bluuebunny/crossref_metadata_2025 huggingface dataset:
Informal Caregiving to Persons with AIDS in the United States: Caregiver Burden Among Central Cities Residents Eighteen to Forty‐Nine Years Old
Authors: Turner Heather A. , Catania Joseph A.
Published: September 2003

Characteristics and caregiving experiences of friends and family members caring for people with AIDS (PWAs) were examined. Based on a probability sample of informal AIDS caregivers ages 18–49 living in central cities of the United States (n = 260), analyses were conducted to (a) identify the sociodemographic characteristics of young central city caregivers; and (b) examine the effects of caregiver characteristics (relationship to PWA, gender, race/ethnicity, income, sexual orientation, HIV status, perceived susceptibility), and level of objective caregiving demands, on subjective caregiver burden. Results indicate that the largest group of caregivers in this age category are male friends of the PWA—a group not typically found among caregivers to persons with other types of illnesses. In general, gay or bisexual caregivers, caregivers who have traditional family ties to the PWA, men relative to women, and lower income caregivers, report the greatest burden. While level of caregiving demands represents the most influential predictor of caregiver burden, white and male caregivers experience greater burden, independent of level of involvement and other caregiver characteristics. Receiving instrumental support with caregiving buffers the impact of high objective demands on subjective burden.
The Multitextured Lives of Women of Color
Authors: Bond Meg A.
Published: September 2003

In this commentary, I suggest that our work with women of color should be held together by three primary threads: (a) appreciation for history as we decipher and interpret the adaptive strategies of women of color; (b) recognition of the intersections of race, gender, and class as central to our work; and (c) self‐critical examination of the meanings we attach to “difference.” The papers in the current special issue provide good examples regarding the importance of each thread. I argue that attention to these three themes should help us to keep our focus on contextually driven questions and to move forward our appreciation for the lives of women of color.
The Experience of Caregiving Among Mothers of Adults Suffering from Psychotic Disorders: Factors Associated with Their Psychological Distress
Authors: St-Onge Myreille , Lavoie Francine
Published: September 2003

To identify correlates of psychological distress among multiple indicators, 99 women with adult children suffering from a psychotic disorder were interviewed. The women, who were recruited through hospitals and self‐help groups, represented different socioeconomic levels. A face‐to‐face standardized interview was conducted, mainly in the participants' homes. Multiple hierarchical regression analysis showed that dimensions of burden and social support were strongly associated with distress reported by the participants. The negative interactions that participants had with their main confidant or spouse constituted a more powerful correlate than their perception of the quality of this relationship. Furthermore, a perception of their own health as poorer is a strong correlate of their distress. Since no control group was studied simultaneously, these results suggest, but do not prove, the presence of differences between mothers of adults with psychotic disorders and other mothers.
Dissociation, posttraumatic symptomatology, and sexual revictimization: A prospective examination of mediator and moderator effects
Authors: Sandberg David A. , Matorin Abigail I. , Lynn Steven Jay
Published: September 2003

Using prospective data gathered from a sample of 323 college women over a 10‐week academic quarter, the present study examined whether dissociation and posttraumatic symptomatology mediate or moderate sexual revictimization. Results indicated that posttraumatic symptomatology, but not dissociation, moderated the link between previous and subsequent sexual victimization. Neither posttraumatic symptomatology nor dissociation mediated revictimization.
Treatment outcome in Australian veterans with combat‐related posttraumatic stress disorder: A cause for cautious optimism?
Authors: Creamer Mark , Morris Philip , Biddle Dirk , Elliott Peter
Published: September 2003

This study investigated treatment outcome in combat‐related posttraumatic stress disorder (PTSD). Participants were 419 Australian Vietnam veterans who completed a 12‐week hospital‐based program. A comprehensive protocol assessed PTSD, comorbidity, and social functioning at admission and at 3 and 9 months posttreatment. Overall, the group showed significant improvements in core PTSD symptoms, anxiety, depression, alcohol abuse, social dysfunction, and anger. Changes occurred mostly between admission and 3 months posttreatment, with gains maintained at 9 months. Ratings by patients and their partners indicated perceived improvement and strong satisfaction with treatment. Nevertheless, treatment gains were variable and, for most veterans, considerable pathology remained following the programs. The current study provides grounds for cautious optimism in the treatment of combat‐related PTSD.
Effects of guided imagery on memory distortion in women reporting recovered memories of childhood sexual abuse
Authors: Clancy Susan A. , McNally Richard J. , Schacter Daniel L.
Published: September 2003

We tested whether having participants imagine unusual childhood events inflates their confidence that these events happened to them, and tested whether this effect is greater in women who report recovered memories of childhood sexual abuse than in women who do not. Participants were pretested on how confident they were that certain childhood events had happened to them before being asked to imagine some of these events in the laboratory. New confidence measures were readministered. Although guided imagery did not significantly inflate confidence that early childhood events had occurred in either group, the effect size for inflated confidence was more than twice as large in the control group as in the group with recovered memory. These data suggest that individuals can counteract memory distortions potentially associated with guided imagery, at least under some conditions.
Effects of varying diagnostic criteria for posttraumatic stress disorder are endorsing the concept of partial PTSD
Authors: Schützwohl Matthias , Maercker Andreas
Published: September 2003

