Rates of Subthreshold PTSD Among U.S. Military Veterans and Service Members: A Literature Review

The current study’s goal was to provide a comprehensive review of current subthreshold posttraumatic stress disorder (PTSD) rates among U.S. military veterans and service members. PubMed, PsycInfo, ProQuest, Web of Knowledge, Google Scholar, and any relevant articles’ reference lists identified studies of subthreshold PTSD in the U.S. military. Search terms included PTSD in combination with partial, subthreshold or sub-threshold, subsyndromal or sub-syndromal, subclinical or sub-clinical, and military or veteran. Sixteen articles met criteria for review. Current subthreshold PTSD rates ranged from 2.3% to 22.3%, with a weighted mean rate of 7.6%. Definitional variation within and across the “below threshold” terms produced some variability in rates reported. Few studies consistently reported on impairment and comorbidity in the subthreshold PTSD population. Variability of current subthreshold PTSD rates may be due to methodological issues such as sampling methods, sample sizes, and how below threshold PTSD was assessed and defined. Based on our findings, we provide a number of recommendations that can be used to inform future research of subthreshold PTSD among U.S. military veterans and service members. These recommendations include having a standardized term and definition, determining how to more properly assess subthreshold PTSD symptomatology, clarifying subthreshold PTSD diagnostic stability, and identifying appropriate sampling methods.     

Does “Violent” Mean “Bad”? Individual Definitions of Violence

People use the word “violent” to describe a wide range of behaviors. When referring to acts of force, however, past research indicates that people often reserve the word “violent” to refer to acts of force that they define as “bad.” In the current study we use vignettes to explore variation in people’s definitions of a particular instance of the use of force. The findings indicate support for the idea that people reserve the word “violent” to refer to acts of force they view as “bad.” Findings indicate there is variation in perceptions of the level of violence, and whether the incident was even violent. Characteristics of the incident as well as the gender of those involved account for the majority of the variance explained.     

Minnesota clergy’s attitudes on suicide prevention and likelihood to inquire about suicidal thoughts and intent

Clergy are a recognised profession for suicide prevention and intervention in the United States. The current objective was to determine if clergy’s suicide prevention training, perceived roles in suicide prevention, and suicide prevention self-efficacy predicted likelihood to inquire about suicidal thoughts and intent. Among 367 Minnesota clergy surveyed, 30% reported a suicide in their congregation in the past year, and about one-third reported adequate training in suicide intervention strategies. The majority (85%) reported it was their role to provide education on suicide and mental health to their congregations, although 32% reported no or low ability to do so. Most (70%) stated, if concerned about a parishioner’s mental health, they would inquire about suicidal thoughts, but fewer (59%) stated they would inquire about suicidal intent. Significant, but weak, predictors of likelihood to inquire about suicide included self-efficacy and perceived role. Clergy could benefit from suicide prevention education, training, and support.     

Maintenance of mother-child aversive relationships: A fresh look at an old controversy

Data were obtained from 46 mother-child pairs from the Child Behavior Institute (CBI) at the University of Tennessee. These mother-child dyads were referred for psychological help because of the child’s aversive behavior. Child-parent interactions were quantified using a multi-code, observational system. Correlational and multiple regression analyses (stepwise) were conducted to find the best predictor of the child’s aversive behavior. Results showed that the child’s aversive behavior was significantly correlated with the mother’s aversive, indiscriminate, and compliance behaviors. The regression analysis showed mother’s aversive behavior to be the best predictor of the child’s aversive behavior. Moreover, our results seem to point out that the compliance hypothesis is more effective in predicting child aversive behavior than the predictability hypotheses. It appears that since the two hypotheses are dealing with similar processes, they are more complementary than oppositional. This study used data collected by the Child Behavior Institute (CBI) at the University of Tennessee, Knoxville. The authors are indebted to Robert Wahler, Michael Smith, and Sue Dunn for their helpful comments on this paper.     

Responsiveness to verbal instruction during anesthesia: a pilot report

Five patients who were undergoing surgery were instructed to tense their forehead muscles. On 11 out of 12 trials, the patient's muscle tension was greater during the suggestion period than during the nonsuggestion condition.     

On authenticity: the question of truth in construction and autobiography

Freud was occupied with the question of truth and its verification throughout his work. He looked to archaeology for an evidence model to support his ideas on reconstruction. He also referred to literature regarding truth in reconstruction, where he saw shifts between historical fact and invention, and detected such swings in his own case histories. In his late work Freud pondered over the impossibility of truth in reconstruction by juxtaposing truth with ‘probability’. Developments on the role of fantasy and myth in reconstruction and contemporary debates over objectivity have increasingly highlighted the question of ‘truth’ in psychoanalysis. I will argue that ‘authenticity’ is a helpful concept in furthering the discussion over truth in reconstruction. Authenticity denotes that which is genuine, trustworthy and emotionally accurate in a reconstruction, as observed within the immediacy of the analyst/patient interaction. As authenticity signifies genuineness in a contemporary context its origins are verifiable through the analyst’s own observations of the analytic process itself. Therefore, authenticity is about the likelihood and approximation of historical truth rather than its certainty. In that respect it links with Freud’s musings over ‘probability’. Developments on writing ‘truths’ in autobiography mirror those in reconstruction, and lend corroborative support from another source.     

Religious and Spiritual Values and Moral Commitment in Marriage: Untapped Resources in Couples Counseling?

The authors investigated the relationship between religious and spiritual values and moral commitment in marriage to further inform marriage and family counselors about the nature of committed relationships. Using a qualitative research design, they examined individuals' perceptions of moral commitment in their marriage and how their religious and spiritual values influence those perceptions. Narrative text was analyzed through an iterative process, involving constant comparison of emerging themes, and 6 categories materialized. Findings build on existing knowledge regarding the importance of moral commitment to marital health specifically as it relates to the counseling profession.     

The influence of suggestibility on memory

We provide a translation of Binet and Henri's pioneering 1894 paper on the influence of suggestibility on memory. Alfred Binet (1857-1911) is famous as the author who created the IQ test that bears his name, but he is almost unknown as the psychological investigator who generated numerous original experiments and fascinating results in the study of memory. His experiments published in 1894 manipulated suggestibility in several ways to determine effects on remembering. Three particular modes of suggestion were employed to induce false recognitions: (1) indirect suggestion by a preconceived idea; (2) direct suggestion; and (3) collective suggestion. In the commentary we suggest that Binet and Henri's (1894) paper written over 115 years ago is still highly relevant even today. In particular, Binet's legacy lives on in modern research on misinformation effects in memory, in studies of conformity, and in experiments on the social contagion of memory.     

Rules of engagement: incomplete and complete pronoun resolution

Research on shallow processing suggests that readers sometimes encode only a superficial representation of a text and fail to make use of all available information. Greene, McKoon, and Ratcliff (1992) extended this work to pronouns, finding evidence that readers sometimes fail to automatically identify referents even when these are unambiguous. In this paper we revisit those findings. In 11 recognition probe, priming, and self-report experiments, we manipulated Greene et al.'s stories to discover under what circumstances a pronoun's referent is automatically understood. We lengthened the stories from 4 to 8 lines. This simple manipulation led to automatic and correct resolution, which we attribute to readers' increased engagement with the stories. We found evidence of resolution even when the additional text did not mention the pronoun's referent. In addition, our results suggest that the pronoun temporarily boosts the referent's accessibility, an advantage that disappears by the end of the next sentence. Finally, we present evidence from memory experiments that supports complete pronoun resolution for the longer but not the shorter stories.