Exposure to War Trauma, War-Related PTSD, and Psychological Impact of Subsequent Hurricane

This study explored the impact of psychological outcomes to war on response to subsequent natural disaster. Participants were 312 military personnel, 66% of whom saw Gulf War duty. All were exposed to the 1992 Hurricane Andrew. Troops were compared on reported traumatic events, hurricane impact responses, and psychological symptoms in subgroups defined by war or no war exposure prior to hurricane and by presence or absence of war-related posttraumatic stress disorder (PTSD). Data were gathered in face-to-face clinical assessments. War trauma prior to hurricane was associated with more reported traumatic events, greater fears for safety during the hurricane, and heightened psychological symptoms. Troops with preexisting war-related PTSD showed more adverse psychological hurricane sequelae and reported more traumatic events, higher depression, anxiety, anger, PTSD symptoms, and physical symptoms, and lower self-esteem than those free of diagnoses. Results point to the negative influence of exposure to one traumatic event on the experience of and response to a subsequent stressor.     

Adapting Cognitive Processing Therapy for PTSD for People With Disabilities: A Case Study With a U.S. Veteran

Many veterans receiving treatment for PTSD in the VA health care system are also living with a disability and utilize assistive technologies for communication and/or mobility. While evidence-based treatments for PTSD have been disseminated in VA hospitals nationwide, clinicians may have concerns about implementing these treatments with people with disabilities or question how to adapt evidence-based protocols to facilitate successful outcomes. This clinical case study details the treatment of a 48-year-old male U.S. veteran with a diagnosis of military-related PTSD and significant functional and communicative complexities characteristic of locked-in syndrome. The study implemented an adapted protocol of Cognitive Processing Therapy (CPT), a first-line evidence-based psychotherapy for PTSD with unknown application to people with disabilities. CPT protocol structure, length, and delivery was adapted to accommodate the veteran’s assistive devices and functional abilities. The veteran experienced a clinically significant reduction in PTSD symptoms over the course of treatment, suggesting successful application of the adapted protocol. In addition to symptom reduction, the veteran reported advances in his ability to tolerate emotional distress while engaged in goal-directed behavior and improved interpersonal functioning. Results suggest that CPT can be adapted and effective in instances where the presence of disability and multiple assistive technologies impact standard treatment implementation. This information is valuable in its potential ability to make evidence-based psychotherapies more accessible and disability-sensitive. Clinical recommendations for using and adapting CPT for people with disabilities are provided.     

Post-Traumatic Stress Disorder,Sensory Integration,and Aquatic Therapy: A Scoping Review

The prevalence of post-traumatic stress disorder (PTSD) continues to increase. Symptomology of PTSD include sensory deficits much like those displayed in children with sensory integration (SI) disorder. The aim of this scoping review is to review symptoms of PTSD and SI, and make a case of how aquatic therapy may be an effective modality in treating clients with PTSD. Eighteen articles were selected for review. From this review, it is suggested that aquatic therapy can be an effective modality in reducing symptoms of PTSD; however, future research is essential in determining its effectiveness.     

Posttraumatic Stress in Survivors of Childhood Cancer and Mothers: Development and Validation of the Impact of Traumatic Stressors Interview Schedule (ITSIS)

This study presents initial data validating the use of a new instrument, the Impact of Traumatic Stressors Interview Schedule (ITSIS), to assess the occurrence of cancer-related posttraumatic stress in childhood cancer survivors and their mothers. Sixty-six child/adolescent cancer survivors and 64 of their mothers, as well as 130 young adult survivors, completed the ITSIS and other measures of posttraumatic stress and general distress. Five ITSIS factors were identified for the mothers and for the young adult survivors, and three ITSIS factors were identified for the child/adolescent survivors. Factors in all three samples reflected symptoms of posttraumatic distress, concern over medical late effects, communication, and changes in self due to cancer. Only young adult survivors had a factor reflecting a positive engagement with the cancer history. Factors correlated with validation measures in predicted ways. The findings further the conceptualization of posttraumatic stress in pediatric cancer by describing the traumatic experience for survivors and mothers. Comparing factors across samples allows an examination of different influences of cancer within families and over the course of development.     

