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Does PTSD occur in sentenced prison populations?CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 3 2007
A systematic literature review
Background,A systematic review of the literature on mental disorder in prisoners, published in 2002, made no mention of post-traumatic stress disorder (PTSD), but indicators from other studies suggest that a history of serious and chronic trauma is common among offenders. Aims,To conduct a systematic review of the literature with the specific questions: does any epidemiological study of sentenced prisoners include data on prevalence of PTSD while in prison? If so, what is the prevalence in this group? Method,Literature databases EMBASE, Medline, PsychInfo, PILOTS and SIGLE were searched. The Journal of Traumatic Stress was searched manually. Preliminary screening was conducted by reading abstracts of hundreds of papers. Ten exclusion criteria were then applied to the screened selection. Reference sections of all accessed papers were searched for any further studies. Results,One hundred and three potentially relevant papers were identified after preliminary screening. Four met all criteria for inclusion and suffered none of the exclusion criteria. PTSD rates ranged from 4% of the sample to 21%. Women were disproportionately affected. Conclusions and implications for practice,All four papers suggested that the prevalence of PTSD among sentenced prisoners is higher than that in the general population, as reported elsewhere. Overall the findings suggest a likely need for PTSD treatment services for sentenced prisoners. Copyright © 2007 John Wiley & Sons, Ltd. [source]
Fred Wilson, PTSD, and Me: Reflections on the History WarsCURATOR THE MUSEUM JOURNAL, Issue 4 2009
But if history is destined to be contested, where should museums be in that contest and how do we get there? Fred Wilson's Mining the Museum has turned out to be a path not taken; Enola Gay was a cautionary tale. But we should have these fights in museums, where the national narrative is blocked out and staged, because of how museums teach us, opening hidden windows on cloaked realities. Museums can start by becoming clearer about what they think they are doing when they make an exhibition. Exhibitions can have a profound effect on visitors at many levels but it doesn't happen very often. Is that because visitors seek another kind of experience from what we typically offer? [source]
The relationship between anxiety disorders and suicide attempts: findings from the National Epidemiologic Survey on Alcohol and Related ConditionsDEPRESSION AND ANXIETY, Issue 9 2010
Josh Nepon M.D.
Abstract Background: Previous work has suggested that anxiety disorders are associated with suicide attempts. However, many studies have been limited by lack of accounting for factors that could influence this relationship, notably personality disorders. This study aims to examine the relationship between anxiety disorders and suicide attempts, accounting for important comorbidities, in a large nationally representative sample. Methods: Data came from the National Epidemiologic Survey on Alcohol and Related Conditions Wave 2. Face-to-face interviews were conducted with 34,653 adults between 2004 and 2005 in the United States. The relationship between suicide attempts and anxiety disorders (panic disorder, agoraphobia, social phobia, specific phobia, generalized anxiety disorder, posttraumatic stress disorder (PTSD)) was explored using multivariate regression models controlling for sociodemographics, Axis I and Axis II disorders. Results: Among individuals reporting a lifetime history of suicide attempt, over 70% had an anxiety disorder. Even after adjusting for sociodemographic factors, Axis I and Axis II disorders, the presence of an anxiety disorder was significantly associated with having made a suicide attempt (AOR=1.70, 95% confidence interval (CI): 1.40,2.08). Panic disorder (AOR=1.31, 95% CI: 1.06,1.61) and PTSD (AOR=1.81, 95% CI: 1.45,2.26) were independently associated with suicide attempts in multivariate models. Comorbidity of personality disorders with panic disorder (AOR=5.76, 95% CI: 4.58,7.25) and with PTSD (AOR=6.90, 95% CI: 5.41,8.79) demonstrated much stronger associations with suicide attempts over either disorder alone. Conclusion: Anxiety disorders, especially panic disorder and PTSD, are independently associated with suicide attempts. Clinicians need to assess suicidal behavior among patients presenting with anxiety problems. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source]
Previous experience of spontaneous or elective abortion and risk for posttraumatic stress and depression during subsequent pregnancyDEPRESSION AND ANXIETY, Issue 8 2010
Abstract Background: Few studies have considered whether elective and/or spontaneous abortion (EAB/SAB) may be risk factors for mental health sequelae in subsequent pregnancy. This paper examines the impact of EAB/SAB on mental health during subsequent pregnancy in a sample of women involved in a larger prospective study of posttraumatic stress disorder (PTSD) across the childbearing year (n=1,581). Methods: Women expecting their first baby completed standardized telephone assessments including demographics, trauma history, PTSD, depression, and pregnancy wantedness, and religiosity. Results: Fourteen percent (n=221) experienced a prior elective abortion (EAB), 13.1% (n=206) experienced a prior spontaneous abortion (SAB), and 1.4% (n=22) experienced both. Of those women who experienced either an EAB or SAB, 13.9% (n=220) appraised the EAB or SAB experience as having been "a hard time" (i.e., potentially traumatic) and 32.6% (n=132) rated it as their index trauma (i.e., their worst or second worst lifetime exposure). Among the subset of 405 women with prior EAB or SAB, the rate of PTSD during the subsequent pregnancy was 12.6% (n,51), the rate of depression was 16.8% (n=68), and 5.4% (n,22) met criteria for both disorders. Conclusions: History of sexual trauma predicted appraising the experience of EAB or SAB as "a hard time." Wanting to be pregnant sooner was predictive of appraising the experience of EAB or SAB as the worst or second worst (index) trauma. EAB or SAB was appraised as less traumatic than sexual or medical trauma exposures and conveyed relatively lower risk for PTSD. The patterns of predictors for depression were similar. Depression and Anxiety, 2010.© 2010 Wiley-Liss, Inc. [source]
Efficacy of interpersonal therapy-group format adapted to post-traumatic stress disorder: an open-label add-on trialDEPRESSION AND ANXIETY, Issue 1 2010
Rosaly F.B. Campanini MSc.
