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 95,504 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study aimed at the identification of acute and post-traumatic stress responses, and comorbid mental disorders in breast cancer patients. Structured clinical interviews for DSM-IV (SCID) were conducted post-surgery with 127 patients (t1). Screening measures were used to assess post-traumatic stress responses, anxiety, and depression at t1 and at 6 months follow-up (t2). Based on the SCID, prevalence rates were 2.4% for both, cancer-related ASD and PTSD. Experiences most frequently described as traumatic were the cancer diagnosis itself and subsequent feelings of uncertainty. Patients with lifetime PTSD (8.7%) were more likely to meet the criteria for cancer-related ASD or PTSD (OR=14.1). Prevalence estimates were 7.1% for Adjustment Disorder, 4.7% for Major Depression, 3.1% for Dysthymic Disorder and 6.3% for Generalized Anxiety Disorder. Using the screening instruments, IES-R, PCL-C and HADS, we found PTSD in 18.5% at t1 and 11.2-16.3% at t2. The estimates of anxiety and depression reveal rates of 39.6% (t1) and 32.7% (t2) for anxiety, as well as 16.0% (t1) and 13.3% (t2) for depression (t1) (cut-off> or =8). The diagnosis of a life-threatening illness has been included as a potential trauma in the DSM-IV. However, it has to be critically evaluated whether subjective feelings of uncertainty like fears of treatment count among traumatic stressors, and thus, whether the diagnosis of PTSD is appropriate in this group of cancer patients. However, a large number of women with emotional distress illustrate the need for psychosocial counseling and support in this early treatment phase.
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PMID:Prevalence of acute and post-traumatic stress disorder and comorbid mental disorders in breast cancer patients during primary cancer care: a prospective study. 1685 47

This community survey studied remission from pathological gambling (PG) among American Indian (AI) and Hispanic American (HA) veterans. Remission was defined as having a lifetime diagnosis of PG, but no gambling symptoms in the last year. Sample consisted of 1624 AI and Hispanic veterans. Instruments included demographic data, the computer-based algorithmic Quick Diagnostic Interview Schedule Symptom, and three symptom checklists, one each for substance related problems (MAST/AD), anxiety and depressive symptoms (BSI-57), and combat-related post-trauma symptoms (PCL/M). Remission was associated with absence of a current Axis 1 diagnosis, especially absence of a current post-traumatic stress disorder.
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PMID:Remission from pathological gambling among Hispanics and Native Americans. 1689 10

This study documents the prevalence of male childhood sexual abuse (CSA) and psychological sequelae in a sample of disaster workers deployed to the World Trade Center (WTC) site following the September 11, 2001 terrorist attack. There are limited data on male CSA and its psychological impact, especially on a large non-treatment seeking sample. As part of a mandatory medical screening program, workers were assessed with well-validated and widely used clinician interview and self-report measures following their involvement in the restoration of services to Ground Zero and surrounding areas of lower Manhattan. Frequency of CSA measured by the Traumatic Events Interview (TEI) was 4.3% (n = 92). Clinician interview and self-report data were analyzed using t-tests, revealing statistically significant relationships (but not clinically meaningful scores) between CSA and scores on the CAPS, PCL, BDI, STAXI, and SDS. Further analyses revealed that individuals endorsing CSA were three-times more likely to score high (vs. low) on the BDI and CAPS. Since disaster workers traditionally summon images of strength and mastery, professionals may overlook CSA and symptoms of depression and PTSD in this population.
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PMID:Incidence of male childhood sexual abuse and psychological sequelae in disaster workers exposed to a terrorist attack. 1713 72

The authors examined the psychometric characteristics and factor structure of the Civilian Version of the PTSD Checklist (PCL-C; F. W. Weathers, B. T. Litz, J. A. Huska, & T. Keane, 1994) in elderly survivors, aged 66-90, of the 2004 Florida hurricane disasters. Confirmatory factor analyses of nine models of PCL-C structure revealed the strongest support for a 4-factor model consisting of reexperiencing, avoidance, numbing, and arousal dimensions. Future studies will be facilitated by the knowledge that the PCL-C 4-factor model appears to apply across the adult age range and a variety of posttraumatic stress disorder-producing conditions.
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PMID:Confirmatory factor analysis of the PTSD checklist in the elderly. 1759 25

The main aim of this study was to investigate the occurrence of cancer-related posttraumatic stress disorder (PTSD) among parents of children on cancer treatment. A longitudinal design with assessments at one week (T1), two (T2), and four (T3) months after the child's diagnosis was used. Two hundred and fourteen parents (107 mothers, 107 fathers) participated at T1-T3. The PTSD Checklist Civilian (PCL-C), a self-report screening instrument for PTSD, was answered by parents over the telephone. According to the PCL-C symptom criteria method 33%, more mothers than fathers, score as potential cases of acute stress disorder (ASD) at T1, whereas 28% as potential cases of PTSD at T2 and 22% at T3. The levels of acute- and posttraumatic stress symptoms show a linear, descending pattern, and mothers report higher levels than fathers. Half of the parents who score as potential cases of ASD a week after the child's diagnosis score as potential cases of PTSD four months later. The findings illustrate that a group of parents of children with cancer experience serious psychological distress related to their child's disease. A traumatic stress perspective on childhood cancer should be applied to paediatric oncology care and appropriate psychosocial interventions should be offered to parents when needed.
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PMID:Posttraumatic stress disorder among parents of children on cancer treatment: a longitudinal study. 1784 23

