating biases in the genetic counseling process is explored.
Ethical and Professional Challenges Posed by Patients with Genetic Concerns: A Report of Focus Group Discussions with Genetic Counselors, Physicians, and Nurses
Authors: Veach Patricia McCarthy , Bartels Dianne M. , LeRoy Bonnie S.
Published: December 2002

Ninety‐seven physicians, nurses, and genetic counselors from four regions within the United States participated in focus groups to identify the types of ethical and professional challenges that arise when their patients have genetic concerns. Responses were taped and transcribed and then analyzed using the Hill et al. (1997, Counsel Psychol 25:517–522) Consensual Qualitative Research method of analysis. Sixteen major ethical and professional domains and 63 subcategories were identified. Major domains are informed consent; withholding information; facing uncertainty; resource allocation; value conflicts; directiveness/nondirectiveness; determining the primary patient; professional identity issues; emotional responses; diversity issues; confidentiality; attaining/maintaining proficiency; professional misconduct; discrimination; colleague error; and documentation. Implications for practitioners who deal with genetic issues and recommendations for additional research are given.
PTSD scale of the child behavior checklist: Concurrent and discriminant validity with non‐clinic‐referred sexually abused children
Authors: Ruggiero Kenneth J. , McLeer Susan V.
Published: December 2002

Several assessment instruments include measures that are purported to assess characteristics of posttraumatic stress disorder (PTSD). Although these measures are used often by researchers and clinicians, few are supported by extensive validity data. The PTSD scale of the Child Behavior Checklist (CBCL) is one that has not yet encountered significant challenges to its validity. We examine the concurrent and discriminant validity of the CBCL‐PTSD scale. Participants included 63 non‐clinic‐referred sexually abused (SA) children, 60 non‐SA psychiatric outpatient children, and 61 non‐SA, non‐clinic‐referred schoolchildren. Results revealed questionable concurrent validity for this scale, and suggest poor discriminant validity between SA children and non‐SA psychiatric outpatients.
Anger, dissociation, and posttraumatic stress disorder among female assault victims
Authors: Feeny Norah C. , Zoellner Lori A. , Foa Edna B.
Published: December 2002

The goal of the present study was to explore the relationship between anger and dissociation and their relationship to symptoms of posttrauma pathology. One hundred four female assault victims were assessed prospectively 2, 4, and 12 weeks postassault. Measures of posttraumatic stress disorder (PTSD) severity, social functioning, anger, and dissociation were obtained at all assessments. Results revealed that differentiation between symptoms that predict later PTSD and impaired social functioning first becomes evident at 4 weeks postassault. At 4 weeks postassault, anger expression was predictive of later PTSD severity, whereas dissociation was predictive of poorer later functioning.
The effects of extreme early stress in very old age
Authors: Landau Ruth , Litwin Howard
Published: December 2002

This article examines a community‐based sample of Holocaust survivors aged 75 and over, in comparison to persons of similar age and sociocultural background who did not personally experience the Holocaust. The analysis compares respondents' sociodemographic characteristics, interpersonal resources (locus of control and social network), and vulnerability, stratified by gender (n = 194). Assessments of vulnerability (physical health, mental health, and posttraumatic stress disorder—PTSD) are compared across groups. The results reveal almost no differences regarding the sociodemographic and interpersonal variables. Nevertheless, survivors are found to be more vulnerable than the others in the comparison group: (a) male survivors demonstrate a higher prevalence of PTSD, and (b) female survivors indicate greater health‐related difficulties and poorer self‐rated health.
A correlational test of the relationship between posttraumatic growth, religion, and cognitive processing
Authors: Calhoun Lawrence G. , Cann Arnie , Tedeschi Richard G. , McMillan Jamie
Published: December 2002

The present study examined the degree to which event related rumination, a quest orientation to religion, and religious involvement is related to posttraumatic growth. Fifty‐four young adults, selected based on prescreening for experience of a traumatic event, completed a measure of event related ruminations, the Quest Scale, an index of religious participation, and the Posttraumatic Growth Inventory. The three subscales of the Quest Scale, the two groups of rumination items (soon after event/ within past two weeks), and the index of religious participation were entered in a standard multiple regression with the total score of the Postlraumatic Growth Inventory as the dependent variable. The degree of rumination soon after the event and the degree of openness to religious change were significantly related to Posttraumatic Growth. Congruent with theoretical predictions, more rumination soon after the event, and greater openness to religious change were related to more posttraumatic growth. Present findings offer some confirmation of theoretical predictions, and also offer clear direction for further research on the relationships of religion, rumination, and posttraumatic growth.
Effects of posttraumatic stress and acculturation on marital functioning in Bosnian refugee couples
Authors: Spasojević Jelena , Heffer Robert W. , Snyder Douglas K.
Published: December 2002

Forty Bosnian refugee couples living in the United States completed a translated version of the PTSD Symptom Scale—Self Report, the Behavioral Acculturation Scale, the Marital Satisfaction Inventory—Revised, and a demographic questionnaire. Posttraumatic stress disorder (PTSD) symptomatology was the best predictor of marital functioning and was related negatively to acculturation. After controlling for PTSD, acculturation did not predict marital functioning. Wives' marital satisfaction was best predicted by husbands' PTSD, husbands' acculturation, and their own PTSD. Husbands' marital satisfaction was not predicted significantly by any of these variables. These findings suggest several implications for mental health professionals dealing with refugees and other traumatized populations.
Relationship between attachment style and posttraumatic stress symptomatology among adults who report the experience of childhood abuse
Authors: Muller Robert T. , Sicoli Lisa A. , Lemieux Kathryn E.
Published: December 2002