The purpose of the present study was to investigate the appropriateness of different diagnostic criteria sets for posttraumatic stress disorder (PTSD). This was done by varying diagnostic criteria on the diagnosis of PTSD in a study group of N = 146 former political prisoners, and comparing the resulting diagnostic groups with a study group of N = 75 nontraumatized controls with regard to mean scores on measures of subjective distress (i.e., IES‐R, BDI, BAI, SCL‐90‐R). The findings did not support the diagnostic boundaries as defined by the DSM‐IV or the lowering of the avoidance criterion from three to two symptoms. The concept of partial PTSD appeared to be the most appropriate way to provide diagnostic coverage for those who did not meet full DSM IV criteria.
Reliability of reports of violent victimization and posttraumatic stress disorder among men and women with serious mental illness
Authors: Goodman Lisa A. , Thompson Kim M. , Weinfurt Kevin , Corl Susan , Acker Pat , Mueser Kim T. , Rosenberg Stanley D.
Published: September 2003

Although violent victimization is highly prevalent among men and women with serious mental illness (SMI; e.g., schizophrenia, bipolar disorder), future research in this area may be impeded by controversy concerning the ability of individuals with SMI to report traumatic events reliably. This article presents the results of a study exploring the temporal consistency of reports of childhood sexual abuse, adult sexual abuse, and adult physical abuse, as well as current symptoms of posttraumatic stress disorder (PTSD) among 50 people with SMI. Results show that trauma history and PTSD assessments can, for the most part, yield reliable information essential to further research in this area. The study also demonstrates the importance of using a variety of statistical methods to assess the reliability of self‐reports of trauma history.
MMPI, MMPI‐2 and PTSD: Overview of scores, scales, and profiles
Authors: Lyons Judith A. , Wheeler‐Cox Trilby
Published: September 2003

A number of issues should be considered when applying profile interpretations and subscales derived from the original MMPI. These issues and the overall utility of the MMPI‐2 for posttraumatic stress disorder (PTSD) evaluations are summarized. The Keane PTSD scale is found to be an effective tool for differential diagnosis when a cut‐off score of 28 is used. The Schlenger PTSD scale warrants additional study. Various MMPI‐2 validity scales are useful in detecting malingering, but concurrence regarding cut‐off scores is lacking. The 2‐8/8‐2 MMPI PTSD profile does not emerge as consistently on the MMPI‐2 as it did on the MMPI, due to the frequent elevation of scale 7 on the MMPI‐2.
Pathways from war trauma to posttraumatic stress symptoms among Tamil asylum seekers, refugees, and immigrants
Authors: Steel Zachary , Silove Derrick , Bird Kevin , McGorry Patrick , Mohan P.
Published: September 2003

Path analysis was used to examine the antecedents of posttraumatic stress (PTS) symptoms in Tamil asylum‐seekers, refugees, and immigrants in Australia. The Harvard Trauma Questionnaire and a postmigration living difficulties questionnaire were completed by 62 asylum‐seekers, 30 refugees, and 104 immigrants who responded to a mail‐out. Demographic characteristics, residency status, and measures of trauma and postmigration stress were fitted to a structural model in PTS symptoms. Premigration trauma exposure accounted for 20% of the variance of PTS symptoms. Postmigration stress contributed 14% of the variance. Although limited by sampling constraints and retrospective measurement, the study supports the notion that both traumatic and posttraumatic events contribute to the expression of PTS symptoms.
The effects of exposure to community violence on Khmer refugee adolescents
Authors: Berthold S. Megan
Published: September 2003

The aim of the study was to examine the relationship between exposure to violence and mental health outcomes among Khmer refugee adolescents. Seventy‐six Khmer junior and senior high school students and their parents participated in a cross‐sectional survey study. Half of the adolescents survived violence directed at them, and two thirds witnessed violence. Although approximately one quarter either partially or fully met the criteria for posttraumatic stress disorder (PTSD), most were functioning adequately. Ordinary least squares regression analyses indicated that the number of violent events they were exposed to in their lifetime significantly predicted their level of functioning and PTSD. Recommendations for future research and implications for clinicians and educators working with Khmer and other refugee adolescents are discussed.
Hospitalized adolescents' reports of sexual and physical abuse: A comparison of two self‐report measures
Authors: Lipschitz Deborah S. , Bernstein David P. , Winegar Robert K. , Southwick Steven M.
Published: September 2003

This study assesses the consistency of adolescents' reports of sexual and physical abuse via two self‐report questionnaires with different measurement approaches and examines demographic and psychopathological characteristics that influence abuse reporting. Seventy adolescent inpatients completed the Childhood Trauma Questionnaire (CTQ) (Likert‐type items are summed to form dimensional scales, and cutoff scores determine abuse status), the Traumatic Events Questionnaire—Adolescents (multiple‐choice items determine abuse status) and measures of depression, suicidal ideation, and dissociative symptoms. Consistent reports of physical and sexual abuse were given by 86% and 71% of youngsters, respectively. Discrepant reporters of sexual abuse were significantly more likely to be male, whereas consistent reporters were significantly more depressed and suicidal and reported higher levels of sexual abuse and emotional and physical neglect. Adolescents, for the most part, were consistent in their responses about sexual and physical abuse on both a Likert scale and a direct‐answer‐format questionnaire. The CTQ had a lower threshold for detection of sexual abuse, particularly for boys.
Validation of the PTSD checklist–civilian version in survivors of bone marrow transplantation
Authors: Smith Meredith Y. , Redd William , DuHamel Katherine , Vickberg Suzanne Johnson , Ricketts Patricia
Published: September 2003