This study assessed the longitudinal association between clinician and patient ratings of posttraumatic stress disorder (PTSD) symptoms over the course of 2 different randomized clinical trials of veterans with chronic PTSD. One trial, the Department of Veterans Affairs Cooperative Study 420 (CSP 420; N = 360) compared trauma-focused and present-centered group therapies, and the 2nd trial compared cognitive processing theory and a waitlist control condition (N = 60). Linear mixed effects modeling revealed significant associations between clinician ratings (Clinician-Administered PTSD Scale; CAPS; D. D. Blake et al., 1990) and patient ratings (Posttraumatic Stress Disorder Checklist; PCL; F. W. Weathers, B. T. Litz, J. A. Herman, J. A. Huska, & T. M. Keane, 1993) in total and symptom clusters of PTSD. Contrary to hypothesis, the amount of change on the CAPS ranged from .75 to .82 standard deviations for every 1 standard deviation change on the PCL. The CAPS and PCL were more closely associated in the trauma-focused vs. present-centered treatment condition in CSP 420, and especially regarding hyperarousal symptoms. When comparing categorization of clinically significant change on the CAPS and PCL, the authors found no differences in the percentages of agreement between clinicians and patients in improvement and exacerbation. The value of multimodal assessment of PTSD treatment outcomes is discussed.
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PMID:Change in posttraumatic stress disorder symptoms: do clinicians and patients agree? 1855 90

Interpretation of ethnic differences in PTSD is predicated on demonstration that differences are not due to measurement bias. This is difficult when multiple languages are used in the assessment. This study used confirmatory factor analysis to examine possible differential item functioning (DIF) across English and Spanish versions of the PTSD Checklist-Civilian Version (PCL-C). Data were derived from two assessments of Hispanics (Ns = 304, 213), who were hospitalized with physical injuries. After correction for multiple testing, univariate tests revealed no statistically significant DIF effects; multivariate tests revealed some indication of DIF at the initial assessment only. This bias was inconsistent across waves and unlikely to be substantively consequential, indicating that the two versions of the PCL-C were generally equivalent.
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PMID:Spanish and English versions of the PTSD Checklist-Civilian version (PCL-C): testing for differential item functioning. 1872 Mar 94

Our study evaluated the relationship between positive affect (PA) and negative affect (NA) traits on the development of posttraumatic stress symptoms (PTSS) among peacekeepers. A longitudinal study with 138 army personnel deployed to a peacekeeping mission in Haiti was conducted. An instrument for measuring PA and NA traits was used before deployment. PTSS, indexed by posttraumatic stress disorder Checklist--Military Version (PCL-M) and frequency of stressful situations were measured after return. Regression analysis showed that both NA and number of stressful situations contributed toward increasing PCL-M scores (Adjusted R = 0.25; p < 0.001). We also found that NA traits interact with intensively stressful situations enhancing the occurrence of PTSS (Adjusted R = 0.32; p < 0.001). These findings suggest that NA traits are an important predictor for PTSS among peacekeepers and also worsen the consequences of being exposed to stressful situations.
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PMID:Negative affect predicts posttraumatic stress symptoms in Brazilian volunteer United Nations peacekeepers in Haiti. 1900 38

This is a clinical case study of a 45-year-old, Caucasian male, active duty military officer. It demonstrates the short-term efficacy of habit-reversal training on the treatment of trichotillomania (TTM) in three 50-minute sessions, with concomitant, but unanticipated decreases in post-traumatic stress disorder (PTSD) symptoms and emotional distress as measured by the PTSD Checklist, Form PCL-M and OQ-45, respectively. This study discusses the benefits and limitations of such a short treatment for comorbid TTM and PTSD, while positing the relationship between the two disorders. Finally, it lends support for the classification of TTM as an anxiety disorder rather than an impulse-control disorder.
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PMID:Trichotillomania and post-traumatic stress disorder: a case study. 1905 91

Tonic immobility is the last defense reaction to entrapment by a predator. In humans, peritraumatic tonic immobility was correlated with PTSD severity and poor response to treatment. This study compared the role of peritraumatic dissociation, panic physical symptoms and tonic immobility as predictors of response to standard pharmacotherapy for PTSD. Thirty-six PTSD patients underwent a naturalistic pharmacological treatment. The Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C) and the Clinical Global Impressions Severity of Illness item scores (CGI-S) were employed at baseline and endpoint to examine treatment outcome. Peritraumatic reactions were assessed using the Physical Reactions Subscale, the Peritraumatic Dissociative Experiences Questionnaire and four motor questions of the Tonic Immobility Scale. After controlling for confounders, tonic immobility was the best predictor of a poor response to treatment, either considering the PCL-C or the CGI-S scores. Tonic immobility seems to have a greater negative impact on PTSD prognosis than peritraumatic panic or dissociation. Additional translational and clinical research may inform about particular mechanisms underlying tonic immobility and open new avenues for prevention and treatment of PTSD.
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PMID:The impact of tonic immobility reaction on the prognosis of posttraumatic stress disorder. 1979 89


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