Physical symptom trajectories following trauma exposure: longitudinal findings from the normative aging study

This study modeled physical symptom trajectories from ages 30 to 75 in 1079 older male military veterans who were assessed every 3 to 5 years since the 1960s. Combat exposure and noncombat trauma were used to define four groups: no trauma (N = 249), noncombat trauma only (N = 333), combat only (N = 152), and both combat and noncombat trauma (N = 345). Number of symptoms on the Cornell Medical Index physical symptom scale increased 29% per decade. Men who had experienced either combat or noncombat trauma did not differ from nonexposed men, but those who had experienced both combat and noncombat trauma had 16% more symptoms across all ages. There were no differences in age-related trajectories as a function of trauma history. In cross-sectional analysis, men with combat and noncombat trauma had more posttraumatic stress disorder symptoms, but not more depression symptoms, than men with either no trauma or noncombat trauma only. Discussion focuses on the importance of considering physical as well as psychological outcomes of exposure to traumatic events.     

Adjustment differences among male substance abusers varying in degree of combat experience in Vietnam.

Tested C. R. Figley's (1978) hypothesis that combat veterans will evidence more indications than will noncombat veterans of such posttraumatic stress reactions as sleep disturbances, emotional numbing, social withdrawal, and difficulties in controlling anger. 87 combat and 120 noncombat veterans seeking treatment for substance abuse were compared on demographic, family, and military variables; ratings on Figley's postmilitary problems list; traditional measures of personality (e.g., the MMPI); and childhood and present family environment scales. In combat–noncombat comparisons, combat Ss rated significantly more stress responses as problems than did noncombat Ss. Support for Figley's hypothesis was even stronger when comparing heavy with light combat-experienced Ss. Results strongly support contentions that stress responses persist long after combat experiences, that a subcategory of stress reactions may exist among some substance abusers, and that more specific and sensitive measures of stress reactions are needed beyond traditional measures of personality and environment. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Combat-related posttraumatic stress disorder symptoms in older men.

Nearly 25% of US men aged 55 yrs or older served in combat, yet its impact on aging is unknown. The relationship of posttraumatic stress disorder (PTSD) symptoms to combat exposure was examined in 1,210 veterans of World War II (WWII) and the Korean War, who were participants in the Normative Aging Study. Over 54% of WWII and 19% of Korean veterans reported combat experience. The relationship between combat exposure and PTSD symptoms was stronger in the WWII cohort. The sample prevalence of PTSD by combat exposure ranged from 0% to 12.4%, differing by the PTSD measure. WWII veterans exposed to moderate or heavy combat had 13.3 times greater risk of PTSD symptoms measured 45 yrs later, compared with noncombat veterans. It is suggested that military service in general, and combat exposure in particular, is a "hidden variable" in the study of aging men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Vietnam combat veterans with Posttraumatic Stress Disorder: Analysis of marital and cohabitating adjustment.

21 help-seeking Vietnam combat veterans (mean age 34.71 yrs) with a diagnosis of posttraumatic stress disorder (PTSD) were compared with 18 help-seeking combat veterans (mean age 33.44 yrs) without evidence of PTSD and 21 help-seeking veterans (mean age 33.4 yrs) with minimal combat experience on indexes of cohabitating and marital adjustment. Also, premilitary adjustment was assessed and validated by relative's reports. The PTSD group reported significantly more problems than did the other groups with self-disclosure and expressiveness to their partners, physical aggression toward their partners, and global relationship adjustment. The PTSD group did not differ from the other groups on measures of intimacy and affectionate behavior. The findings were not attributable to premilitary adjustment, response style, or demographic factors. Previous reports that combat veterans have special difficulties expressing positive emotions were not supported by present findings. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychodynamics of partner, stranger, and generally violent male college students.