Associations of depression,anxiety and PTSD with neurological disability and cognitive impairment in survivors of moyamoya disease

Depression, anxiety and posttraumatic stress disorder (PTSD) are common complications of cerebrovascular diseases. However, they were seldom explored in Moyamoya Disease (MMD) survivors. In this study, we measured the prevalence of depression, anxiety and PTSD in MMD survivors. We evaluated the association of mental disorders with neurological disability and cognitive impairment, and further find out the independent protective and risk factors of neurological disability and cognitive impairment. In MMD survivors, the prevalence of these three mental disorders is high, 46.7% for depression, 50% for anxiety and 47.5% for PTSD. Anxiety and PTSD were significantly associated with more severe neurological disability (p = 0.039 and < 0.001); depression and anxiety were significantly associated with greater cognitive deficiency (p = 0.004 and 0.002). We further found PTSD was the only risk factor associated with neurological disability, and the corresponding odds ratio (OR) and 95% confidence interval (CI) was 81.74 (9.91–674.17); depression and anxiety were risk factors associated with cognitive impairment, and the corresponding OR and 95%CI were 2.73 (1.10–6.81) and 3.37 (1.29–8.78). Therefore, these three mental disorders were associated with more severe neurological disability and greater cognitive deficiency in MMD survivors.     

A Cross-Lagged Panel Approach to Understanding Social Support and Chronic Posttraumatic Stress Disorder Symptoms in Veterans: Assessment Modality Matters

Although there is a strong and consistent association between social support and posttraumatic stress disorder (PTSD), the directionality of this association has been debated, with some research indicating that social support protects against PTSD symptoms, whereas other research suggests that PTSD symptoms erode social support. The majority of studies in the literature have been cross-sectional, rendering directionality impossible to determine. Cross-lagged panel models overcome many previous limitations; however, findings from the few studies employing these designs have been mixed, possibly due to methodological differences including self-report versus clinician-administered assessment. The current study used a cross-lagged panel structural equation model to explore the relationship between social support and chronic PTSD symptoms over a 1-year period in a sample of 264 Iraq and Afghanistan veterans assessed several years after trauma exposure. Approximately a third of the sample met criteria for PTSD at the baseline assessment, with veterans’ trauma occurring an average of 6 years prior to baseline. Two separate models were run, with one using PTSD symptoms assessed via self-report and the other using clinician-assessed PTSD symptoms. Excellent model fit was found for both models. Results indicated that the relationship between social support and PTSD symptoms was affected by assessment modality. Whereas the self-report model indicated a bidirectional relationship between social support and PTSD symptoms over time, the clinician-assessed model indicated only that baseline PTSD symptoms predicted social support 1 year later. Results highlight that assessment modality is one factor that likely impacts disparate findings across previous studies. Theoretical and clinical implications of these findings are discussed, with suggestions for the growing body of literature utilizing these designs to dismantle this complex association.     

Parent and Child Agreement for Acute Stress Disorder,Post-Traumatic Stress Disorder and other Psychopathology in a Prospective Study of Children and Adolescents Exposed to Single-Event Trauma

Examining parent-child agreement for Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD) in children and adolescents is essential for informing the assessment of trauma-exposed children, yet no studies have examined this relationship using appropriate statistical techniques. Parent-child agreement for these disorders was examined by structured interview in a prospective study of assault and motor vehicle accident (MVA) child survivors, assessed at 2–4 weeks and 6 months post-trauma. Children were significantly more likely to meet criteria for ASD, as well as other ASD and PTSD symptom clusters, based on their own report than on their parent’s report. Parent-child agreement for ASD was poor (Cohen’s κ = −.04), but fair for PTSD (Cohen’s κ = .21). Agreement ranged widely for other emotional disorders (Cohen’s κ = −.07–.64), with generalised anxiety disorder found to have superior parent-child agreement (when assessed by phi coefficients) relative to ASD and PTSD. The findings support the need to directly interview children and adolescents, particularly for the early screening of posttraumatic stress, and suggest that other anxiety disorders may have a clearer presentation post-trauma.     

