The panic attack-posttraumatic stress disorder model: applicability to orthostatic panic among Cambodian refugees

This article examines the ability of the panic attack-posttraumatic stress disorder (PTSD) model to predict how panic attacks are generated and how panic attacks worsen PTSD. The article does so by determining the validity of the panic attack-PTSD model in respect to one type of panic attack among traumatized Cambodian refugees: orthostatic panic (OP) attacks (i.e. panic attacks generated by moving from lying or sitting to standing). Among Cambodian refugees attending a psychiatric clinic, the authors conducted two studies to explore the validity of the panic attack-PTSD model as applied to OP patients (i.e. patients with at least one episode of OP in the previous month). In Study 1, the panic attack-PTSD model accurately indicated how OP is seemingly generated: among OP patients (N = 58), orthostasis-associated flashbacks and catastrophic cognitions predicted OP severity beyond a measure of anxious-depressive distress (Symptom Checklist-90-R subscales), and OP severity significantly mediated the effect of anxious-depressive distress on Clinician-Administered PTSD Scale severity. In Study 2, as predicted by the panic attack-PTSD model, OP had a mediational role in respect to the effect of treatment on PTSD severity: among Cambodian refugees with PTSD and comorbid OP who participated in a cognitive behavioural therapy study (N = 56), improvement in PTSD severity was partially mediated by improvement in OP severity.     

The SF-36 Among Cambodian and Vietnamese Refugees: An Examination of Psychometric Properties

Among traumatized Cambodian (N=90) and Vietnamese (N=94) refugees attending a psychiatric clinic, the study examined the validity and psychometric properties of the Short Form-36 Health Survey (SF-36), a measure of self-perceived mental and physical health. In both patient samples, all eight SF-36 scales displayed excellent internal consistency (item-scale correlations and Cronbach's α). But, similar to other studies of Asian samples, (a) the Vitality (VT) scale did not separate from the Mental Health (MH) and General Health (GH) scales, as evidenced by item-scale and interscale correlations, and (b) the VT scale loaded as strongly (Vietnamese sample) or more strongly (Cambodian sample) than the MH scale on the so-called Mental Factor in a two-factor solution of the eight scales (with the GH scale also loading heavily on the same factor).     

A Distributed Connectionist Production System

DCPS is a connectionist production system interpreter that uses distributed representations. As a connectionist model it consists of many simple, richly interconnected neuron-like computing units that cooperate to solve problems in parallel. One motivation for constructing DCPS was to demonstrate that connectionist models are capable of representing and using explicit rules. A second motivation was to show how "coarse coding" or "distributed representations" can be used to construct a working memory that requires far fewer units than the number of different facts that can potentially be stored. The simulation we present is intended as a detailed demonstration of the feasibility of certain ideas and should not be viewed as a full implementation of production systems. Our current model only has a few of the many interesting emergent properties that we eventually hope to demonstrate: It is damage-resistant, it performs matching and variable binding by massively parallel constraint satisfaction, and the capacity of its working memory is dependent on the similarity of the items being stored.     

Personality and Church Attendance Among Artists

A sample of 157 adult artists completed the Eysenck Personality Questionnaire together with information about the frequency of church attendance. The data confirmed that church attendance is significantly associated with psychoticism scores, but independent of both extraversion and neuroticism.     

How a ten-year-old girl faced her death

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Ilse Hellman. From War Babies to Grandmothers: Forty-Eight Years in Psychoanalysis. London: Karnac Books &; The Institute of Psycho-Analysis. 1990. £16 (paperback).

James and Joyce Robertson. Separation and the Very Young. London: Free Association Books. 1989. £25.00 (hardback). Edward C. Melhuish and Peter Moss (eds.). Day Care for Young Children: International Perspectives. London and New York: Tavistock/Routledge. 1990. £12.99 (paperback).

Jeremy Holmes and Richard Lindley: The Values of Psychotherapy. Oxford: Oxford University Press. 1989. (£17.50).

Caroline Case and Tessa Dalley (Editors): Working with Children in Art Therapy. Published by Tavistock/Routledge. London and New York, 1990. £14.9.     

Introduction: Fragmentation of the Unus Mundus

This panel is a series of presentations by a father and his three sons. The first is a critique of the concept of the Unus Mundus, an idea that goes back at least as far as Plato's Cave in western intellectual history. A longing for unchanging foundational ideas lies at the core of much of our culture, psychology, and theology. The subsequent presentations describe various unforeseen, destructive results stemming from the perspective of the Unus Mundus. The first example is of persons with Alzheimer's disease, whose singular subjectivity is often ignored because they are seen as a category. They are 'Alzheimer-ed', subtly enabling those around them to avoid an anxiety-producing encounter with their enigmatic otherness. Another important perspective is the modernist re-construction of city spaces that has resulted in the loss of an organic sense of containment. The lengthy horizon of the grand boulevards seemed like openings upon infinity, often provoking panic and agoraphobia, as seen in the work of Edvard Munch. Lastly, the genocidal tendencies of modern times epitomize the dangers of totalizing, Utopian ideas. Violent elimination may be visited upon groups or peoples who are deemed 'impure', as besmirching idealized social visions. Such examples illustrate some of the ethical dangers of conceptualizations related to the Unus Mundus.     

Symptom Presentation and Symptom Meaning Among Traumatized Cambodian Refugees: Relevance to a Somatically Focused Cognitive-Behavior Therapy

Among psychologically distressed Cambodian refugees, somatic complaints are particularly prominent. Cambodians interpret anxiety-related somatic sensations in terms of “Wind” (khyâl), an ethnophysiology that gives rise to multiple catastrophic interpretations; and they have prominent trauma-memory associations to anxiety-related somatic symptoms. In this article, we detail some of the common sensation-related dysphoric networks of Cambodian refugees, focusing on catastrophic cognitions and trauma associations. We argue that delineating symptom-related dysphoric networks is crucial to successfully adapt cognitive-behavioral interventions to treat panic disorder and posttraumatic stress disorder among Cambodian refugees, and that such an approach may be useful for the culturally sensitive adaptation of cognitive-behavior therapy for other traumatized non-Western groups.