Life‐threatening illness now qualifies as a precipitating stressor for posttraumatic stress disorder (PTSD). We examined the validity of the PTSD Checklist–Civilian Version (PCL–C; Weathers, Litz, Herman, Juska, & Keane, 1993), a brief 17‐item inventory of PTSD‐like symptoms, in a sample of 111 adults who had undergone bone marrow transplantation an average of 4.04 years previously. Exploratory factor analysis of the PCL–C identified four distinct patterns of symptom responses: Numbing–Hyperarousal, Dreams–Memories of the Cancer Treatment, General Hyperarousal, Responses to Cancer‐Related Reminders and Avoidance–Numbing. Respondents meeting PTSD symptom criteria on the PCL–C had significantly lower physical, role, and social functioning, greater distress and anxiety, and significantly more intrusive and avoidant responses than individuals who did not meet PTSD symptom criteria.
Performance of children of adults with PTSD on the Stroop color‐naming task: A preliminary study
Authors: Moradi Ali R. , Neshat‐Doost Hamid T. , Taghavi Reza , Yule William , Dalgleish Tim
Published: September 2003

Investigators have used various experimental paradigms to study how individuals with different emotional disorders process emotional information. However, little research has been done on relatives of individuals with emotional disorders, despite developments in the area of emotional contagion. In the current experiment, children of adults with posttraumatic stress disorder (PTSD) (n = 18) and control participants (n = 21), ages 9–17 years, participated in a modified Stroop color‐naming task. The results indicated that the children of adults with PTSD showed increased Stroop interference for threat‐related relative to neutral words and to the performance of the controls. These findings are discussed with respect to the literature on information processing in PTSD and emotional contagion in families.
PTSD among bereaved parents following the violent deaths of their 12‐ to 28‐year‐old children: A longitudinal prospective analysis
Authors: Murphy Shirley A. , Braun Tom , Tillery Linda , Cain Kevin C. , Johnson L. Clark , Beaton Randal D.
Published: September 2003

This study examined the prevalence of posttraumatic stress disorder (PTSD) among parents bereaved by the violent deaths of their 12‐ to 28‐year‐old children. A community‐based sample of 171 bereaved mothers and 90 fathers was recruited by a review of Medical Examiner records and followed for 2 years. Four important findings emerged: Both parents' gender and children's causes of death significantly affected the prevalence of PTSD symptoms. Twice as many mothers and fathers whose children were murdered met PTSD caseness (full diagnostic) criteria compared with accident and suicide bereavement. Symptoms in the reexperiencing domain were the most commonly reported. PTSD symptoms persisted over time, with 21% of the mothers and 14% of the fathers who provided longitudinal data still meeting caseness criteria 2 years after the deaths. Parents who met caseness criteria for PTSD, compared with those who did not, were significantly different on multiple study variables. Both theoretical and clinical implications for the findings are discussed.
Evaluation of dream content in combat‐related PTSD
Authors: Esposito Karin , Benitez Amparo , Barza Lydia , Mellman Thomas
Published: September 2003

Nightmares that replicate traumatic events are among the criteria that define posttraumatic stress disorder (PTSD); however, there has been limited systematic assessment of the content of dreams in PTSD. A PTSD dream rating instrument was developed to operationalize features attributed to dreams associated with combat‐related PTSD that incorporated dimensions from the dream content analysis literature, and its reliability was assessed. Then the instrument was used to characterize dream reports in 18 Vietnam combat veterans diagnosed with PTSD. Approximately half of the group's target dreams contained features characteristic of combat, and all but 3 (17%) were moderately to highly threatening. Fifty‐three percent were set at least partially in the present and 79% contained distorted elements. We therefore conclude that target dreams of combat veterans with PTSD vary with regard to replication of trauma and elements normally associated with dreaming, but typically are threatening.
Effects of varying scoring rules of the clinician administered PTSD scale (CAPS) for the diagnosis of PTSD after acute burn injury
Authors: Fleming Megan P. , Difede JoAnn
Published: September 2003

The Clinician Administered Posttraumatic Stress Disorder Scale (CAPS) enables quantification of the severity of each of the 17 posttraumatic stress disorder (PTSD) symptoms. Blanchard and colleagues (1995) have documented variation in rates of PTSD among survivors of motor vehicle accidents depending on the CAPS scoring rule used. This report examines the effects of varying the scoring rules of the CAPS on rates of acute PTSD symptoms in hospitalized burn patients. Changing from the most liberal to the most conservative scoring rule resulted in a change in diagnosis of acute PTSD from 25% to 32% of the sample. The variation documented in this study and others has implications for a range of issues, including rates of PTSD in epidemiological studies, treatment outcome research, and forensic evaluations.
Compelled attention: The effects of viewing trauma‐related stimuli on concurrent task performance in posttraumatic stress disorder
Authors: Chemtob Claude M. , Roitblat Herbert L. , Hamada Roger S. , Muraoka Miles Y. , Carlson John G. , Bauer Gordon B.
Published: September 2003