Understanding the dynamics of partner violence has been complicated by the fact that "partner violence" may include both partner and generally violent men. The authors hypothesized that partner violence may involve intimacy-related threats to masculinity, violence toward strangers may relate to alcohol abuse, and both partner and stranger violence may relate to object relations pathology. College men were nonviolent or violent toward partners, strangers, or partners and strangers (n?=?10 men in each group). Partner violence was related to higher Schwartz Castration Anxiety Scale scores (B. Schwartz, 1991), from Thematic Apperception Test responses. Stranger violence was related to higher Minnesota Multiphasic Personality Inventory (MMPI-2) and MacAndrew Alcoholism Scale-Revised scores. Neither partner nor stranger violence was related to MMPI-2 anxiety or Westen's Social Cognition and Object Relations Scale (D. Westen, A. Barends, J. Leigh, M. Mendel, & D. Silbert, 1990). The authors discussed implications for understanding the dynamics of partner violence and treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Posttraumatic stress disorder, exposure to combat, and lower plasma cortisol among Vietnam veterans: Findings and clinical implications.

Several clinical studies suggest that individuals with posttraumatic stress disorder (PTSD) experience neuroendocrine system alterations, resulting in significantly lower plasma cortisol. To test this hypothesis, morning serum cortisol was compared among a national sample of Vietnam "theater" veterans (n?=?2,490) and a sample of Vietnam "era" veterans (n?=?1,972) without service in Vietnam. Analysis of covariance was used to compare cortisol concentrations after adjusting for 9 covariates (education, income, race, age, smoking status, alcohol use, illicit drug use, medication use, and body mass index ). Adjusted cortisol was lower among theater veterans with current PTSD but not era or theater veterans with lifetime PTSD. Among theater veterans, cortisol was inversely related to combat exposure, with veterans exposed to heavy combat having the lowest concentrations. Analysis of plasma cortisol, together with other clinical data, may be instrumental in the future diagnosis and treatment of stress disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trauma-induced weight loss and cognitive deficits among former prisoners of war.

Former prisoners of war (POWs) from the Korean Conflict and WWII reporting confinement weight losses of >35% (n?=?60) and ≤35% (n?=?113) and non-POW combat veterans (n?=?50) were compared on Wechsler Adult Intelligence Scale—Revised (WAIS—R) and Wechsler Memory Scale (WMS) Logical Memory indices. High weight-loss POWs performed more poorly than combat veterans on Performance IQ, Arithmetic, Similarities, and Picture Completion subtests, Witkin-Goodenough Attention–Concentration Factor, and WMS Immediate and Delayed Recall and more poorly than low weight-loss POWs on Arithmetic, Attention–Concentration Factor, and the WMS immediate memory measure. Low weight-loss POWs and combat veterans differed only on WMS immediate memory. Findings support the hypothesis of P. Thygesen et al (1970) that severity of POW confinement stress reflected by trauma-induced weight-loss is predictive of long-term compromise in cognitive performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk for HIV infection among bisexual men seeking HIV-prevention services and risks posed to their female partners.

The present study interviewed gay (n?=?473) and bisexual men (n?=?146) as part of an HIV prevention program and investigated social cognitive factors associated with HIV risk. Results indicated that HIV risk in homosexual men was associated with sexual openness and connections to gay communities, factors not associated with risk for bisexual men. Compared with men at lower risk, those who practiced high-risk sex scored lower on measures of perceived safer sex norms, safer sex self-efficacy, and social skills. Bisexual men with primary female partners often had not disclosed their bisexuality to female partners (75%), and 64% had not modified their behavior to protect female partners. Bisexual men who engage in high-risk behaviors therefore pose a risk to female partners who may be unaware of their involvement with men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexuality and the commission of physical violence to partners and non-partners by men and women.

In 2 studies of physical violence and sexuality among college students, more than 75% of men and more than 60% of women reported committing physical violence in the past year, including more women to partners and more men to non-partners. More than 90% of men who committed violence to partners were also violent to non-partners. In Study 1, among 193 men and 203 women, people who committed violence had higher scores on sexual depression and general depression than did people who were not violent. People violent to non-partners had more sexual preoccupation and more alcohol use problems than did other people. In Study 2, among 160 college men and 138 college women, people in 4 violence groups did not differ in total sexual fantasies or sexual functioning. The findings support the importance of differentiating between violence toward partners and toward non-partners among both men and women and suggest a role of depression in partner violence and antisocial features in violence toward non-partners. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dependency characteristics of partner assaultive men.