Abstract Background: Post-traumatic stress disorder (PTSD) is a highly prevalent condition, yet available treatments demonstrate only modest efficacy. Exposure therapies, considered by many to be the "gold-standard" therapy for PTSD, are poorly tolerated by many patients and show high attrition. We evaluated interpersonal therapy, in a group format, adapted to PTSD (IPT-G PTSD), as an adjunctive treatment for patients who failed to respond to conventional psychopharmacological treatment. Methods: Research participants included 40 patients who sought treatment through a program on violence in the department of psychiatry of Federal University of São Paulo (UNIFESP). They had received conventional psychopharmacological treatment for at least 12 weeks and failed to have an adequate clinical response. After signing an informed consent, approved earlier by the UNIFESP Ethics Review Board, they received a semi-structured diagnostic interview (SCID-I), administered by a trained mental health worker, to confirm the presence of a PTSD diagnosis according to DSM-IV criteria. Other instruments were administered, and patients completed out self-report instruments at baseline, and endpoint to evaluate clinical outcomes. Results: Thirty-three patients completed the trial, but all had at least one second outcome evaluation. There were significant improvements on all measures, with large effect sizes. Conclusions: IPT-G PTSD was effective not only in decreasing symptoms of PTSD, but also in decreasing symptoms of anxiety and depression. It led to significant improvements in social adjustment and quality of life. It was well tolerated and there were few dropouts. Our results are very preliminary; they need further confirmation through randomized controlled clinical trials. Depression and Anxiety, 2010. © 2009 Wiley-Liss, Inc. [source]
Psychometric properties of the Trauma Assessment for AdultsDEPRESSION AND ANXIETY, Issue 2 2009
Matt J. Gray Ph.D.
Abstract Background: The Trauma Assessment for Adults (TAA) was developed to facilitate the assessment of exposure to traumatic events that could result in posttraumatic stress disorder (PTSD). The TAA inquires about numerous potentially traumatic events that an individual may have experienced. Although the TAA has been used extensively for clinical and research purposes, its psychometric properties have never been formally evaluated. The objective of the present investigation was to evaluate the psychometric properties of this frequently used measure. Methods: The studies reported here describe the performance of the TAA in two samples,college undergraduates (N=142) and community mental health center clients (N=67). Among undergraduates, 1-week temporal stability was evaluated and, in both samples, item- and scale-level convergence of the TAA with an established trauma exposure measure was assessed. Convergence of the TAA with clinically related constructs was also evaluated. Results: The TAA exhibited adequate temporal stability (r=.80) and satisfactory item-level convergence with existing measures of trauma history among college students. In the clinical sample, the TAA again converged well with an established measure of trauma exposure (r=.65). It was not as strongly predictive, in either sample, of trauma-related distress relative to an alternate trauma exposure measure. Conclusion: Although it performs satisfactorily, the TAA does not appear to be superior to other existing measures of trauma exposure. Depression and Anxiety, 2009. © 2008 Wiley-Liss, Inc. [source]
Negative appraisals and cognitive avoidance of intrusive memories in depression: a replication and extensionDEPRESSION AND ANXIETY, Issue 7 2008
Alishia D. Williams B.A. (Hons.)
