Post-Traumatic Stress Disorder in Vietnamese Women

This article describes the extraordinary events Vietnamese women immigrants and refugees experienced prior to their resettlement in the United States. Oral history data illustrate the need for sensitization to issues of Post-Traumatic Stress Disorder and the historical-cultural background of this special population. Oral history narratives from five Vietnamese women suggest differences in the way men and women define wartime trauma, and that women's biological makeup may precipitate some stress reactions unique to women. These narratives are examined in terms of Post-Traumatic Stress Disorder (PTSD), a diagnosis that has been applied primarily to male veterans in treating their physical and psychological problems resulting from war, not to Vietnamese women who lived under war conditions.     

Attachment Theory and Post-Traumatic Stress Disorder

Attachment theory is applied to understanding and treatment of the anxiety condition of post-traumatic stress disorder in adults. Conceptualized as intensified attachment behavior which is elicited at separation or loss or threat of separation, PTSD responses represent an inherent, though exaggerated, attempt to ensure protection and security. The secure base of a therapeutic relationship reduces the intensity of responses and provides an opportunity to review experiences relevant to current distress in order to affirm emotional reactions and come to terms with distressing events. Implications for prevention are discussed.     

Comorbidity of attention Deficit Hyperactivity Disorder and Post-Traumatic Stress Disorder

Attention Deficit Hyperactivity Disorder (ADHD) and Post-Traumatic Stress Disorder (PTSD) show a high degree of comorbidity in traumatized children. Two hypotheses may help explain this relationship: children with ADHD are at higher risk for trauma due to their impulsivity, dangerous behaviors, and parents who may have a genetic predisposition for impairment of their own impulse control; and hyperarousal induced by severe trauma and manifested by hypervigilance and poor concentration may impair attention to create an ADHD-like syndrome. Four illustrative cases are presented, and implications for treatment are discussed.     

Post-Traumatic Stress Disorder Among Salvadoran Women:

Previous research has documented post-traumatic stress disorder among Salvadoran refugees in this country, but information on refugees living in El Salvador is not available. This study investigated the patterns of psychological distress and documented the existence of PTSD in Salvadoran refugee women in El Salvador. A team of U.S. mental health workers traveled to a refugee camp in El Salvador to interview women about their traumatic experiences and current symptoms of distress. This study provides strong evidence that many refugee women in El Salvador have developed PTSD and that many others show significant signs of distress. Data from this study also provided insight into clinical issues for Salvadoran women experiencing PTSD. In response to requests from Salvadoran mental health providers, a treatment program was developed to help Salvadoran women reduce their distress. Goals of the treatment included associating distress with the trauma as a normal reaction to a very abnormal event, reducing feelings of loss of control, reducing "survivor guilt," and lessening anxiety and high arousal level. These goals were accomplished using cognitive-behavioral and community-oriented strategies.     

创伤后应激障碍病因及发病机制的研究进展

创伤后应激障碍(post-traumatic stress disorder,PTSD)是一种严重的应激相关障碍,指个体面临异常强烈的精神应激后延迟发生的精神障碍,文献报告PTSD的终生患病率为1%～14%,高危人群研究发现PTSD的患病率为3%～58%,女性约为男性的两倍[1]。PTSD的病因及发病机制较为复杂,涉及很多方面,本文将对PTSD病因及发病机制的研究进展进行综述。     

创伤后应激障碍病因及发病机制的研究进展

创伤后应激障碍(post-traumatic stress disorder,PTSD)是一种严重的应激相关障碍,指个体面临异常强烈的精神应激后延迟发生的精神障碍,文献报告PTSD的终生患病率为1%～14%,高危人群研究发现PTSD的患病率为3%～58%,女性约为男性的两倍[1].PTSD的病因及发病机制较为复杂,涉及很多方面,本文将对PTSD病因及发病机制的研究进展进行综述.     

The Use of Psychoendocrine Strategies in Post-Traumatic Stress Disorder1

An overview is presented of a pilot psychoendocrine study of PTSD inpatients in comparison with several subgroups of schizophrenic and affective disorder patients. Using a hormonal profile including Cortisol, norepinephrine, epinephrine, testosterone, and thyroxine, it was found that the mean values for the PTSD group were at or near the extreme end of the range for every hormone measured, i.e., relatively low for Cortisol and high for the remaining hormones. The possible clinical meaning of these findings is considered in the light of prior psychoendocrine research on chronic stress. The hormonal alterations in PTSD appear to be persistent and suggest the possibility of being linked largely to traits or character structure, perhaps particularly to cognitive variables related to defense and coping mechanisms, as reviewed in detail for each hormonal system. There appears to be a potential for a fruitful union between the traumatic stress and psychoendocrine fields and some future strategies for developing and strengthening such a union are suggested.     