This study examines the relationship between adult attachment style and posttraumatic stress symptomatology in a volunteer sample of adults who reported the experience of childhood abuse. Sixty‐six individuals completed measures of abuse history, attachment style, and posttraumatic stress symptomatology. Results indicated that 76% of participants endorsed one of the three insecure attachment styles (dismissing, fearful, or preoccupied). Analyses of variances revealed that those who displayed fearful and preoccupied attachment styles, which represent a negative view of the self, had the highest mean scores on posttraumatic sympoms. Correlational analyses revealed a significant positive relationship between negative view of self and posttraumatic stress symptomatology, but not between negative view of other and posttraumatic stress symptomatology. Regression analyses indicated that having a negative view of self was most highly associated with posttraumatic stress symptoms, followed by a history of physical abuse. The regression analysis further indicated that negative view of other was unrelated to posttraumatic stress symptoms.
Distress experienced by participants during an epidemiological survey of posttraumatic stress disorder
Authors: Parslow Ruth A. , Jorm Anthony F. , O'Toole Brian I. , Marshall Richard P. , Grayson David A.
Published: December 2002

We examined the potential for epidemiological studies of mental disorders, specifically of posttraumatic stress disorder (PTSD), to cause further harm to participants involved. Of 1,000 randomly selected Australian Vietnam veterans. 641 agreed to participate in an epidemiological survey. Participants were asked about distress experienced during the interview when traumatic events were raised. Significant distress attributed to the interview was reported by 75.3% of those with current PTSD, 56.5% of those with past PTSD, and 20.6% of those with no PTSD diagnosis. Distress did not affect participants' use of medical services following the interview nor did it affect their willingness to continue participating in the study. We concluded that research interviews about PTSD may cause short‐term distress, but found no evidence of long‐term harm.
Exploring the roles of emotional numbing, depression, and dissociation in PTSD
Authors: Feeny Norah C. , Zoellner Lori A. , Fitzgibbons Lee A. , Foa Edna B.
Published: December 2002

Some researchers consider emotional numbing a cardinal feature of posttraumatic stress disorder (PTSD). Others view numbing symptoms as representing an overlap between PTSD, depression, and dissociation. In this study, we examined the ability of early emotional numbing, depression, and dissociation symptoms to predict PTSD. One‐hundred sixty‐one women who were recent victims of sexual or nonsexual assault were assessed prospectively for 12 weeks. Emotional numbing, depression, and dissociation were each associated with initial PTSD severity. Notably, regression analyses revealed that after depression and dissociation were accounted for, early numbing contributed to the prediction of later PTSD.
Trauma exposure and PTSD symptoms in international relief and development personnel
Authors: Eriksson Cynthia B. , Kemp Hendrika Vande , Gorsuch Richard , Hoke Stephen , Foy David W.
Published: December 2002

International relief and development personnel may be directly or indirectly exposed to traumatic events that put them at risk for developing symptoms of Post‐traumatic Stress Disorder (PTSD). In order to identify areas of risk and related reactions, surveys were administered to 113 recently returned staff from 5 humanitarian aid agencies. Respondents reported high rates of direct and indirect exposure to life‐threatening events. Approximately 30% of those surveyed reported significant symptoms of PTSD. Multiple regression analysis revealed that personal and vicarious exposure to life‐threatening events and an interaction between social support and exposure to life threat accounted for a significant amount of variance in PTSD severity. These results suggest the need for personnel programs; prede‐ployment training, risk assessment, and contingency planning may better prepare personnel for service.
Prevalence, characteristics, and long‐term sequelae of natural disaster exposure in the general population
Authors: Briere John , Elliott Diana
Published: December 2002

A sample of 935 participants from the general population completed a mail‐out questionnaire containing the Trauma Symptom Inventory (J. Briere, 1995) and the Traumatic Events Survey (D. M. Elliott, 1992). The lifetime seif‐reported prevalence of natural disasters in this sample was 22%. Although time from the last disaster to involvement in the study was an average of 13 years, previous disaster was associated with significantly higher scores on 6 of 10 symptom scales. Disaster characteristics (especially the presence of physical injury, fear of death, and property loss) were better predictors of symptomatology than was disaster type. Disaster exposure continued to predict symptomatology after controlling for interpersonal violence history, although interpersonal violence accounted for more overall symptom variance.
Validation of a self‐report measure of posttraumatic stress disorder in a sample of college‐age women
Authors: Cross Melissa R. , McCanne Thomas R.
Published: December 2002

The Posttraumatic Stress Disorder Interview (PTSD‐I; Watson, C. G., Juba, M., Manifold, V., Kucala, T., & Anderson, E. D., 1991) was adapted into a self‐report questionnaire, the Posttraumatic Stress Disorder Questionnaire (PTSD‐Q), which was validated against the Structured Clinical Interview for DSM‐IV (SCID‐IV) PTSD module (First, Spitzer, Gibbon, & Williams, 1995), using a sample of 76 college‐age women who were not seeking help for psychological problems. The women completed the PTSD‐Q and were later interviewed with the SCID‐IV PTSD module. Use of a Receiver Operating Characteristic curve analysis indicated that a cut point of 60 on the PTSD‐Q provided the optimal diagnostic efficiency relative to the SCID‐IV diagnosis. Using a cut point of 60 on the PTSD‐Q resulted in a sensitivity of .81 and a specificity of .82, relative to SCID‐IV diagnoses. The PTSD‐Q may be a useful screening measure to identify individuals who are not seeking help but who have PTSD.