Abstract Recent research has demonstrated that intrusive negative autobiographical memories represent a shared phenomenological feature of posttraumatic stress disorder (PTSD) and depression. A preliminary investigation (Starr and Moulds, 2006) successfully applied a cognitive appraisal model of PTSD to the maintenance of intrusive memories in depression. The current investigation sought to replicate and extend these findings. Two hundred and fifty first-year undergraduate students were interviewed to assess for the presence of a negative autobiographical memory that had spontaneously intruded in the past week. Participants completed self-report inventories assessing trait and situational employment of cognitive avoidance mechanisms in response to these memories. Consistent with Starr and Moulds, intrusion-related distress correlated with dysphoria, irrespective of intrusion frequency. Assigning negative appraisals to one's intrusive memory and attempts to control the memory were positively associated with intrusion-related distress, level of depression, and cognitive avoidance mechanisms. Additionally, negative appraisals and control influenced the employment rumination as an avoidant response to a greater degree than the corresponding trait tendency. Finally, negative appraisals and the use of cognitive mechanisms were predictive of depression concurrently. The results support the validity of borrowing from PTSD models to elucidate the cognitive mechanisms that maintain intrusive memories in depressed samples. Depression and Anxiety 0:1,8, 2007. © 2007 Wiley-Liss, Inc. [source]
Clinical and sociodemographic variables associated with the onset of posttraumatic stress disorder in road traffic accidentsDEPRESSION AND ANXIETY, Issue 5 2008
Ramón Coronas M.D.
Abstract Our objective was to identify variables related to the onset of acute posttraumatic stress disorder (PTSD) after a road traffic accident. We evaluated 60 victims of a motor vehicle accident (MVA) in 2004 at 2 months postaccident. Thirty of them had developed PTSD; the other 30 had not developed PTSD. Clinical data, physical injuries, and sociodemographic characteristics were determined in 60 victims. The Davidson Trauma Scale (DTS) and a Structured Clinical Interview for DSM-IV (SCID) were used to evaluate PTSD occurrence. PTSD scores assessed by DTS and SCID at 2 months were significantly and positively associated with female sex, severe physical injuries, perceived social deprivation, and loss of job activity due to the accident. Female sex, severe physical injury, perceived social deprivation, and sick leave were related to the diagnosis of PTSD 2 months after the accident. Depression and Anxiety 0:1,8, 2007. © 2007 Wiley-Liss, Inc. [source]
Rumination in posttraumatic stress disorderDEPRESSION AND ANXIETY, Issue 5 2007
Tanja Michael Ph.D.
Abstract Recent studies have shown that rumination is a powerful predictor of persistent posttraumatic stress disorder (PTSD). However, to date, the mechanisms by which rumination maintains PTSD symptoms are little understood. Two studies of assault survivors, a cross-sectional (N = 81) and a 6-month prospective longitudinal study (N = 73), examined several facets of ruminative thinking to establish which aspects of rumination provide the link to PTSD. The current investigation showed that rumination is not only used as a strategy to cope with intrusive memories but it also triggers such memories. Certain characteristics of rumination, such as compulsion to continue ruminating, occurrence of unproductive thoughts, and "why" and "what if" type questions, as well as negative emotions before and after rumination, were significantly associated with PTSD, concurrently and prospectively. These characteristics explained significantly more variance in PTSD severity than the mere presence of rumination, thereby indicating that not all ways of ruminative thinking are equally maladaptive. Depression and Anxiety 24:307,317, 2007. © 2006 Wiley-Liss, Inc. [source]
Demographic and clinical characteristics of motor vehicle accident victims in the community general health outpatient clinic: a comparison of PTSD and non-PTSD subjectsDEPRESSION AND ANXIETY, Issue 4 2007
Marina Kupchik M.D.
Abstract Motor vehicle accidents (MVAs) are the leading cause of posttraumatic stress disorder (PTSD) in the general population, often with enduring symptomatology. This study details epidemiological and clinical features that characterize PTSD among MVA victims living in a nonhospitalized community setting long after the MVA event, and includes exploration of premorbid and peritraumatic factors. MVA victims (n=60; 23 males, 37 females) identified from the registry of a community general health outpatient clinic during a 7-year period were administered an extensive structured battery of epidemiological, diagnostic and clinical ratings. Results indicated that 30 subjects (50%; 12 males, 18 females) had MVA-related PTSD (MVAR-PTSD). Among those with PTSD, 16 individuals exhibited PTSD in partial remission, and six, in full remission. There were no significant demographic or occupational function differences between PTSD and non-PTSD groups. The most common comorbid conditions with MVAR-PTSD were social phobia (20%), generalized anxiety disorder (7.8%) and obsessive,compulsive disorder (0.5%). Previous MVA's were not predictive of PTSD. Subjects with MVAR-PTSD scored worse on the Clinician-Administered Posttraumatic Stress Disorder Scale, Part 2 (CAPS-2), Impact of Event Scale, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Impulsivity Scale, and Toronto Alexithymia Rating Scale. Study observations indicate a relatively high rate of PTSD following an MVA in a community-based sample. The relatively high rate of partially remitted MVAR-PTSD (N=16) underscores the importance of subsyndromal forms of illness. Alexithymia may be an adaptive method of coping with event stress. The development of PTSD appears not to be associated with the severity of MVA-related physical injury. Depression and Anxiety 24:244,250, 2007. © 2006 Wiley,Liss, Inc. [source]
A controlled trial of paroxetine for chronic PTSD, dissociation, and interpersonal problems in mostly minority adults,DEPRESSION AND ANXIETY, Issue 2 2007
Randall D. Marshall M.D.