We examined the ability of Vietnam veterans with PTSD to focus attention on a primary digit detection task while concurrently viewing neutral or Vietnam‐related picture and word distractors. Controlling for combat exposure, military service, and psychopathology, veterans with PTSD took longer to detect the target when Vietnam‐related pictures were distractors. There were no reaction time differences when word stimuli were distractors. The latency effect was specific to trials with trauma‐related pictures and did not spread to neutral trials interleaved within a mixed block of trauma and neutral pictures. Individuals with PTSD recalled proportionally more Vietnam‐related words than other groups, implying differential attention to Vietnam‐related words. Attending to trauma‐related pictures interferes with performance of a concurrent task by individuals with PTSD.
Posttraumatic stress disorder and interpersonal functioning in Vietnam war veterans: A mediational model
Authors: MacDonald Carol , Chamberlain Kerry , Long Nigel , Flett Ross
Published: September 2003

This study examines the association between posttraumatic stress disorder (PTSD) and interpersonal functioning in a New Zealand community sample of 756 Vietnam War veterans. The results support previous research findings showing that PTSD adversely affects veterans' interpersonal relationships, family functioning, and marital/dyadic adjustment and show that the effects of PTSD on family functioning and dyadic adjustment are mediated by severity of interpersonal problems. It is suggested that higher levels of PTSD affect the ability of veterans to initiate and maintain interpersonal relationships and that these interpersonal problems are evident in poorer levels of family functioning and poorer dyadic adjustment.
A comparison of ICD10 and DSM‐IV criteria for posttraumatic stress disorder
Authors: Peters Lorna , Slade Tim , Andrews Gavin
Published: September 2003

The assumption that participants receiving an ICD10 diagnosis of posttraumatic stress disorder (PTSD) will also receive a DSM‐IV diagnosis of PTSD was tested. Data were gathered for 1,364 participants using the Composite International Diagnostic Interview (CIDI). The 12‐month prevalence of PTSD was 3% for DSM‐IV and 7% for ICD10 Diagnostic Criteria for Research (ICD10‐DCR). The agreement between the two systems was fair (kappa = .50). Forty eight percent of the discrepancies between the systems were accounted for by the additional criterion requiring clinically significant distress or impairment included in DSM‐IV. The inclusion of symptoms of general numbing of responsiveness accounted for 18% of the discrepancies. It is concluded that ICD10‐DCR PTSD cannot be assumed to be identical to DSM‐IV PTSD.
Dissociative processes and symptoms of posttraumatic stress in Vietnam veterans
Authors: Tampke Anna K. , Irwin Harvey J.
Published: September 2003

The diagnostic taxonomy of posttraumatic stress disorder (PTSD) is a contentious issue. Commentators are divided as to whether PTSD should remain grouped with the anxiety disorders or conceptualized as a dissociative disorder. This study sought to clarify the issue by investigating the extent to which anxiety and dissociative processes differentially predict the severity of each of the three symptom clusters in PTSD. Seventy‐four Australian veterans of the Vietnam War were assessed on measures of dissociation, trait anxiety, and posttraumatic stress symptomatology. Multiple regression analyses showed that all three symptoms clusters were predicted by anxiety, but the clusters differed in the pattern of their relationship with dissociation variables. The failure of pathological dissociation to predict PTSD symptoms prompts a reconsideration of the point at which dissociative mechanisms may impact on this disorder. The findings are consistent with current classification of combat‐related PTSD as an anxiety disorder.
Effects of mode of writing on emotional narratives
Authors: Brewin Chris R. , Lennard Hayley
Published: September 2003

The authors hypothesized that writing longhand about a stressful experience, compared to typing, arouses greater negative emotion. Eighty college students were randomly assigned to describe either a neutral or stressful topic by typing or writing longhand, in a 2 × 2 factorial design. Students describing the stressful topic, compared to the neutral topic, wrote for a longer period, used more words, and reported greater negative and less positive affect. Consistent with prediction, writing about a stressful experience longhand induced greater negative affect than typing, and led to more self‐rated disclosure. These findings suggest a method whereby therapists can help patients control their levels of negative affect when producing a trauma narrative.
Posttraumatic stress disorder and service utilization among urban mental health center clients
Authors: Switzer Galen E. , Dew Mary Amanda , Thompson Kenneth , Goycoolea Jean M. , Derricott Tonya , Mullins Stephen D.
Published: September 2003

Although the urban poor are at high risk for exposure to trauma, community mental health clinics rarely diagnose clients with PTSD. Failure to diagnose PTSD may undermine the effectiveness of services provided. Our objectives were to (1) assess prevalence of traumatic experiences and PTSD, and (2) examine differences in service utilization between those who had PTSD and those who did not. Interview data were gathered from 181 urban psychiatric outpatients. A substantial number of clients had experienced at least one lifetime trauma (94%), and of those, 42% had PTSD during the past year. Analyses comparing service use between PTSD and nonPTSD clients supported our expectation that clients with PTSD would use more mental health services, and would be less satisfied with services than their nonPTSD counterparts.
MMPI‐2 data for Australian Vietnam veterans with combat‐related PTSD
Authors: Forbes David , Creamer Mark , McHugh Tony
Published: September 2003

