ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Dissociative symptoms are frequently present in trauma survivors with posttraumatic stress disorder (PTSD). However, the possibility that dissociative symptoms may comprise a risk factor for the development of PTSD has not been examined. The current research investigates this possibility by evaluating dissociative symptoms in a group of adult offspring of Holocaust survivors, whom we have previously shown to be at increased risk of PTSD. Eighty-seven Holocaust survivor offspring and 39 comparison participants completed the Dissociative Experiences Scale, and assessments of trauma exposure, psychopathology, and parental PTSD. Dissociative symptoms were elevated in individuals with current PTSD, but not in those with past PTSD or with the risk factor of parental PTSD. Dissociative symptoms were also associated with forms of psychopathology other than PTSD. The results suggest that dissociative symptoms are related to current psychiatric symptomatology, including PTSD, rather than representing an enduring trait or preexisting risk factor for the development of PTSD.

ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Secondary traumatization from the tragic events of September 11, 2001 was studied among an ethnically diverse group of refugees who had been previously traumatized in their native war torn countries. A brief clinically oriented questionnaire was developed and administered to a clinic population of Vietnamese, Cambodian, Laotian, Bosnian and Somalian refugees in the Intercultural Psychiatric Program at Oregon Health & Science University. Traumatic symptoms and responses to the widely televised images from September 11 were assessed among the five ethnic groups, and the differential responses among patients with posttraumatic stress disorder (PTSD), depression, and schizophrenia also were assessed. The strongest responses were among Bosnian and Somalian patients with PTSD, and the Somalis had the greatest deterioration in their subjective sense of safety and security. Regardless of ethnic group, PTSD patients reacted most intensely, and patients with schizophrenia the least. Although patients largely returned to their baseline clinical status after two to three months, this study shows that cross-cultural reactivation of trauma has a significant clinical impact. It is essential that clinicians anticipate PTSD symptom reactivation among refugees when they are reexposed to significant traumatic stimuli.

ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Using American Academy of Sleep Medicine research criteria, sleep-disordered breathing (SDB) was assessed in a pilot study of 187 sexual assault survivors with posttraumatic stress symptoms. Nightmares, sleep quality, distress, and quality of life were also assessed along with historical accounts of prior treatments for sleep complaints. Presumptive SDB diagnoses were established for 168 patients. Twenty-one of 168 underwent sleep testing, and all met objective SDB diagnostic criteria. There were no clinically meaningful differences in age, body-mass index, sleep quality, distress, or quality of life measures between 21 confirmed SDB cases and 147 suspected cases not tested. Compared with 19 women without SDB, 168 women with diagnosed or suspected SDB reported significantly worse nightmares, sleep quality, anxiety, depression, posttraumatic stress, and impaired quality of life. Despite suffering from sleep problems for an average of 20 years, which had not responded to repeated use of psychotropic medications or psychotherapy, few of these women had been referred to sleep specialists. SDB appears widespread among sexual assault survivors seeking help for nightmares. Research is needed to clarify the associations among SDB, distress, and physical and mental health impairment in trauma patients.

ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The authors examined the prevalence of self-reported childhood physical or sexual abuse in a sample of adult patients presenting for treatment of panic disorder, social phobia, or generalized anxiety disorder. Regardless of the presence of comorbid anxiety disorders or comorbid depression, patients with panic disorder had significantly higher rates of past childhood physical or sexual abuse than patients with social phobia. Patients with generalized anxiety disorder had intermediate rates of past physical or sexual abuse that were not significantly different from the other two diagnostic groups. Anxiety disorder patients with a history of childhood abuse were also more likely to have comorbid major depression than those without. These findings are discussed in terms of biological and behavioral factors that may influence the development of anxiety disorders after the experience of a traumatic event.

ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Few studies have investigated maternal aggression toward infants among women with a severe mental illness that emerges in the postpartum period. In this prospective study of 50 Indian women admitted to a psychiatric hospital for severe mental illness occurring in the postpartum period, we examined the prevalence, pattern, and predictors of maternal aggression, infanticidal ideas, and infanticidal behavior. Nearly half (43%) of the mothers reported infanticidal ideas, 36% reported infanticidal behavior, and 34% reported both infanticidal ideas and behavior. Infanticidal ideas and behavior co-occurred frequently (r= .80). Infanticidal ideas were associated with depression in the mother, adverse maternal reaction to separation from the infant, and psychotic ideas toward the infant. Infanticidal behavior was associated with having a female infant, psychotic ideas toward the infant, and adverse maternal reaction to separation from the infant. Logistic regression analyses indicated that presence of depression and of psychotic ideas predicted infanticidal ideas, whereas presence of psychotic ideas toward the infant predicted infanticidal behavior.

ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

This study assessed rates and correlates of suicidal ideation and suicide attempts in individuals seeking treatment for pathological gambling. At intake to gambling treatment programs, 342 pathological gamblers completed the Addiction Severity Index and the South Oaks Gambling Screen. Participants were categorized into three groups: no suicidal ideation (N= 175, 51%), suicidal ideation alone (N= 109, 32%), and suicide attempters (N= 58, 17%). After controlling for gender, age, treatment site, and substance abuse treatment histories, differences among the groups emerged in terms of severity of psychiatric, social/family, and gambling problems. Compared with nonsuicidal gamblers, those with suicidal ideation suffered from more psychiatric symptoms, were less satisfied with their living situations, and experienced more days of conflict in the month before entering gambling treatment. Compared with pathological gamblers with no history of suicidal ideation, those with suicidal ideation spent more money gambling in the month before entering treatment, reported greater cravings for gambling, and had higher South Oaks Gambling Screen scores. These data confirm other reports of high rates of suicidality in pathological gamblers and may suggest the need for more intensive and focused treatments in pathological gamblers with suicidality.

ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Seventy-three patients (ages 18 to 66) with specific phobias from one of four DSM-IV subtypes (animal, situational, blood-injection-injury, and natural environment) were assessed by experienced clinicians using a semistructured diagnostic interview. All patients were free of lifetime anxiety comorbidity. Subtype groups were compared on age of onset, mode of onset, presence of unexpected panic attacks, and focus of fear. Consistent with earlier findings, participants with situational phobia had a later age of onset and more unexpected panic attacks. No differences were found across subtypes in mode of onset. Contrary to previous findings, natural environment and situational phobias were most frequently associated with a focus on danger or harm rather than other foci such as internal sensations associated with panic attacks. Implications for the usefulness of current subtype categories are discussed.

ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:2002

数据来源: OVID