Behavioural Treatment of Post-Traumatic Stress Disorder Associated with Recovered Memories

Post-traumatic stress disorder (PTSD) is sometimes associated with recovered memories (RMs) of traumatic events. That is, the sufferer reports having forgotten traumatic events for a period of time, only to recall them later on. As the memories of traumatic events are recalled, post-traumatic stress disorder may emerge. The cause of recovered memories is uncertain and is the subject of debate. Some recovered memories may be reasonably accurate, while others may be ''recollections'' of imagined rather than actual events. It is unclear whether conventional PTSD therapies, such as behaviour therapy, are appropriate and effective in treating PTSD-RM. The present article considers these issues in the context of a case study, in which a patient with PTSD-RM was treated with behaviour therapy ( in vivo and imaginal exposure). The patient sought treatment because he wanted relief from his PTSD symptoms, regardless of whether his recovered memories were accurate (he was completely convinced in the accuracy of the memories). Treatment outcome was compared with the outcome of 13 PTSD patients who did not have recovered memories, who were also treated with behaviour therapy. Results suggest that PTSD-RM can be effectively treated with behaviour therapy. However, such treatment is unlikely to be appropriate for all cases of PTSD- RM. Selection criteria are discussed.     

Recent trends in Sri Lankan Buddhism

The South Asian island of Sri Lanka continues to be an important field site for the study of contemporary Buddhism. Numerous scholars in the field of religion base their arguments about the modern rise of Buddhist revivalism and fundamentalism on ethnographic data from Sri Lanka's long tradition of Theravāda Buddhism. This article, based on fieldwork in Colombo during summer 2002, serves to update previous knowledge on Sri Lankan Buddhism by reporting on newer developments in this religious tradition. I argue that many of the recent trends in Sri Lankan Buddhism are linked in part to broader political and economic realities observed in the island today.     

The Biological Findings in Post-Traumatic Stress Disorder: A Review1

In this paper the authors review the literature on biological and treatment studies of post-traumatic stress disorder (PTSD) and present current unifying hypotheses regarding the pathophysiology. The psychophysiological studies stress overarousal, while endocrine studies suggest a decreased Cortisol production in denial and low symptom states with increases in highly symptomatic states. Suggestive evidence is provided that PTSD is associated with permanent changes in brain mechanisms involving the locus coeruleus, amygdala, and the hypothalamo-pituitary-adrenal axis. Drug treatments are promising but not fully satisfactory as yet. Directions for further research are provided.     

The time of trauma: Husserl's phenomenology and Post-Traumatic Stress Disorder

The phenomenology of inner temporalizing developed by Edmund Husserl provides a helpful framework for understanding a type of experiencing that can be part of the Post-Traumatic Stress Disorder (PTSD). My paper extrapolates hints from Husserl's work in order to describe those memories — flashbacks — that come so strongly to consciousness as to overtake the experiencer. Husserl's work offers several clues: his view of inner temporalization by which conscious experiences flow in both a serial and a nonserial manner; a characterization of process memory as distinct from representational memory; and the notion of telos, which takes human subjectivity as intrinsically changeable, for example, by means of a retroactive cancellation that would allow the PTSD experiencer to re-process the original meaning of the traumatic experience into a meaning that fits the current situation and thus allows a recovery.     

Management of Post-Traumatic Stress Disorder in the Military: An Intervention Model

Military Forces are involved in combat, peacekeeping operations and disaster management. The nature of such operations include violent conflict, death of women and children, child soldiers and own forces. These traumatic circumstances can contribute to the development of post traumatic stress disorder (PTSD) in members involved. This article discusses the role and function of psychological debriefing for trauma with operational military units. It also proposes a preliminary intervention model to manage PTSD in military forces.     

Steps Toward Evaluating Post-Traumatic Stress Reaction as a Psychiatric Disorder1

This brief paper summarizes comments made in discussing papers given in the November 1988 NIHM workshop “Traumatic Stress: Defining Terms and Instruments”. It raises questions about current criteria for posttraumatic stress in terms of the traumatic events considered appropriate, the coherence of the syndrome described, and the scarcity of data on its course, its familiarity, and its relationship to other syndromes. It is suggested that long-term studies of general population cases will be needed to answer these questions.     