Abstract This study evaluated the efficacy of paroxetine for symptoms and associated features of chronic posttraumatic stress disorder (PTSD), interpersonal problems, and dissociative symptoms in an urban population of mostly minority adults. Adult outpatients with a primary DSM-IV diagnosis of chronic PTSD received 1 week of single-blind placebo (N = 70). Those not rated as significantly improved were then randomly assigned to placebo (N = 27) or paroxetine (N = 25) for 10 weeks, with a flexible dosage design (maximum 60,mg by week 7). Significantly more patients treated with paroxetine were rated as responders (14/21, 66.7%) on the Clinical Global Impression,Improvement Scale (CGI-I) compared to patients treated with placebo (6/22, 27.3%). Mixed effects models showed greater reductions on the Clinician-Administered PTSD Scale (CAPS) total score (primary plus associated features of PTSD) in the paroxetine versus placebo groups. Paroxetine was also superior to placebo on reduction of dissociative symptoms [Dissociative Experiences Scale (DES) score] and reduction in self-reported interpersonal problems [Inventory of Interpersonal Problems (IIP) score]. In a 12-week maintenance phase, paroxetine response continued to improve, but placebo response did not. Paroxetine was well tolerated and superior to placebo in ameliorating the symptoms of chronic PTSD, associated features of PTSD, dissociative symptoms, and interpersonal problems in the first trial conducted primarily in minority adults. Depression and Anxiety 24:77,84, 2007. Published 2006 Wiley-Liss, Inc. [source]
Initial symptoms and reactions to trauma-related stimuli and the development of posttraumatic stress disorderDEPRESSION AND ANXIETY, Issue 2 2005
Karin Elsesser Ph.D.
Abstract We investigated laboratory and experimental variables as predictors of the development of posttraumatic stress disorder (PTSD). Evoked heart rate response to trauma-related pictures, attentional bias in the dot-probe task, and viewing time were assessed in 35 victims of a traumatic event and again after 3 months. Data was compared to 26 control participants. At first assessment trauma victims showed heart rate (HR) acceleration and controls showed HR deceleration to trauma-related material. The group of trauma victims improved clinically over time. Predictors of the number of PTSD symptoms after 3 months were re-experiencing (33% of the variance) and amplitude of the evoked HR reaction to trauma-related pictures (15%). The two variables were highly correlated. Trauma victims were also more anxious, viewed trauma-related pictures for a longer time, and had a longer reaction time in the dot-probe task (but no distinct attentional bias) than control participants. Results indicate that specific fear responses and re-experiencing contribute to the development of posttraumatic stress disorder. Depression and Anxiety 21:61,70, 2005. © 2005 Wiley-Liss, Inc. [source]
Risk factors and outcome in ambulatory assault victims presenting to the acute emergency department setting: Implications for secondary prevention studies in PTSDDEPRESSION AND ANXIETY, Issue 2 2004
Peter P. Roy-Byrne M.D.
Abstract Prevention of post-traumatic stress disorder (PTSD) in trauma victims is an important public health goal. Planning for the studies required to validate prevention strategies requires identification of subjects at high risk and recruitment of unbiased samples that represent the larger high-risk population (difficult because of the avoidance of many trauma victims). This study recruited high-risk victims of interpersonal violence (sexual or physical assault) presenting to an urban emergency department for prospective 1- and 3-month follow-up. Of 546 victims who were approached about participating, only 56 agreed to be contacted and only 46 participated in either the 1- or 3-month interviews. Of the 46, 43 had been previously victimized with a mean of over six traumas in the group; 21% had prior PTSD, 85% had prior psychiatric illness, and 37% had prior substance abuse. Sixty-seven percent had positive urine for alcohol or drugs on presentation. Fifty-six percent developed PTSD at 1 or 3 months with the rate declining between 1 and 3 months. There was high use of medical and psychiatric services. These findings document both the difficulty of recruiting large samples of high-risk assault victims to participate in research, and the high rate of prior traumatization, PTSD, substance use, and psychiatric morbidity in these subjects which, if still active at the time of victimization, may complicate efforts to document preventive treatment effects. Depression and Anxiety 19:77,84, 2004. © 2004 Wiley-Liss, Inc. [source]
Prevalence and relationship to delusions and hallucinations of anxiety disorders in schizophreniaDEPRESSION AND ANXIETY, Issue 2 2003
F.R.C.P.C., Philip Tibbo M.D.
