Some preliminary data on the psychological characteristics of Vietnam veterans with posttraumatic stress disorders.

There appears to be a high incidence of posttraumatic stress disorders (PTSDs) among Vietnam combat veterans; yet, there is little information available on the utility of traditional psychological inventories for assessment of this disorder. The present study examined whether responses on a variety of standardized psychological inventories (the MMPI, Self-Rating Depression Scale, Beck Depression Inventory, State-Trait Anxiety Inventory, and Fear Survey Schedule–II) would distinguish 3 carefully matched groups of Vietnam veterans: (a) 12 Ss (mean age 34 yrs) with an exclusive diagnosis of PTSD, (b) 12 Ss (mean age 35 yrs) with other nonpsychotic psychological diagnoses, and (c) 12 Ss (mean age 34 yrs) with combat experience who are currently well-adjusted. Univariate and multivariate statistical analyses indicated that the assessment battery was able to discriminate with good success Vietnam combat veterans with PTSD from relevant comparison groups. (28 ref) (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)     

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)     

Etiology of Posttraumatic Stress Disorder in Vietnam veterans: Analysis of premilitary, military, and combat exposure influences.

43 Vietnam veterans seeking psychological services at a VA medical center were assigned to positive and negative groups of posttraumatic stress disorder (PTSD) based on the DSM-III. The average S was a 33-yr-old White male with 13 yrs of education. Ss were extensively assessed to examine the relative contributions of premilitary adjustment, military adjustment, and extent of combat exposure to the development of combat-related, chronic PTSD. In addition, groups were compared on profiles from the MMPI and a psychological problem checklist. Results of multiple regression analyses demonstrated that combat exposure and, to a lesser degree, military adjustment were significantly related to PTSD symptomatology, whereas premilitary adjustment was not. Discriminant function analyses showed that the MMPI had moderate ability to correctly classify Ss on the basis of PTSD diagnosis. However, problem checklist items indicative of anxiety-based disorders, particularly generalized anxiety and pervasive disgust, formed a discriminant function that correctly classified more than 90% of Ss. Results are discussed in terms of complications for an empirically derived conceptualization of PTSD. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Posttraumatic stress disorder: Silent problem among older combat veterans.

Examines posttraumatic stress disorder (PTSD) among older Vietnam combat veterans. It is suggested that PTSD among these veterans is generally chronic, silent, and exacerbated by the problems of aging. These Ss with PTSD can be divided into those with full PTSD and those with partial PTSD. Studies are cited showing prevalence rates for PTSD. The difficulties in measuring PTSD are described. Several moderating variables influence the expression of trauma problems at later life, including the presence of other stressors, health status, social support, and comorbidity. Several forms of therapy are considered, including cognitive behavioral therapy, reminiscence, and relaxational desensitization. Also, several treatment suggestions are given, advocating interventions of a stuck narrative in an aging population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Empirical development of an MMPI subscale for the assessment of combat-related posttraumatic stress disorder.

200 male Vietnam combat veterans who were assigned to a posttraumatic stress disorder (PTSD) group (n?=?100) or a non-PTSD group (n?=?100) were administered the MMPI to develop empirically based criteria for use of the MMPI to aid in assessment and diagnosis of PTSD. Standard clinical profiles demonstrated that PTSD Ss had overall higher mean elevations, and discriminant function analysis correctly classified 74% of Ss in each group. A special PTSD subscale was developed and cross-validated that improved diagnostic hit rates to 82% of Ss. (9 ref) (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)     

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)     

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)     

Psychometric profile of posttraumatic stress disorder, anxious, and healthy Vietnam veterans: Correlations with psychophysiologic responses.

Three groups of Vietnam combat veterans, posttraumatic stress disorder (PTSD, n?=?25), anxious (n?=?7) and healthy (n?=?18), completed a battery of psychometric tests. Measurement of psychophysiologic responses to imagery of individualized combat experiences followed the psychometrics. The PTSD Ss differed significantly from the healthy Ss on almost all measures but showed fewer differences from the anxious Ss. The typical PTSD S was characterized as anxious, depressed, prone to dissociation, and external in locus of control. Correlations with the physiologic responses supported the validity of psychometric scales specifically designed to measure PTSD but cast doubt on the interpretation of traditional measures of overreporting or dissimulation in this disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An in vivo assessment of physiological arousal in posttraumatic stress disorder.

Measured physiological function (heart rate [HR], systolic blood pressure [SBP], diastolic blood pressure [DBP], sublingual temperature, and respiration rate) in a nonresearch setting—the medical triage area of a large Veterans Affairs Medical Center while patients were awaiting physical examination. Ss were 32 Vietnam veterans with combat-related PTSD and 26 Vietnam-era veterans with no combat experience. Results indicated that PTSD veterans had significantly higher HR, SBP, and DBP, but not sublingual temperature or respiration rate. These data support the position that individuals with PTSD do indeed demonstrate higher levels of cardiovascular arousal across settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Utility of psychophysiology measurement in the diagnosis of posttraumatic stress disorder: Results from a department of Veteran's Affairs cooperative study.