Considerable attention has been devoted to the MMPI in the assessment of combat‐related PTSD. To date, published data have focused almost exclusively on American Vietnam veterans. This study investigated MMPI‐2 profiles of 100 Australian Vietnam veterans admitted to an intensive PTSD treatment program. Comparisons with United States (U.S.) data suggested strong similarities between the American and Australian populations in terms of F‐scale elevations and typical 3‐point code types (8‐7‐2). However, the American samples showed relatively higher elevations of Scales 4 and 6, suggesting social alienation and a tendency to externalize, while a subgroup of Australian veterans showed a greater propensity for somatization (Scale 1). The results provide overall support for the generalizability of American MMPI data to an alternative cultural group of combat veterans.
Partner abuse and posttraumatic stress disorder as risk factors for suicide attempts in a sample of low‐income, inner‐city women
Authors: Thompson Martie P. , Kaslow Nadine J. , Kingree J. B. , Puett Robin , Thompson Nancy J. , Meadows Lindi
Published: September 2003

This study examined partner abuse and posttraumatic stress disorder (PTSD) as risk factors for suicidal behavior among women, and whether or not PTSD mediated the partner abuse‐suicidal behavior association. Attempters (n = 119) were approximately three times more likely to be above clinical cut‐points for physical partner abuse, nonphysical abuse, and PTSD than nonattempters (n = 85). Physical partner abuse, but not nonphysical partner abuse, was associated with an increased risk for PTSD. Further, PTSD mediated the link between physical partner abuse and suicidality, such that when PTSD was statistically controlled, the association between physical partner abuse and suicide attempt status was reduced to nonsignificance. Implications of findings for interventions for female victims of partner abuse, and women who make nonfatal suicide attempts are discussed.
Chronicity in posttraumatic stress disorder (PTSD) and predictors of course of comorbid PTSD in patients with anxiety disorders
Authors: Zlotnick Caron , Warshaw Meredith , Shea M. Tracie , Allsworth Jennifer , Pearlstein Teri , Keller Martin B.
Published: September 2003

The purpose of this study was to examine the course of comorbid posttraumatic stress disorder (PTSD) in 54 patients with another anxiety disorder. Using a prospective longitudinal design, the present study found that during the first 5 years of follow‐up the probability of full remission from a chronic episode of PTSD was .18. Findings from this and other research confirm clinical impressions that a substantial number of people never fully remit from their PTSD even after many years. Variables associated with a longer time to remit from an episode of chronic PTSD were a history of alcohol abuse and a history of childhood trauma.
A model of war zone stressors and posttraumatic stress disorder
Authors: Fontana Alan , Rosenheck Robert
Published: September 2003

We present a theoretical model of field placement, war zone stressors (fighting, death and injury of others, threat of death or injury to oneself, killing others, participating in atrocities, harsh physical conditions and insufficiency of resources in the environment) and posttraumatic stress disorder (PTSD). Theater veterans from the National Vietnam Veterans Readjustment Study were divided randomly into two subsamples of 599 each. The model was developed on the first subsample and cross‐validated on the second using structural equation modeling. The model provides a theoretically and empirically satisfactory description of the anatomy of war zone stressors and their role in the etiology of PTSD, but it leaves unanswered important questions regarding the etiological role of insufficiency of resources in the environment.
Psychological impact and prevalence of traumatic events in a student sample in Israel: The effect of multiple traumatic events and physical injury
Authors: Amir Marianne , Sol Oren
Published: September 2003

The prevalence of exposure and the psychological impact of traumatic events were studied in 983 Israeli university students. The psychological effects of exposure to single versus multiple traumatic events, and the effects of trauma‐related physical injury were also examined. It was found that 67% of the respondents reported having been exposed to at least one traumatic event. Of those exposed, 6% were diagnosed as having posttraumatic stress disorder (PTSD). Men were more at risk for exposure, but women were more at risk for PTSD. Women and the physically injured showed more psychological distress following exposure. Being exposed to one type of traumatic event was associated with increased psychological distress, but being exposed to multiple types of traumatic events was associated with lowering of distress. The results are discussed in comparison with similar studies from the United States.
Cues, frequency, and the disturbing nature of intrusive thoughts: Patterns seen in rescue workers after the crash of Flight 427
Authors: Schooler Tonya Y. , Dougall Angela Liegey , Baum Andrew
Published: September 2003

Intrusive thoughts have been identified as key elements of chronic or traumatic stress, but many questions remain about how they operate and what causes persistence of disturbing intrusions. The present study considers these questions, examining the impact of having intrusive thoughts that are cued by stimuli in one's environment as opposed to uncued intrusions that seem to “come out of the blue.” In addition, this research evaluates the extent to which distress accompanying intrusive thoughts shortly after a traumatic event predicts persistence of intrusions over time. Rescue workers who responded to the crash of Flight 427 were studied 4 to 8 weeks, and 6, 9, and 12 months after the disaster. Participants who reported crash‐related thoughts that were not prompted by cues showed higher levels of distress than those reporting only cued thoughts or those reporting neither. The magnitude of distress that these thoughts caused in the first 2 months after the crash was important in predicting subsequent frequency of unwanted thoughts. The presence or absence of cues and their role in the maintenance of distress also is discussed.
Screening for posttraumatic stress disorder symptoms among Bosnian refugees
Authors: Thulesius Hans , Håkansson Anders
Published: September 2003