Abstract We investigated the prevalence of anxiety disorders in a sample of individuals with chronic schizophrenia, controlling for anxiety symptoms that may be related to delusions and hallucinations, and the possible differences in clinical variables between the groups. Individuals with a diagnosis of schizophrenia and able to give informed consent were recruited from the community. The Mini International Neuropsychiatric Interview (MINI) was administered to both confirm the DSM-IV diagnosis of schizophrenia and screen for comorbid anxiety disorders. If a comorbid anxiety disorder was found, its relation to the individual's delusions and hallucinations was examined. Clinical rating scales for schizophrenia were administered as well as rating scales for specific anxiety disorders where appropriate. Overall, anxiety disorders ranged from 0% [ for Post Traumatic Stress Disorder (PTSD)] to 26.7% [ for generalized anxiety disorder (GAD) and agoraphobia without panic] with lower rates when controlled for anxiety symptoms related to delusions and hallucinations. In investigating clinical variables, the cohort was initially divided into schizophrenics with no anxiety disorders and those with an anxiety disorder; with further analyses including schizophrenics with anxiety disorders related to delusions and hallucinations and those with anxiety disorders not related to delusions and hallucinations. The most consistent difference between all the groups was on the PANSS-G subscale. No significant differences were found on the remaining clinical variables. Comorbid anxiety disorders in schizophrenia can be related to the individual's delusions and hallucinations, though anxiety disorders can occur exclusive of these positive symptoms. Clinicians must be aware that this comorbidity exists in order to optimize an individual's treatment. Depression and Anxiety 17:65,72, 2003. © 2003 Wiley-Liss, Inc. [source]
Circuits and systems in stress.DEPRESSION AND ANXIETY, Issue 1 2002
Abstract This paper follows the preclinical work on the effects of stress on neurobiological and neuroendocrine systems and provides a comprehensive working model for understanding the pathophysiology of posttraumatic stress disorder (PTSD). Studies of the neurobiology of PTSD in clinical populations are reviewed. Specific brain areas that play an important role in a variety of types of memory are also preferentially affected by stress, including hippocampus, amygdala, medial prefrontal cortex, and cingulate. This review indicates the involvement of these brain systems in the stress response, and in learning and memory. Affected systems in the neural circuitry of PTSD are reviewed (hypothalamic-pituitary-adrenal axis (HPA-axis), catecholaminergic and serotonergic systems, endogenous benzodiazepines, neuropeptides, hypothalamic-pituitary-thyroid axis (HPT-axis), and neuro-immunological alterations) as well as changes found with structural and functional neuroimaging methods. Converging evidence has emphasized the role of early-life trauma in the development of PTSD and other trauma-related disorders. Current and new targets for systems that play a role in the neural circuitry of PTSD are discussed. This material provides a basis for understanding the psychopathology of stress-related disorders, in particular PTSD. Depression and Anxiety 16:14,38, 2002. © 2002 Wiley-Liss, Inc. [source]
Posttraumatic stress disorder and the structure of common mental disordersDEPRESSION AND ANXIETY, Issue 4 2002
Brian J. Cox Ph.D.
Abstract Krueger [1999: Arch Gen Psychiatry 56:921,926] identified a three-factor structure of psychopathology that explained the covariation or grouping of common mental disorders found in the U.S. National Comorbidity Survey (NCS) [Kessler et al., 1994: Arch Gen Psychiatry 51:8,19]. These three fundamental groupings included an externalizing disorders factor and two internalizing disorders factors (anxious-misery and fear). We extended this research through the examination of additional data from a large subsample of the NCS (n=5,877) that contained diagnostic information on posttraumatic stress disorder (PTSD). Factor analytic findings revealed that PTSD showed no affinity with the fear factor defined by panic and phobic disorders, and instead loaded on the anxious-misery factor defined primarily by mood disorders. An identical pattern of results emerged for both lifetime PTSD and 12-month PTSD prevalence figures. Implications of these findings for the classification of PTSD and research on its etiology are briefly discussed. © 2002 Wiley-Liss, Inc. [source]
Effects of a yoga breath intervention alone and in combination with an exposure therapy for post-traumatic stress disorder and depression in survivors of the 2004 South-East Asia tsunamiACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2010
Descilo T, Vedamurtachar A, Gerbarg PL, Nagaraja D, Gangadhar BN, Damodaran B, Adelson B, Braslow LH, Marcus S, Brown RP. Effects of a yoga breath intervention alone and in combination with an exposure therapy for PTSD and depression in survivors of the 2004 South-East Asia tsunami. Objective:, This study evaluated the effect of a yoga breath program alone and followed by a trauma reduction exposure technique on post-traumatic stress disorder and depression in survivors of the 2004 Asian tsunami. Method:, In this non-randomized study, 183 tsunami survivors who scored 50 or above on the Post-traumatic Checklist-17 (PCL-17) were assigned by camps to one of three groups: yoga breath intervention, yoga breath intervention followed by 3,8 h of trauma reduction exposure technique or 6-week wait list. Measures for post-traumatic stress disorder (PCL-17) and depression (BDI-21) were performed at baseline and at 6, 12 and 24 weeks. Data were analyzed using anova and mixed effects regression. Results:, The effect of treatment vs. control was significant at 6 weeks (F2,178 = 279.616, P < 0.001): mean PCL-17 declined by 42.5 ± 10.0 SD with yoga breath, 39.2 ± 17.2 with Yoga breath + exposure and 4.6 ± 13.2 in the control. Conclusion:, Yoga breath-based interventions may help relieve psychological distress following mass disasters. [source]