This multisite study tested the ability of psychophysiological responding to predict posttraumatic stress disorder (PTSD) diagnosis (current, lifetime, or never) in a large sample of male Vietnam veterans. Predictor variables for a logistic regression equation were drawn from a challenge task involving scenes of combat. The equation was tested and cross-validated, demonstrating correct classification of approximately 2/3 of the current and never PTSD participants. Results replicate the finding of heightened psychophysiological responding to trauma-related cues by individuals with current PTSD, as well as differences in a variety of other domains between groups with and without the disorder. Follow-up analyses indicate that veterans with current PTSD who do not react physiologically to the challenge task manifest less reexperiencing symptoms, depression, and guilt. Discussion addresses the value of psychophysiological measures for assessment of PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interpersonal problem solving and coping reactions of Vietnam veterans with posttraumatic stress disorder.

In order to assess the relation between posttraumatic stress disorder (PTSD) and interpersonal problem solving and coping, 43 Vietnam veterans were assigned to the following four groups: (a) combat veterans with PTSD, (b) combat veterans with severe adjustment problems but not PTSD-diagnosable (AP), (c) combat veterans who were well adjusted (WA), and (d) veterans with little or no combat exposure who served during the Vietnam era (ERA). Multivariate analyses of variance indicated that both the PTSD and AP groups reported less effective coping reactions and poorer problem solving than both the WA and ERA groups. The PTSD subjects also reported less effective problem solving and less problem-focused coping reactions than the AP veterans. Implications of these results are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

PTSD among Israeli former prisoners of war and soldiers with combat stress reaction: a longitudinal study

OBJECTIVE: The aim of this study was to assess the long-term impact of war captivity and combat stress reaction on rates of posttraumatic stress disorder (PTSD) in Israeli veterans of the 1973 Yom Kippur war. METHOD: One hundred sixty-four former prisoners of war (POWs), 112 veterans who had had combat stress reaction, and 184 combat veteran comparison subjects filled out the PTSD Inventory, a self-report scale based on the DSM-III-R criteria for PTSD. The inventory diagnoses past and present PTSD, assesses its intensity, and provides a symptom profile. RESULTS: Thirty-seven percent of the veterans who had had combat stress reaction, 23% of the former POWs, and 14% of the comparison subjects had had diagnosable PTSD at some time in the past. The current rates were 13%, 13%, and 3%, respectively. The results showed different recovery rates over time: almost two-thirds of the veterans with combat stress reaction who had had PTSD in the past recovered, while less than one-half of the POW group showed this improvement. CONCLUSIONS: These findings indicate that small but significant proportions of the POWs and veterans with combat stress reaction were still suffering from PTSD almost two decades after the war. The different recovery rates in the two groups may reflect the differences in duration and severity of stressors, the impact of immediate intervention on long-term adjustment, or both.     

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)     

Disorders of extreme stress following war-zone military trauma: Associated features of posttraumatic stress disorder or comorbid but distinct syndromes?

Disorders of extreme stress not otherwise specified (DESNOS) and posttraumatic stress disorder (PTSD) were found to be comorbid but distinct among military veterans seeking inpatient PTSD treatment: 31% qualified for both conditions, 29% were diagnosed PTSD only, 26% were classified DESNOS only, and 13% met criteria for neither. PTSD diagnosis was associated with elevated levels of war-zone trauma exposure and witnessing atrocities and with impairment on the Mississippi Scale for Combat-Related PTSD and the Penn Inventory. DESNOS classification (but not PTSD) was associated with (a) early childhood trauma and participation in war-zone atrocities, (b) extreme levels of intrusive trauma reexperiencing, (c) impaired characterological functioning (object relations), and (d) use of intensive psychiatric services. PTSD and DESNOS may be comorbid but distinct posttraumatic syndromes and, as such, warrant careful clinical and scientific investigation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An examination of family adjustment among Operation Desert Storm veterans.

This study examined interrelationships among combat exposure, symptoms of posttraumatic stress disorder (PTSD), and family adjustment in a sample of male and female Operation Desert Storm veterans (N = 1,512). In structural equation models for both male and female veterans, higher combat exposure was associated with higher PTSD symptoms, which in turn were associated with poorer family adjustment, although these indirect effects did not reach statistical significance. The model for female veterans evidenced a significant direct negative association between combat exposure and family adjustment when it statistically accounted for PTSD symptoms. When the relative impacts of separate PTSD symptom groupings were examined, those reflecting withdrawal/numbing symptoms and arousal/lack of control symptoms significantly and indirectly accounted for the negative effects of combat exposure on family adjustment. Study findings indicate a number of possible pathways through which war-zone deployments negatively impact military families and suggest several avenues for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chronic posttraumatic stress disorder and chronic pain in Vietnam combat veterans

A study was conducted to investigate chronic pain patterns in Vietnam veterans with posttraumatic stress disorder (PTSD). Combat veterans with PTSD completed standardized PTSD severity, pain, somatization, and depression measures. Of 129 consecutive out-patient combat veterans with PTSD, 80% reported chronic pain. In descending order were limb pain (83%), back pain (77%), torso pain (50%), and headache pain (32%). Compared to PTSD combat veterans without chronic pain, PTSD veterans who reported chronic pain reported significantly higher somatization as measured by the Minnesota Multiphasic Inventory 2 hypochondriasis and hysteria subscales. In the sample of 103 combat veterans with PTSD and chronic pain, MMPI 2 hypochondriasis scores and B PTSD symptoms (reexperiencing symptoms) were significantly related to pain disability, overall pain index, and current pain level MMPI 2 hypochondriasis and depression scores were also significantly related to percent body pain. These results are discussed in the context of current conceptualizations of PTSD.