Men who had physically assaulted female partners (PA group; N?=?24) were compared with maritally discordant nonviolent men (DNV group; N?=?24) and happily married nonviolent men (HNV group; N?=?24) on measures of dependency and related constructs. PA men reported higher interpersonal dependency, higher spouse-specific dependency, and lower self-esteem than both contrast groups, but did not differ significantly on a measure of jealousy. Data reduction indicated 2 constructs underlying these measures: perceived personal inadequacy and emotional investment in the primary relationship. PA men were high on both, while DNV men had moderate perceived inadequacy and low emotional investment and HNV men had low perceived inadequacy and high emotional investment. The findings support the clinical observation that interpersonal dependency is an important factor in the motivational dynamics of relationship violence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of mental and physical health service utilization among Vietnam veterans.

This study investigated predictors of mental and physical health care service utilization among 1,632 male (n = 1,200) and female (n = 432) Vietnam veterans who participated in the National Vietnam Veterans Readjustment Study. Using Anderson's theory as a model (Anderson & Bartkus, 1973), the authors examined both direct and mediated relationships among predisposing factors (i.e., age, marital status, and combat exposure), enabling factors (e.g., household income and insurance), and need factors (e.g., medical and psychological symptomatology) and physical and mental health care utilization outcomes. Need factors were the most consistent and strongest mediators of predisposing variables for both physical and mental health care service utilization, although there were differences between male and female veterans. For men, combat exposure indirectly predicted mental health care utilization through the need variables (with the effects of posttraumatic stress disorder being greatest). For women, physical health problems mediated the relationship between combat exposure and physical health outpatient care utilization. These findings have implications for screening and outreach efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interpersonal problems of Vietnam combat veterans with symptoms of posttraumatic stress disorder.

274 male veterans seeking treatment for substance abuse were divided on the basis of combat experience and DSM-III criteria of posttraumatic stress disorder (PTSD). Ss with evidence of PTSD were compared with a non-PTSD group of Vietnam combat veterans and a noncombat group of Vietnam-era veterans on measures of specific interpersonal problems using the Horowitz Interpersonal Problem Inventory, traditional measures of family and social adjustment, and the MMPI. The PTSD group scored significantly higher on clusters of problems dealing with intimacy and sociability than did either of the comparison groups. PTSD Ss also scored higher on the MMPI scales of Paranoia, Psychopathic Deviate, Social Introversion, Social Maladjustment, Family Problems, and Manifest Hostility, but did not differ from other groups on Family Environment Scale variables. Results, which were not attributable to premilitary adjustment differences or to confounding demographic variables, are compared to previous studies, and research questions that remain outstanding are discussed. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reliability and validity of Mississippi Scale for Combat-Related Posttraumatic Stress Disorder.

This study examined the reliability and validity of the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (M-PTSD) in a sample of Vietnam combat veterans with PTSD (n?=?101) and substance-abusing patients without combat-related PTSD (n?=?102). The M-PTSD was found to have high internal consistency, and a principle-components analysis indicated that its items measure three dimensions: intrusive reexperiencing/numbing-avoidance, anger/lability, and social alienation. Discriminant validity of the M-PTSD was supported by its high sensitivity in identifying PTSD patients (93%) and specificity in discriminating them from substance-abusing control subjects (88.2%). Finally, convergent validity of the M-PTSD was substantiated by significant correlations of the instrument with measures of combat exposure and interview and psychometric measures of PTSD symptomatology. The M-PTSD was shown to be a highly reliable and valid measure of the spectrum of PTSD symptoms in Vietnam combat veterans. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Inpatient diagnosis of Posttraumatic Stress Disorder.