Default mode network connectivity as a predictor of post-traumatic stress disorder symptom severity in acutely traumatized subjectsACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2010
R. A. Lanius
Objective:, The goal of this study was to investigate the relationship between default mode network connectivity and the severity of post-traumatic stress disorder (PTSD) symptoms in a sample of eleven acutely traumatized subjects. Method:, Participants underwent a 5.5 min resting functional magnetic resonance imaging scan. Brain areas whose activity positively correlated with that of the posterior cingulate/precuneus (PCC) were assessed. To assess the relationship between severity of PTSD symptoms and PCC connectivity, the contrast image representing areas positively correlated with the PCC was correlated with the subjects' Clinician Administered PTSD Scale scores. Results:, Results suggest that resting state connectivity of the PCC with the perigenual anterior cingulate and the right amygdala is associated with current PTSD symptoms and that correlation with the right amygdala predicts future PTSD symptoms. Conclusion:, These results may contribute to the development of prognostic tools to distinguish between those who will and those who will not develop PTSD. [source]
Validity of ,post-traumatic stress disorder with secondary psychotic features': a review of the evidenceACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2009
M. H. Braakman
Objective:, To review the evidence from empirical studies regarding the validity of ,post-traumatic stress disorder with secondary psychotic features' (PTSD-SP) as a separate diagnostic entity. Method:, The authors performed a review tracing publications between 1980 and January 2008. Results:, Twenty-four comparative studies were included. These studies indicate that PTSD-SP is a syndrome that comprises PTSD-symptoms followed in time by the additional appearance of psychotic features. The psychotic features are not confined to episodes of re-experiencing, but remain present continuously. PTSD-SP seems to have some biological features differentiating it from schizophrenia and PTSD, e.g. there are differences in smooth pursuit eye movement patterns, concentrations of corticotropin-releasing factor and dopamine ,-hydroxylase activity. Conclusion:, There is currently not yet full support for PTSD-SP as a nosological entity. However, the delineation of PTSD-SP from other psychiatric syndromes is notable and biological studies seem to support the validity as a separate diagnostic entity. [source]
Ten-year follow-up study of PTSD diagnosis, symptom severity and psychosocial indices in aging holocaust survivorsACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2009
Objective:, We performed a longitudinal study of holocaust survivors with and without post-traumatic stress disorder (PTSD) by assessing symptoms and other measures at two intervals, approximately 10 years apart. Method:, The original cohort consisted of 63 community-dwelling subjects, of whom 40 were available for follow-up. Results:, There was a general diminution in PTSD symptom severity over time. However, in 10% of the subjects (n = 4), new instances of delayed onset PTSD developed between time 1 and time 2. Self-report ratings at both assessments revealed a worsening of trauma-related symptoms over time in persons without PTSD at time 1, but an improvement in those with PTSD at time 1. Conclusion:, The findings suggest that a nuanced characterization of PTSD trajectory over time is more reflective of PTSD symptomatology than simple diagnostic status at one time. The possibility of delayed onset trajectory complicates any simplistic overall trajectory summarizing the longitudinal course of PTSD. [source]
Memory and prefrontal functions in earthquake survivors: differences between current and past post-traumatic stress disorder patientsACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2009
Objective:, Many studies reported deficits in cognitive functions in post-traumatic stress disorder (PTSD). Most were, however, conducted on man-made trauma survivors. The high comorbidity of alcohol use and depression with PTSD in these studies further complicated the interpretation of their results. We compared prefrontal lobe functions and memory in three earthquake survivor groups: current PTSD, past PTSD and no PTSD. We hypothesized that prefrontal performances of the current and past PTSD groups would be worse than that of control group. Method:, Survivors of the 1999 earthquakes in Turkey were evaluated for current and lifetime PTSD. Memory and prefrontal functions were assessed by a neuropsychological test battery. Results:, Current PTSD patients performed worse on attention, verbal memory, verbal fluency, and psychomotor speed. Past PTSD group was similar to the controls on most cognitive measures, except for their vulnerability to proactive interference and low performance in verbal fluency for animal names. Conclusion:, Our findings indicate that the prefrontal organization and monitorization of verbally processed information are defective in earthquake-related PTSD patients, more so in the current PTSD group. [source]