A Primer Of Closed Head Injury Sequelae In Post-Traumatic Stress Disorder

Abstract

By definition, an individual diagnosed with post-traumatic stress disorder (PTSD) has been exposed to a serious threat of physical harm that engenders concomitant feelings of fear, helplessness, or horror (American Psychiatric Association, 1994). According to the current diagnostic taxonomy, PTSD may develop when the person witnesses harm against someone else or learns of harm occurring to an intimate other. Yet, all too often, PTSD is associated with the direct experience of physical injury through assault, accident, or other violence. As such, individuals with PTSD are at increased risk of having sustained a head injury, particularly during the traumatic events that elicited the PTSD symptoms (Knight, 1996). Consistent with this assertion, there are indications that individuals who sustain a head injury are increasingly likely to develop subsequent PTSD (Bryant & Harvey, 1998; Chemtob et al., 1998), with the prevalence of PTSD in this population estimated to be as high as 30% (Bryant & Harvey, 1996). Moreover, among people with PTSD, those who have sustained head injuries are apt to have more severe symptoms than those who have not (Chemtob et al., 1998).     

Pavlovian Eyeblink Conditioning in Combat Veterans With and Without Post-Traumatic Stress Disorder

Several recent studies have investigated relationships between post-traumatic stress disorder (PTSD) and learning and memory problems. These reports have found in general that not only does PTSD affect trauma-related memories, but when patients with PTSD are compared with similar trauma patients without PTSD, general memory impairments have been found. The present paper reports a study in which associative learning, using Pavlovian eyeblink conditioning, was investigated in combat veterans with and without chronic PTSD, using interstimulus intervals of 500 and 1000 msec in two separate experiments. Although several recent reports suggest that larger-magnitude autonomic conditioned responses occur in patients with PTSD during Pavlovian conditioning, the present study found evidence of impaired Pavlovian eyeblink conditioning in combat veterans with and without PTSD, compared to non-combat veterans. Although these data suggest that combat leads to an impaired associative learning process regardless of whether PTSD is apparent, a group of community-dwelling combat veterans not under medical treatment showed normal conditioning, suggesting that variables other than prior combat must also be involved.     

Causal Attributions, Depression, and Post-Traumatic Stress Disorder in Victims of Crime

The major purpose of this study was to investigate relationships between causal attributions and symptomatology in victims of crime. Fifty-one subjects who had not been crime victims and 120 subjects who had been crime victims participated in the study and were assessed for symptoms of post-traumatic stress disorder (PTSD) and depression. Subjects also completed two attributional questionnaires. The potential differences in symptomatology among victims of a single crime, multiple crimes, and nonvictims were investigated. Results did not indicate differences in depression and PTSD based on single vs. multiple victimization, although differences between victims and nonvictims were found. Results using the Causal Dimension Scale (CDS; Peterson et al., 1982) indicated significant differences in the causal attributions of victims and nonvictims. On the Attributional Style Questionnaire (ASQ; Russell, 1982), group comparisons among nonvictims, PTSD victims, depression victims, both depression and PTSD victims, and victims with low symptoms did not yield significant results. However, regression analyses indicated that several subscales of both the CDS and ASQ were found to be moderate predictors of symptomatology. Implications for future research are discussed.     

Post-Traumatic Stress Disorder as a Consequence of a Toxic Spill in Northern California

This study examined the development of post-traumatic stress disorder (PTSD) and associated features in residents of Dunsmuir, California, following a toxic spill. Classification of PTSD was based on a cutoff score from the Impact of Event Scale. It was predicted that greater exposure to the spill would increase the risk of PTSD and associated symptoms among spill residents; that those classified with PTSD would report more symptoms than would those without PTSD and controls; and that litigants would be classified with PTSD more than would nonlitigants. Results suggest that spill residents classified with PTSD had greater levels of tension, depression, anxiety, anger, fatigue, and confusion than did spill residents without PTSD and control residents with and without PTSD. Spill residents with PTSD reported more memory problems and sleep disorders than did those without PTSD and control residents with and without PTSD. Measures of physiological arousal showed that spill residents had higher systolic blood pressure several hours after a stressful interview than did control residents without PTSD. Pulse rates several hours after a stressful interview were higher for spill residents with and without PTSD than for control residents with PTSD. Results suggest that exposed residents are at risk for developing PTSD and associated symptoms.