The Relationship Between Acute Stress Disorder and Posttraumatic Stress Disorder Following Cancer.

In this study, the authors investigated the relationship between acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) following cancer diagnosis. Patients who were recently diagnosed with 1st onset head and neck or lung malignancy (N = 82) were assessed for ASD within the initial month following their diagnosis and reassessed (n = 63) for PTSD 6 months following their cancer diagnosis. At the initial assessment, 28% of patients had ASD, and 32% displayed subsyndromal ASD. At follow-up, PTSD was diagnosed in 53% of patients who had been diagnosed with ASD and in 11% of those who had not met criteria for ASD; 36% of patients with PTSD did not initially display ASD. In this study, the authors question the use of the ASD diagnosis to identify recently diagnosed patients at risk of PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Posttraumatic Stress Disorder Symptomatology Among Partners of Men in Treatment for Relationship Abuse.

This longitudinal study examined posttraumatic stress disorder (PTSD) symptoms among current and former female partners (N=96) of men participating in a group treatment program for partner abuse perpetrators. Female partner probable PTSD rates, obtained during time points corresponding with pretreatment, posttreatment, and 6-month follow-up for the male clients, were 52%, 34%, and 29%, respectively. Psychological abuse exposure was more strongly and uniquely associated with PTSD symptoms than was physical abuse exposure. Among psychological abuse ratings, denigration, restrictive engulfment, and dominance/intimidation behaviors evidenced the strongest associations with PTSD symptoms. Findings from this study suggest the association between psychological abuse and PTSD is complex and multidetermined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of Posttraumatic Stress Disorder in Military and Veteran Populations.

While concerns about the psychological effects of war are not new, only recently has systematic attention been paid to such problems among past and present military personnel. There is increasing recognition that mental health has serious implications for operational performance, retention, and compensation. Although little controlled research exists with this population, preliminary evidence suggests that psychological treatments for posttraumatic stress disorder may be beneficial, albeit less so than for civilian populations. This article reviews evidence for each of several psychological treatment stages: stabilization and engagement, psychoeducation, symptom management, prolonged exposure, cognitive restructuring, and relapse prevention, with particular reference to the clinical issues raised by military personnel. Possible explanations for reduced treatment effects in this population compared with civilians are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Key Elements in Couples Therapy With Veterans With Combat-Related Posttraumatic Stress Disorder.

If a client dealing with combat-related posttraumatic stress disorder (PTSD) presents for psychotherapy, should you consider including his or her partner in treatment? How could couples therapy be beneficial? What framework do you have to conceptualize the relational issues and potential treatment? Although clinicians have long been encouraged to include families in the treatment of combat-related PTSD, few specific couple-family therapies exist, and outcome research is scarce. Because of the adverse effects of PTSD on relationships, couples therapy can be a powerful adjunct treatment; however, few receive this service. A new framework for conceptualizing couples therapy organizes treatment around the 3 PTSD symptom clusters (reexperiencing, avoidance, and arousal). Relationship consequences of each symptom cluster are summarized, followed by useful treatment interventions and a case study. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Secondary traumatization in Dutch couples of World War II survivors.

This study examined whether signs of secondary traumatic stress were present in a community sample of couples who experienced World War II. The authors hypothesized that symptoms of posttraumatic stress disorder (PTSD) in either spouse may be predicted not only by his or her own war experiences but also by the war experiences and posttraumatic symptoms of the partner. Approximately 50 years after the end of World War II, 444 couples from a community sample of elderly Dutch citizens answered a questionnaire. A multilevel regression analysis was performed with symptoms of PTSD as the dependent variable. The most important predictors of PTSD symptoms were the number of war events reported by the participant and the current level of PTSD symptoms of his or her spouse. The results lend empirical support to the notion that posttraumatic stress reactions of both members of a couple are not independent from each other. Several explanations of the findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Epidemiology of Trauma and Posttraumatic Stress Disorder in Mexico.

Prevalence rates of trauma and posttraumatic stress disorder (PTSD) were estimated from a probability sample of 2,509 adults from 4 cities in Mexico. PTSD was assessed according to Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) criteria using the Composite International Diagnostic Interview (CIDI; WHO, 1997). Lifetime prevalence of exposure and PTSD were 76% and 11.2%, respectively. Risk for PTSD was highest in Oaxaca (the poorest city), persons of lower socioeconomic status, and women. Conditional risk for PTSD was highest following sexual violence, but nonsexual violence and traumatic bereavement had greater overall impact because of their frequency. Of lifetime cases, 62% became chronic; only 42% received medical or professional care. The research demonstrates the importance of expanding the epidemiologic research base on trauma to include developing countries around the world. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluating a Cognitive-Behavioral Group Treatment Program for Veterans With Posttraumatic Stress Disorder.