Posttraumatic stress disorder as a risk factor for obesity among male military veteransACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2007
W. V. R. Vieweg
Objective:, Obesity is a significant public health problem in the United States, particularly among military veterans with multiple risk factors. Heretofore, posttraumatic stress disorder (PTSD) has not clearly been identified as a risk factor for this condition. Method:, We accessed both a national and local database of PTSD veterans. Results:, Body mass index (BMI) was greater (P < 0.0001) among male military veterans (n = 1819) with PTSD (29.28 ± 6.09 kg/m2) than those veterans (n = 44 959) without PTSD (27.61 ± 5.99 kg/m2) in a sample of randomly selected veterans from the national database. In the local database of male military veterans with PTSD, mean BMI was in the obese range (30.00 ± 5.65) and did not vary by decade of life (P = 0.242). Conclusion:, Posttraumatic stress disorder may be a risk factor for overweight and obesity among male military veterans. [source]
Psychological effects of the November 1999 earthquake in Turkey: an epidemiological studyACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2003
Objective: This study assessed the traumatic stress symptoms and related factors in two towns affected by two earthquakes, which killed 20 000 people in 1999 in Turkey. Method: A total of 430 people in selected households were seen 18 months after the earthquake. They were given a self-report questionnaire assessing post-traumatic stress (PTSD) and depressive symptoms, demographics and trauma exposure. Results: The rates of PTSD and depression were higher in the site closer to the epicenter. The traumatic stress symptom checklist scores were predicted by fear during earthquake, loss of friends and neighbours, female gender, lower education and living in rented accomodation. Depression was predicted by study site, death of relatives and past psychiatric illness. Conclusion: These results show that severe earthquakes can cause long-lasting morbidity. Our previous findings that showed a differential prediction for depressive and traumatic stress symptoms after earthquakes are also supported. [source]
Post-traumatic stress disorder: a review of psychobiology and pharmacotherapyACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2001
Objective: To review the literature on the psychobiology and pharmacotherapy of PTSD. Method: Relevant studies were identified by literature searches (Pub-med, web of science) and through reference lists. The search was ended by May 2001. Results: There is evidence of involvement of opioid, glutamatergic, GABAergic, noradrenergic, serotonergic and neuroendocrine pathways in the pathophysiology of PTSD. Medications shown to be effective in double-blind placebo-controlled trials includes selective serotonin reuptake inhibitors, reversible and irreversible MAO-inhibitors, tricyclic antidepressants and the anticonvulsant lamotrigine. Still more agents appear promising in open-label trials. Conclusion: The complexity of the psychobiology is reflected by the difficulties in treating the disorder. According to the present knowledge, suggestions for drug treatment of PTSD are made. [source]
Surviving a Distant Past: A Case Study of the Cultural Construction of Trauma Descendant IdentityETHOS, Issue 4 2003
Carol A. Kidron
Despite the abundance of psychological studies on trauma related ills of descendants of historical trauma, and the extensive scholarly work describing the memory politics of silenced traumatic pasts, there has yet to emerge a critical analysis of the constitutive practices of descendants of historical trauma. This article presents an ethnographic account of a support group for descendants of Holocaust survivors, proposing that the discursive frame of intergenerational transmission of Post Traumatic Stress Disorder (PTSD) and support group based narrative practices allow descendants to fashion their sense of self as survivors of the distant traumatic past. The discursive frame of transmitted PTSD acts as both a mnemonic bridge to the past and a mechanism of identity making, as participants narratively reemplot their life stories as having been personally constituted by the distant past A close ethnographic reading of on-site discursive practices points to how culture ferments to produce narratives, practices and ultimately carriers of memory to both sustain and revitalize historical grand narratives and the cultural scenarios they embed. [source]
The co-morbidity of eating disorders and anxiety disorders: a reviewEUROPEAN EATING DISORDERS REVIEW, Issue 4 2007
Jessica M. Swinbourne
Abstract Objective To critically review the literature examining the co-morbidity between eating disorders and anxiety disorders. Method A review of the literature on the co-morbidity between anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified and the anxiety disorders of OCD, PTSD, social anxiety, GAD, panic and agoraphobia. Results Of the empirical studies undertaken, it is clear that anxiety disorders are significantly more frequent in subjects with eating disorders than the general community. Researchers have shown that often anxiety disorders pre-date eating disorders, leading to a suggestion that early onset anxiety may predispose individuals to developing an eating disorder. To date however, the research presents strikingly inconsistent findings, thus complicating our understanding of eating disorder and anxiety co-morbidity. Furthermore, despite indications that eating disorder prevalence amongst individuals presenting for anxiety treatment may be high, there is a distinct lack of research in this area. Discussion This review critically examines the available research to date on the co-morbidity of eating disorders and anxiety disorders. Some of the methodological limitations of previous research are presented, in order to highlight the issues which warrant further scientific investigation in this area. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association. [source]