Placing Age Differences in Cultural Context: A Comparison of the Effects of Age on PTSD After Disasters in the United States, Mexico, and Poland

Criterion symptoms of posttraumatic stress disorder (PTSD) were measured 6–12 months after Hurricane Andrew in the United States (non-Hispanic n = 270), Hurricane Paulina in Mexico (n = 200), and the 1997 flood in Poland (n = 285), using English, Spanish, and Polish versions of the Revised Civilian Mississippi Scale. The samples ranged in age from 18 to 88. Linear and quadratic effects of age were tested by using hierarchical multiple regression, with the effects of gender, trauma, and education controlled. Among Americans, age had a curvilinear relation with PTSD such that middle-aged respondents were most distressed. Among Mexicans, age had a linear and negative relation with PTSD such that younger people were most distressed. Among Poles, age had a linear and positive relation with PTSD such that older people were most distressed. Thus, there was no one consistent effect of age; rather, it depended upon the social, economic, cultural, and historical context of the disaster-stricken setting.     

儿童青少年创伤后应激障碍(PTSD)治疗的研究热点——基于美国文献的知识图谱分析

为了解近10年(2006~2016)来美国18岁及以下的儿童青少年创伤后应激障碍(PTSD)治疗研究的热点和重点,利用Bicomb 2.0软件和IBM SPSS Statistics 20.0软件,对ISI Web of Science数据库中查询到的363篇论文进行了知识图谱的可视化分析。结果表明,近10年来美国儿童青少年PTSD治疗研究可分为两个大的研究领域。领域一为儿童青少年PTSD的精神科和神经生物学相关的治疗,包括了两个小的研究热点:(1)儿童青少年PTSD精神科药物治疗相关的研究;(2)儿童青少年PTSD眼动脱敏再加工治疗等神经生物学机制的疗法。领域二为儿童青少年PTSD的心理学治疗,包括了两个小的研究热点:(1)家庭暴力导致的儿童青少年PTSD心理学治疗研究;(2)儿童青少年PTSD的认知行为治疗研究。其中关于儿童青少年PTSD的认知行为治疗研究是研究的热点和重点领域,但关于儿童青少年PTSD治疗效果的长期纵向研究还较为缺乏,未来研究者应加强对儿童青少年PTSD治疗效果的追踪研究,并开展心理治疗与药物治疗相结合的疗效研究。     

Treating PTSD in Patients With Psychosis: A Within-Group Controlled Feasibility Study Examining the Efficacy and Safety of Evidence-Based PE and EMDR Protocols

The present study uses a within-group controlled design to examine the efficacy and safety of two psychological approaches to posttraumatic stress disorder (PTSD) in 10 patients with a concurrent psychotic disorder. Patients were randomly assigned either to prolonged exposure (PE; N = 5) or eye movement desensitization and reprocessing (EMDR; N = 5). Before, during, and after treatment, a total of 20 weekly assessments of PTSD symptoms, hallucinations, and delusions were carried out. Twelve weekly assessments of adverse events took place during the treatment phase. PTSD diagnosis, level of social functioning, psychosis-prone thinking, and general psychopathology were assessed pretreatment, posttreatment, and at three-month follow-up. Throughout the treatment, adverse events were monitored at each session. An intention-to-treat analysis of the 10 patients starting treatment showed that the PTSD treatment protocols of PE and EMDR significantly reduced PTSD symptom severity; PE and EMDR were equally effective and safe. Eight of the 10 patients completed the full intervention period. Seven of the 10 patients (70%) no longer met the diagnostic criteria for PTSD at follow-up. No serious adverse events occurred, nor did patients show any worsening of hallucinations, delusions, psychosis proneness, general psychopathology, or social functioning. The results of this feasibility trial suggest that PTSD patients with comorbid psychotic disorders benefit from trauma-focused treatment approaches such as PE and EMDR.     