The need to develop and further refine efficient and effective treatments for individuals with posttraumatic stress disorder (PTSD) in a climate of reduced mental health resources is critical. This study examined the impact of a series of cognitive-behavioral groups administered in an urban VA setting. The participants were veterans with chronic and severe PTSD, many of them struggling with additional physical and mental health problems. The data indicate modest improvements in the distress level of the veterans. Additional research is needed to further isolate the key elements of treatment that are most effective, palatable for patients, and cost-effective for the providers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Prospective Study of Autobiographical Memory and Posttraumatic Stress Disorder Following Cancer.

In this study, the authors investigated the relationship between autobiographical memory and the onset and maintenance of distressing memories following cancer. In Study 1, participants recently diagnosed with head, neck, or lung cancer were assessed for acute stress disorder (ASD). Participants with ASD reported fewer specific memories than did participants without ASD. In Study 2, the same participants were assessed 6 months later for autobiographical memory and cancer-related posttraumatic stress disorder (PTSD). Deficits in the retrieval of specific memories in Study 1 were not predictive of subsequent PTSD. Increased hopelessness during the 6 months was associated with a decline in the retrieval of positive memories and an increase in the retrieval of negative memories. These findings accord with propositions that retrieval of distressing memories is guided by current self-image and attitude toward one's future. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Governing the grapevine: The study of rumor during World War II.

Throughout the early 1940s, a host of rumors relating to the Second World War began to circulate, leading the government to establish various committees and undertake multiple projects intended to counteract rumors that were believed to threaten civilian morale and compromise national security. Simultaneously, social scientists also began taking measures to study and combat rumor. Such efforts included the institution of several community groups, deemed "rumor clinics," that aimed to decrease the prevalence of wartime rumor by educating the general public. This article outlines the rise and fall of rumor clinics, focusing specifically on the shifting boundaries and the mounting tensions between the United States government and social scientists in the study of rumor during World War II. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Positive Tertiary Appraisals and Posttraumatic Stress Disorder in U.S. Male Veterans of the War in Vietnam: The Roles of Positive Affirmation, Positive Reformulation, and Defensive Denial.

A 70.9% majority of the U.S. male veterans in a nationwide sample appraised the impact of their service in Vietnam on their present lives as mainly positive. A substantial minority, 41.7%, judged the effects to be highly salient. With controls on level of exposure to war-zone stressors measured with data from military records, the valence and salience of these appraisals are investigated in relation to posttraumatic stress disorder (PTSD) and other indicators of wartime and postwar functioning. The results are consistent with the hypothesis that mainly positive tertiary appraisals are affirmations of successful wartime and postwar adaptation rather than defensive denials related to maladaptive outcomes. The possibility that mainly positive tertiary appraisals also contribute to successful postwar adaptation is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk Factors for Course of Posttraumatic Stress Disorder Among Vietnam Veterans: A 14-Year Follow-Up of American Legionnaires.

Risk factors affecting the course of posttraumatic stress disorder (PTSD) are poorly understood. As part of a larger study on characterizing exposure to herbicides in Vietnam, the authors investigated this issue in a random sample of 1,377 American Legionnaires who had served in Southeast Asia during the Vietnam War and were followed over a 14-year period. High combat exposure, perceived negative community attitudes at homecoming, minority race, depression symptoms at Time 1, and more anger at Time 1 predicted a more chronic course. Community involvement at Time 1 was protective and associated with decreased risk at Time 2. Discomfort in disclosing Vietnam experiences was associated with an increased risk for developing PTSD but did not predict its course. Combat exposure predicted PTSD course more strongly than any other risk factor. Findings suggest recovery from PTSD is significantly influenced by perceived social support. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital relations among former prisoners of war: Contribution of posttraumatic stress disorder, aggression, and sexual satisfaction.

In this study, the authors examined the marital adjustment, spousal aggression, and sexual satisfaction of prisoners of war (POWs) 3 decades after their release. More specifically, the authors examined the extent to which impaired marital relations among former POWs are an outcome of their captivity or of the posttraumatic stress disorder (PTSD) that some of them developed. The authors compared 25 former POWs with PTSD, 85 former POWs without PTSD, and 104 control veterans. The findings reveal that the marital problems of former POWs are more related to PTSD than to their captivity. PTSD is related to decreased marital satisfaction, increased verbal aggression, and heightened sexual dissatisfaction among former POWs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validating the Primary Care Posttraumatic Stress Disorder Screen and the Posttraumatic Stress Disorder Checklist with soldiers returning from combat.