REM sleep: a sensitive index of fear conditioning in ratsEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 4 2005
Sushil K. Jha
Abstract To examine the influence of conditioned fear stimuli on sleep-wake states, we recorded sleep in Sprague,Dawley rats after exposure to tones previously paired with footshock. After habituation to a recording chamber and the recording procedure, a baseline sleep recording was obtained the next day. One day later, experimental animals were exposed to shock training designed to induce conditioned fear (FC), consisting of five tone-footshock pairings. The 5-s tones (conditioned stimuli; CS) co-terminated with 1-s footshocks (unconditioned stimuli; US). The next day sleep was recorded for 4 h in the recording chamber after presentation of five CSs alone. Sleep efficiency (total sleep time/recording period) and REM sleep (REM) and non-REM (NREM) measures were determined. While sleep efficiency was not significantly changed after CS presentation, the percentage of total sleep time spent in REM (REM percentage) was reduced in the FC animals. The reduction in REM percentage in the FC animals was due to a decrease in the number of REM bouts. In a separate experiment, we repeated the procedures, except the tones and shocks were presented in an explicitly unpaired (UP) fashion. The next day, presentation of the tones increased REM percentage in the UP group. Results are discussed in terms of the decreases in REM as a response to conditioned fear, and the relevance of these findings to the sleep changes seen in post-traumatic stress disorder (PTSD). [source]
Psychological trauma exposure and trauma symptoms among individuals with high and low levels of dental anxietyEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 4 2006
Ad De Jongh
This questionnaire-based study investigated the traumatic background and trauma-related symptomatology among 141 treatment-seeking individuals with high levels of dental anxiety and among a low-anxious reference group consisting of 99 regular dental patients. The highly anxious individuals reported a significantly higher number of traumatic events, both within and outside the dental or medical setting, than those in the reference group (73% vs. 21%). Horrific experiences in the dental setting were the most common traumatic events reported. Of the highly anxious individuals, 46.1% indicated suffering from one or more of the post-traumatic stress disorder (PTSD) symptom clusters (re-experiencing, avoidance, loss of interest, and insomnia), while in the reference group this percentage was 6%. Severity of dental anxiety was significantly associated with number of screening criteria for specific phobia and the extent to which the anxious subjects displayed symptoms of post-traumatic stress. Two variables were uniquely predictive for positive diagnostic screens for dental phobia and PTSD: having experienced a horrific dental treatment and having been a victim of a violent crime. In conclusion, post-traumatic symptoms are common accompaniments of severe forms of dental anxiety and are experienced even when dental treatment is not imminent. [source]
Experiences of seeking help from health professionals in a sample of women who experienced domestic violenceHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2003
Loraine Bacchus BSc MA PhD
Abstract The present paper describes a qualitative study of women who suffered domestic violence. The aim was to explore their experiences of seeking help from health professionals and assess their psychological health. Purposive sampling was used to select a subsample from a larger sample of women who were screened for domestic violence as part of a study undertaken at Guy's and St Thomas' Hospitals in London, UK. In-depth, semi-structured interviews were conducted with the subsample of women during the postpartum period (up to 14 months). Interviews were conducted in women's homes and general practitioners' (GPs) surgeries. The sample consisted of 10 women who had experienced domestic violence in the past 12 months (including the current pregnancy), and six women who had experienced domestic violence in the past 12 months but not the current pregnancy. The main outcome measures included: women's experiences of seeking help from health professionals; and assessment for postnatal depression, post-traumatic stress disorder (PTSD) and psychological distress. Women scored highly on measures of postnatal depression and PTSD. With regard to seeking help, there was a tendency for women to regard GPs, and accident and emergency staff as less helpful compared with health visitors in responding to domestic violence. Lack of privacy, continuity of care and time constraints were dominant themes which emerged from women's contacts with health professionals. Very few women voluntarily disclosed domestic violence to a health professional and even fewer were asked directly about domestic violence by one. It is important for health professionals to enquire about domestic violence in a sensitive manner and provide a response that takes into accounts the complexity of women's needs. Domestic violence training is necessary to equip health professionals with the knowledge and skills they need to respond to domestic violence more effectively. [source]
Are glucocortoids responsible for putative hippocampal damage in PTSD?HIPPOCAMPUS, Issue 2 2001
when to decide
First page of article [source]