To assess the level of posttraumatic stress disorder (PTSD) symptoms among Bosnian war refugees, a consecutive cohort of 206 Bosnian refugees, arriving in Sweden in 1993, was screened for PTSD using a modified version of the self‐report instrument PTSS‐10. A comparison group of 387 visitors to seven Swedish health centers was recruited. Prevalence of possible PTSD, using two estimates, was 18 to 33% among the Bosnian refugees, and .3 to 1% in the comparison group. The PTSS‐10 showed high internal consistency reliability (Cronbach's alpha = .92) and stability (test‐retest reliability r = .89). Thus, Bosnian war refugees showed high levels of PTSD symptoms compared to a nonrefugee comparison group.
Prevalence of depressive and alcohol abuse symptoms among women VA outpatients who report experiencing sexual assault while in the military
Authors: Hankin Cheryl S. , Skinner Katherine M. , Sullivan Lisa M. , Miller Donald R. , Frayne Susan , Tripp Tara J.
Published: September 2003

Among a national sample of 3,632 women VA outpatients, we determined self‐reported prevalence of sexual assault experienced during military service and compared screening prevalence for current symptoms of depression and alcohol abuse between those who did and did not report this history. Data were obtained by mailed questionnaire. Military‐related sexual assault was reported by 23%. Screening prevalence for symptoms of current depression was 3 times higher and for current alcohol abuse was 2 times higher among those who reported experiencing military‐related sexual assault. Recent mental health treatment was reported by 50% of those who reported experiencing sexual assault during military service and screened positive for symptoms of depression, and by 40% of those who screened positive for symptoms of alcohol abuse.
Bus commuters' coping strategies and anxiety from terrorism: An example of the Israeli experience
Authors: Gidron Yori , Gal Reuven , Zahavi Sa'ar
Published: September 2003

This study examined the use of three coping strategies: (1) emotion‐focused coping (calming‐distraction); (2) problem‐focused coping (checking‐behavior); and (3) denial (reduced perceived vulnerability), and their relationship to anxiety from terrorism among 50 Israeli bus commuters. Their mean age was 31 years (60% females). Commuting frequency was negatively correlated, and problem‐focused coping was positively correlated with anxiety from terrorism. Ratios of problem‐focused coping/denial and of problem‐focused/emotion‐focused coping were each positively correlated with anxiety from terrorism. Coping ratios accounted for 15% of the variance in anxiety from terrorism, after considering commuting frequency. Combining minimal problem‐focused preventative acts with distraction and reduced perceived vulnerability may be beneficial.
Posttraumatic stress disorder and traumatic brain injury: Are they mutually exclusive?
Authors: Joseph Stephen , Masterson Jackie
Published: September 2003

It has been suggested that posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) must be mutually incompatible disorders. However, growing empirical evidence has begun to question this. Evidence suggests that although PTSD may be relatively rare among the TBI population, some TBI patients seem to develop PTSD. We suggest two theoretical routes through which PTSD might develop in TBI patients: through nonconscious processes in individuals who are subsequently amnesic, but who were conscious at the time of the traumatic episode and through subsequent appraisal processes in individuals who were unconscious during the traumatic episode.
Combat, dissociation, and posttraumatic stress disorder in Australian Vietnam veterans
Authors: O'Toole Brian I. , Marshall Richard P. , Schureck Ralph J. , Dobson Matthew
Published: September 2003

The specificity of various wartime stressors for different posttraumatic stress disorder (PTSD) symptoms is inconsistently reported in the literature. Combat, wounding, and peritraumatic dissociation have not been assessed together in their effects on each of the various PTSD symptom clusters. This cohort study of a random sample of male Australian Army Vietnam veterans yielded psychiatric assessments of 641 subjects. PTSD measures comprised symptom criteria for reexperiencing, numbing and avoidance, hyperarousal, and PTSD diagnosis both lifetime and current within the past month. Logistic regression is used to examine the effects of combat, wounding, and peritraumatic dissociation together on PTSD. Combat experiences comprised four components derived from a principal components analysis of combat experiences: direct combat exposure, exposure to death and injury, exposure to civilian death and injury, and exposure to mutilation. Each was differentially related to reexperiencing, avoidance, hyperarousal, and PTSD diagnosis. Being wounded was not related to lifetime or current PTSD and peritraumatic dissociation was related to all diagnostic components of PTSD in the presence of other variables.
War‐related trauma and stress characteristics of American University of Beirut students
Authors: Abu‐Saba Mary B.
Published: September 2003