The purpose of the research was to assess the diagnostic efficiency of the Primary Care Posttraumatic Stress Disorder Screen (PC-PTSD) and the Posttraumatic Stress Disorder Checklist (PCL) as clinical screening tools for active duty soldiers recently returned from a combat deployment. A secondary goal was to examine the item-level characteristics of both the PC-PTSD and the PCL. A validation study conducted with a sample of 352 service members showed that both the PC-PTSD and PCL had good diagnostic efficiency. The overall diagnostic efficiency assessed by the area under the curve (AUC) was virtually the same for both the PC-PTSD and PCL. The most efficient cutoff values for the PC-PTSD were either 2 or 3 "yes" responses with the latter favoring specificity. For the PCL, the most efficient cutoff values were between 30 and 34, mirroring recommended PCL cutoff values from some studies in primary care settings. The examination of item characteristics suggested a 4-item PCL with an AUC virtually identical to that of the full PCL. Item analyses also identified that the most discriminate item in both scales pertained to symptoms of avoidance. Implications and limitations are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Posttraumatic stress disorder treatment in correctional settings: A brief review of the empirical literature and suggestions for future research.

This article reviews the available empirical studies of posttraumatic stress disorder (PTSD) treatments for correctional populations. Despite the large numbers of prisoners and their high rates of victimization and traumatic disorders, few targeted treatments are available, and even fewer have been studied and empirically supported. The treatment modalities that have been studied include two exposure, two cognitive, and two skills-based approaches investigated in a total of eight studies. Four studies that met criteria for this review were conducted with women, three with juvenile males, and one with a single man. The studies possess many methodological weaknesses, and some outcomes have been disappointing. In the hopes of preventing further suffering, revictimization, and recidivism, it is imperative that further development and investigation of targeted treatments continue in this understudied and vulnerable population. Much progress has been made in the treatment of PTSD in the general population, so these approaches could be explored in the correctional system as well. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotional-Processing in Posttraumatic Stress Disorder II: Startle Reflex Modulation During Picture Processing.

This study examined the impact of a trauma-related stressor on subsequent emotional behavior in veterans with (n = 35) and without (n = 24) posttraumatic stress disorder (PTSD). Self-report and physiological responses, including acoustic startle, were recorded during viewing of emotionally evocative photographs at baseline and following exposure to trauma-related and non-trauma-related stressors. The 2 groups exhibited equivalent patterns of emotional response across self-report and physiological measures at baseline. In contrast, following the trauma challenge, participants with PTSD showed a pattern of startle modulation suggestive of greater defensive reactivity and reduced visual perceptual engagement. These findings, along with augmented corrugator EMG reactivity during the same interval, suggest that trauma-related reexperiencing primes subsequent negative emotional responding in individuals with PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological symptoms and marital satisfaction in spouses of Operation Iraqi Freedom veterans: Relationships with spouses' perceptions of veterans' experiences and symptoms.

Much research has shown that spouses of combat veterans with posttraumatic stress disorder (PTSD) have higher rates of psychological and marital distress than do spouses of veterans without PTSD; however, very few studies have examined potential mechanisms of this increased vulnerability. The current study examined spouses of National Guard soldiers recently returned from deployments in Iraq. In addition to documenting elevated levels of psychological symptoms in these spouses, the authors found that spouses experienced greater symptom severity when they perceived high levels of symptoms in soldiers but the soldiers endorsed low levels of symptoms. Furthermore, spouses' marital satisfaction was negatively linked to soldiers' self-reported symptom severity only when spouses perceived that soldiers had experienced low levels of combat activity while deployed. When spouses perceived high levels of such activity, soldiers' self-reported symptoms had no relationship with spouses' marital satisfaction. These findings highlight the importance of interpersonal perceptions in intimate relationships and are consistent with the notion that uncontrollable attributions for a relative's mental health problems may provide a buffer against relationship distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of killing on mental health symptoms in Gulf War veterans.

This study examined the impact of killing on posttraumatic stress symptomatology (PTSS), depression, and alcohol use among 317 U.S. Gulf War veterans. Participants were obtained via a national registry of Gulf War veterans and were mailed a survey assessing deployment experiences and postdeployment mental health. Overall, 11% of veterans reported killing during their deployment. Those who reported killing were more likely to be younger and male than those who did not kill. After controlling for perceived danger, exposure to death and dying, and witnessing killing of fellow soldiers, killing was a significant predictor of PTSS, frequency and quantity of alcohol use, and problem alcohol use. Military personnel returning from modern deployments are at risk of adverse mental health symptoms related to killing in war. Postdeployment mental health assessment and treatment should address reactions to killing in order to optimize readjustment. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Bridging the Gap Between Posttraumatic Stress Disorder Research and Clinical Practice: The Example of Exposure Therapy.

There are notable challenges in translating empirically supported psychosocial treatments (ESTs) into general routine clinical practice. However, there may be additional unique dissemination and implementation obstacles for ESTs for trauma-related disorders. For example, despite considerable evidence from randomized clinical trials that attests to the efficacy of exposure therapy for posttraumatic stress disorder, front-line clinicians in real-world settings rarely use this treatment. Perceived and actual barriers that interfere with adoption include clinician misconceptions about what exposure entails and complex cases to which ESTs may not be readily applicable. Specific suggestions for bridging the science-into-service gap in trauma ESTs (in general) and in exposure therapy (in particular) are proposed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)