Behavior Ratings and Observations of Externalizing Symptoms in Girls: The Role of Child Popularity with Adults

This study examined staff ratings and live observations of externalizing behavior in 149 girls with and without attention-deficit/hyperactivity disorder (ADHD), who participated in all-female naturalistic research camps. Girls' popularity with adult camp staff was hypothesized to explain discrepancies between ratings and observations. Compared to behavior observations, staff ratings overestimated the externalizing behavior of girls who were disliked by staff. In contrast, ratings and observations were consistent for girls who were liked by staff. Among girls who were disliked by staff, unpopularity with peers predicted a larger discrepancy between staff ratings and observations, but peer status made little difference in rating–observation discrepancies of girls liked by staff. All results held after controlling for the participants' ADHD versus comparison status. Results suggest that staff ratings may be biased by personal feelings about children and that direct observations may be more immune to such bias.     

Children with Autism and Their Friends: A Multidimensional Study of Friendship in High-Functioning Autism Spectrum Disorder

This study of Israeli and American preadolescent children examined characteristics of friendship in 44 children with high-functioning autism spectrum disorder (HFASD) compared to 38 typically developing children (TYP), as they interacted with a close friend Participants were 8-12 years of age (HFASD: Israel, n = 24; USA, n = 20; TYP: Israel, n = 23; USA, n = 15), and were matched on SES, receptive language vocabulary, child age, and gender (each study group included one girl). Multidimensional assessments included: individual behaviors of target children and observed child-friend interactions during construction and drawing scenarios; target child's and friend's self-perceived mutual friendship qualities; and mother-reported characteristics (friendship's duration/frequency; friend's age/gender/disability status). Overall, children with HFASD displayed a number of differences on individual and dyadic friendship measures. Both age and verbal abilities affected friendship behaviors. Children with HFASD and their friends perceived friendship qualities similarly, suggesting that preadolescents with HFASD have capacities for interpersonal awareness. Between-group similarities also emerged on several complex social behaviors, suggesting that friendship follows a developmental trajectory in autism and may enhance social interaction skills in autism.     

Innovations in Assessing ADHD: Development, Psychometric Properties, and Factor Structure of the ADHD Symptoms Rating Scale (ADHD-SRS)

This research involved the development of a behavior rating scale designed to measure ADHD and the investigation of the scale's psychometric properties and factor structure. This scale, the ADHD Symptoms Rating Scale (ADHD-SRS), was developed for the assessment of ADHD in the school-age (K–12) population. Participants were 1006 children and adolescents (in grades K–12) who were rated by their parents and/or teachers. The results indicate that the ADHD-SRS possesses strong internal consistency reliability and test–retest reliability and moderate cross-informant reliability. The data also suggest that the ADHD-SRS has strong content validity. Convergent validity of this instrument was also high, as demonstrated by correlations with three previously validated behavior rating scales. Significant age and gender differences in ADHD symptoms were found with both the parent and teacher respondent populations. Finally, the factor analysis of the ADHD-SRS suggested a two factor oblique rotation as the best fit for both the parent and the teacher data. After a visual inspection of the items which loaded on each factor, Factor 1 was named Hyperactive-Impulsive and Factor 2 was named Inattention. These two factors, along with the items which loaded on each factor, appear to be remarkably similar to the two categories listed in the DSM-IV for ADHD. Directions for future research, as well as clinical implications and limitations of the research are discussed.     