Attempted to distinguish among 3 types of inpatient veterans: (a) those with a diagnosis of posttraumatic stress disorder (PTSD) and combat experience; (b) those with a diagnosis other than PTSD and with combat experience; and (c) non-PTSD, noncombat patients. 75 Vietnam-era veterans classified in these groups were administered an assessment battery that included the Minnesota Multiphasic Personality Inventory (MMPI), State-Trait Anxiety Inventory, and Profile of Mood States. Results show no differences among the groups on premorbid variables. PTSD Ss, however, responded in a more pathological direction on psychometric and adjustment variables. A discriminant analysis using these variables correctly classified 85% of the Ss in the 3 groups. Time spent in combat was highly correlated with PTSD variables such as intrusion and numbing experiences; total stress; and symptoms of anxiety, depression, and anger. Results also cross-validate the MMPI-based PTSD scale developed by T. Keane et al (see record 1985-02913-001). (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validation of a multimethod assessment of posttraumatic stress disorders in Vietnam veterans.

There appears to be a high incidence of posttraumatic stress disorders (PTSD) in Vietnam veterans, yet there is little available information on the reliability and validity of any approach to the assessment of these combat-related stress disorders. The present study was designed to determine if responses to the presentation of mild combat stimuli would distinguish the following 3 carefully matched groups of veterans (N?=?30): (a) veterans (mean age 35 yrs) with an exclusive diagnosis of PTSD, (b) inpatients (mean age 36 yrs) on a psychiatry ward who clearly did not have PTSD, and (c) Vietnam veterans (mean age 35 yrs) with combat experience who were well-adjusted at the time of the study. Behavioral, physiological, and self-report measures of anxiety obtained through this laboratory-based assessment clearly distinguished the PTSD Ss from the remaining 2 groups. The utility of this tripartite assessment approach for the reliable identification of PTSD secondary to combat is discussed. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cholinergic/serotonergic interactions in hypothermia: implications for rat models of depression

Vietnam combat veterans (N = 151) with chronic posttraumatic stress disorder (PTSD) completed measures of atrocities exposure, combat exposure, PTSD symptom severity, guilt and interpersonal violence. PTSD symptom severity, guilt and interpersonal violence rates were similar to previously reported studies that examined treatment seeking combat veterans with PTSD. Controlling for combat exposure, endorsement of atrocities exposure was related to PTSD symptom severity, PTSD B (reexperiencing) symptoms, Global Guilt, Guilt Cognitions, and cognitive subscales of Hindsight-Bias/Responsibility and Wrongdoing. These results are discussed in the context of previous research conducted regarding atrocities exposure and PTSD.     

Violence in close relationships—development of a research area: Comment on Archer (2000).

A brief history of empirical research on violence in close relationships is presented. Assumptions of and conclusions made by feminist researchers about the problems of battered wives are reviewed. It is argued that their focus on marital violence as a form of aggression against women by men and their concern for severely beaten wives may have caused them to ignore high levels of female violence in marriage and dating. J. Archer's (see record 2000-15524-001) meta-analysis of studies of marital and dating violence showed that both sexes display violence in these relationships, although women are more likely to be injured. An expansion of Archer's definition of heterosexual violence (or violence in close relationships) to include sexual aggression and stalking is suggested. Reasons for relatively high levels of female violence in close relationships relative to violence toward strangers are briefly discussed. It is argued that more attention needs to be given to male victims of violence from their partners. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anger, impulsivity, and anger control in combat-related posttraumatic stress disorder.

Examined the association of combat-related posttraumatic stress disorder (PTSD) with anger. 24 veterans of the Vietnam War with PTSD scored significantly higher on an Anger factor comprising multiple measures of anger than did comparison groups of 23 well-adjusted Vietnam combat veterans and 12 noncombat Vietnam-era veterans with psychiatric diagnoses. In contrast, the 3 groups did not differ significantly on orthogonal factors, one of which comprised cognitive impulsivity measures and the other of which reflected motor impulsivity. Changes in heart rate in response to provocation loaded positively on the Anger factor and negatively on the 2 Impulsivity factors. Concurrent depression and trait anxiety did not have an effect on level of anger in individuals with PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)