An investigation of war‐trauma was made utilizing an initial pool of 1,268 undergraduates at the American University of Beirut. Based on the number of war events the students had experienced, 400 students were invited to return for further questioning about their present stress characteristics. Inventories measuring anxiety, depression, and PTSD were administered to 273 students responding to the request. Those who experienced many war events scored significantly higher on all three stress scales. Women scored higher than men on anxiety regardless of war exposure category, but there was no difference between women and men on PTSD or depression.
An examination of antecedent traumas and psychiatric comorbidity among male inmates with PTSD
Authors: Gibson Laura E. , Holt John C. , Fondacaro Karen M. , Tang Tricia S. , Powell Thomas A. , Turbitt Erin L.
Published: September 2003

Despite substantially higher rates of posttraumatic stress disorder (PTSD) among male inmates than among men in the general population, there is a dearth of research on PTSD among incarcerated men. The current study addresses traumatic events that precede PTSD and psychiatric disorders that are comorbid with PTSD in an inmate sample. Seeing someone seriously injured or killed, being sexually abused, and being physically assaulted were the three most commonly reported antecedent traumas to PTSD. Lifetime and current rates of mood disorders, anxiety disorders, and antisocial personality disorder were elevated among inmates with a diagnosis of PTSD. Two hundred and thirteen inmates participated in the study. Sixty‐nine participants (33%) met lifetime DSM–III–R criteria for PTSD, and 45 (21%) met current criteria. The findings are compared with general population samples, and implications of the findings are discussed.
Analysis of violent behavior in Vietnam combat veteran psychiatric inpatients with posttraumatic stress disorder
Authors: McFall Miles , Fontana Alan , Raskind Murray , Rosenheck Robert
Published: September 2003

This study tested the hypothesis that male Vietnam veterans seeking inpatient treatment for PTSD (n = 228) exhibit more violent behavior compared with a mixed diagnostic group of male psychiatric inpatients without PTSD (n = 64) and a community sample of Vietnam veterans with PTSD not undergoing inpatient treatment (n = 273). Violent acts assessed included property destruction, threats without a weapon, physical fighting, and threats with a weapon. PTSD inpatients engaged in more types of violent behavior than both comparison conditions. Correlates of violence among PTSD inpatients included PTSD symptom severity and, to a lesser degree, measures of substance abuse. These findings justify routine assessment of violent behavior among inpatients with PTSD, as well as application of specialized interventions for anger dyscontrol and aggression.
Virtual reality exposure therapy for PTSD Vietnam veterans: A case study
Authors: Rothbaum Barbara Olasov , Hodges Larry , Alarcon Renato , Ready David , Shahar Fran , Graap Ken , Pair Jarrel , Hebert Philip , Gotz Dave , Wills Brian , Baltzell David
Published: September 2003

Virtual reality (VR) integrates real‐time computer graphics, body tracking devices, visual displays, and other sensory input devices to immerse a participant in a computer‐generated virtual environment that changes in a natural way with head and body motion. VR exposure (VRE) is proposed as an alternative to typical imaginal exposure treatment for Vietnam combat veterans with posttraumatic stress disorder (PTSD). This report presents the results of the first Vietnam combat veteran with PTSD to have been treated with VRE. The patient was exposed to two virtual environments, a virtual Huey helicopter flying over a virtual Vietnam and a clearing surrounded by jungle. The patient experienced a 34% decrease on clinician‐rated PTSD and a 45% decrease on self‐rated PTSD. Treatment gains were maintained at 6‐month follow‐up.
Dissociative symptoms in acute stress disorder
Authors: Harvey Allison G. , Bryant Richard A.
Published: September 2003

This study provides a profile of symptoms, and particularly dissociative symptoms, in the diagnosis of acute stress disorder (ASD) following motor vehicle accidents (MVAs). Consecutive adult non‐brain‐injured admissions to a major trauma hospital (N = 92) were assessed between 2 days and 4 weeks following an MVA. Presence of ASD was determined by a structured clinical interview. The occurrence of full and subsyndromal ASD was approximately 13% and 21%, respectively. The majority of those who met criteria for subsyndromal ASD did not meet the ASD criteria for dissociation. At least 80% of individuals who reported derealization also reported reduced awareness and depersonalization. This significant overlap between dissociative symptoms questions the discriminatory power and conceptual independence of the dissociative criteria. These findings suggest the need for a more refined conceptual and operational understanding of dissociative symptoms in the acute trauma stage.
Memory functioning in adult women traumatized by childhood sexual abuse
Authors: Stein Murray B. , Hanna Cindy , Vaerum Vibeke , Koverola Catherine
Published: September 2003

Memory impairment has been reported in some studies of patients with combat‐related posttraumatic stress disorder (PTSD) and in rape victims with PTSD. The authors tested whether explicit memory impairment was evident in adult women who were traumatized by severe sexual abuse in childhood. The California Verbal Learning Test (Delis, Kramer, Kaplan, & Ober, 1987) and the Benton Visual Retention Task (Benton, 1974) were administered to 22 female adult survivors of childhood sexual trauma and to 20 demographically and educationally similar nonvictimized women. No evidence was found of explicit memory impairment in the abuse survivors. Furthermore, neither PTSD severity, dissociative symptom severity, nor extent of preexisting amnesia for childhood trauma contributed to the variance in memory functioning. Additional studies are needed to determine the extent to which impaired explicit memory functioning is a common feature of posttraumatic stress syndromes.
Coping responses and posttraumatic stress symptomatology in urban fire service personnel
Authors: Beaton Randal , Murphy Shirley , Johnson Clark , Pike Ken , Corneil Wayne
Published: September 2003