Adjustment to War Captivity: The Role of Sociodemographic Background,Trauma Severity,and Immediate Responses,in the Long-Term Mental Health of Israeli Ex-Pows

This study assessed the role of sociodemographic features, pre-captivity combat exposure, captivity severity, emotional responses and coping during captivity, and social support at homecoming, to the short- and long-term mental health of 164 Israeli POWs of the 1973 Yom Kippur War. The major contributors to the POWs' mental health were psychological responses during captivity, followed first by their education and ethnic status, and then by severity of captivity. Both traumatic stress of captivity and the results of the study were discussed in the light of Conservation of Resources (COR) theory.     

Visual Information and the Control of Reaching in Children: A Comparison Between Children With and Without Developmental Coordination Disorder

Three experiments were performed on reach and grasp in 9- to 10-year-old children (8 controls and 8 with developmental coordination disorder [DCD]). In normal reaching, children in the DCD group were less responsive to the accuracy demands of the task in controlling the transport component of prehension and spent less time in the deceleration phase of hand transport. When vision was removed as movement began, children in the control group spent more time decelerating and reached peak aperture earlier. Children in the DCD group did not do that, although, like the control group, they did increase grip aperture in the dark. When depth cues were reduced and only the target or only the target and hand were visible, children in the control group used target information to maintain the same grip aperture in all conditions, but DCD children behaved as if the target was not visible. Throughout the studies, the control group of 9- to 10-year-olds did not produce adult-like adaptations to reduced vision, suggesting that they had not yet attained adult-like integration of sensory input. Compared with control children, children with DCD did not exhibit increased dependence on vision but showed less recognition of accuracy demands, less adaptation to the removal of vision, and less use of minimal visual information when it was available.     

A Comparison of Alternative Models of Coping: Identifying Relationships Among Coworker Support, Workload, and Emotional Exhaustion in the Workplace

Over the past 20 years, hundreds of studies have examined the construct of coping and its role in the stressor-strain relationship. Although coping is commonly viewed as a buffer in the stressor-strain relationship, multiple alternative models—buffering and direct effects—have been proposed. This study reviews alternative models of coping and then discusses the nature of the empirical support for these models. As a means of efficiently testing the relative soundness of these models, 3 work-related variables that represent a subset of all possible coping mechanisms, stressors, and strains (coworker support, workload, and emotional exhaustion, respectively) are employed. The results suggest that coping resources tend to serve as direct deterrents of strain and, thus, are general health maintenance mechanisms independent of preexisting levels of stressors.     

The Effect of Pastoral Care Services on Anxiety,Depression, Hope,Religious Coping,and Religious Problem Solving Styles: A Randomized Controlled Study

This randomized controlled study measured the effect of chaplain interventions on coronary artery bypass graft (CABG) patients over time. One hundred sixty-six CABG patients, received pre- and post-surgery testing at 1 month and 6 months with four instruments. Five chaplain visits were made to the intervention group, the control group received none. Comparison scores for anxiety, depression, hope, positive and negative religious coping, and religious coping styles were analyzed. Significant difference was found between groups in positive religious coping (PRC) (p = .023) and negative religious coping (NRC) (p = .046) scores over time. PRC increased in intervention group, decreased in the control group while NRC decreased in intervention group and increased in the control group. Demographics were comparable between groups. Moderate chaplain visits (average total visits time, 44 min) may be effective in helping CABG patients increase positive religious coping and decrease negative religious coping.

Managerial Stress, Locus of Control, and Job Strain in Taiwan and UK: A Comparative Study

This study investigated managerial stress in Taiwan and UK using the Occupational Stress Indicator-2 (OSI-2) and the Work Locus of Control (WLCS) scale. Results showed that the reliability and validity of the measures used were acceptable and comparable in the two samples. There were similarities as well as differences in managerial stress in the two countries. Recognition and Managerial role were important predictors of strain for the Chinese managers, whereas Relationships, Organizational climate, and Personal responsibility were important predictors of strain for UK managers. There were consistent moderating (vulnerability) effects of internal control for the Taiwanese managers. Results corroborated some previous studies conducted in the West. However, caution was also suggested for generalizing Western-originated concepts and theories across cultural boundaries.