Emergency workers, including urban fire fighters and paramedics, must cope with a variety of duty‐related stressors including traumatic incident exposures. Little is known about coping responses of emergency workers or whether their coping responses predict future mental health outcomes. The previously formulated Coping Responses of Rescue Workers Inventory (CRRWI) underwent a principal components analysis employing a sample (N = 220) of urban fire fighters and paramedics. Six empirically and theoretically distinct CRRWI components were identified which were relatively stable over a 6‐month period. Scores on one of the CRRWI scales, but neither years of service nor their past half year's traumatic incident exposures, predicted future changes in self‐reports of posttraumatic stress symptomatology.
Functional impairment and utilization of services associated with posttraumatic stress in the community
Authors: Amaya‐Jackson Lisa , Davidson Jonathan R. , Hughes Dana C. , Swartz Marvin , Reynolds Victoria , George Linda K. , Blazer Dan G.
Published: September 2003

This study describes social functioning and service utilization patterns associated with posttraumatic stress symptoms relative to nonpsychiatric controls and depressive disorder controls in a cross‐sectional epidemiological survey. Data from 49 cases and 147 controls who participated in the North Carolina component of the Epidemiologic Catchment Area study were examined. Results indicate that symptoms of posttraumatic stress were associated with impairment along several domains of functioning: social, financial, physical, and psychological. Individuals with posttraumatic stress were found to have more socioeconomic disadvantages and impaired functioning. Despite this, individuals with posttraumatic stress are receiving relatively few mental health services. Further research assessing service use, treatment, and functional outcomes are indicated.
Modeling physical health and functional health status: The role of combat exposure, posttraumatic stress disorder, and personal resource attributes
Authors: Taft Casey T. , Stern Amy S. , King Lynda A. , King Daniel W.
Published: September 2003

This study examined associations of combat exposure and posttraumatic stress disorder (PTSD) with physical health conditions and also incorporated hardiness and social support as mediators and functional health status as an outcome. Data were derived from 1,632 male and female Vietnam veterans who participated in the National Vietnam Veterans Readjustment Study. Path analysis revealed that hardiness and social support operated primarily as intermediary variables between combat exposure and PTSD, and PTSD emerged as the pivotal variable explaining physical health conditions and functional health status. Gender‐based differences in means and patterns of associations among variables were found. The results stress the importance of assessing trauma in clinical settings as a meaningful determinant of health outcomes.
Acute intrusive and avoidant PTSD symptoms as predictors of chronic PTSD following burn injury
Authors: Difede JoAnn , Barocas Daniel
Published: September 2003

Several studies have endeavored to learn if acute PTSD symptoms are predictive of chronic PTSD, with equivocal results. In the present study, acute intrusive and avoidant PTSD symptoms were analyzed as possible predictors of chronic PTSD following burn injury. Results showed that baseline IES scores, within one week of injury, were significantly different for those who were later diagnosed with chronic PTSD. Additional analyses, undertaken to assess the relative importance of each symptom group in predicting chronic PTSD, indicated that both the presence, per se, and severity of acute avoidant symptoms predicted chronic PTSD.
Childhood abuse and sexual revictimization in a female Navy recruit sample
Authors: Merrill Lex L. , Newell Carol E. , Thomsen Cynthia J. , Gold Steven R. , Milner Joel S. , Koss Mary P. , Rosswork Sandra G.
Published: September 2003

To examine effects of childhood abuse on adult rape, 1,887 female Navy recruits were surveyed. Overall 35% of recruits had been raped and 57% had experienced childhood physical abuse (CPA) and/or childhood sexual abuse (CSA). Controlling for CPA, rape was significantly (4.8 times) more likely among women who had experienced CSA than among women who had not. In contrast, CPA (controlling for CSA) was unrelated to likelihood of adult rape. Alcohol problems and number of sex partners were examined as mediators. Although both variabies predicted rape, their effects were independent of the effects of CSA. Finally, despite ethnic group differences in the prevalence of victimization, the predictors of rape did not differ significantly across ethnic groups.
Victimization experiences and HIV infection in women: Associations with serostatus, psychological symptoms, and health status
Authors: Kimerling Rachel , Armistead Lisa , Forehand Rex
Published: September 2003

The present investigation evaluates the relationship between HIV infection and victimization with regard to the interplay of these two factors as they relate to mental and physical health. Eighty eight inner‐city low income African‐American women who are HIV‐infected and a demographically similar comparison group of women who were not HIV‐infected were assessed for victimization experiences (rape, physical assault, robbery/attack) via interview. Additionally, the psychological symptoms and health status correlates of victimization within the HIV‐infected group are delineated. Results indicated that women in the HIV‐infected sample were significantly more likely to report a victimization experience. Additionally, within the HIV‐infected group, victims reported higher levels of global psychological distress, depressive symptomatology, and greater distress regarding physical symptoms than nonvictims. Furthermore, HIV‐infected victims were diagnosed with higher rates of AIDS‐defining conditions than HIV‐infected nonvictims. These results underscore the importance of acknowledging the experience of violent victimization in the prevention and treatment of HIV infection in women.