Peritraumatic and persistent panic attacks in acute stress disorder

This study examined the prevalence of peritraumatic and persistent panic symptoms following trauma. Survivors of civilian trauma (n=30) with either acute stress disorder (ASD) or no acute stress disorder (non-ASD) were administered the Panic Module of the Structured Clinical Interview for DSM-IV (SCID). Participants also completed the Impact of Event Scale, Acute Stress Disorder Scale, Beck Depression Inventory, Beck Anxiety Inventory, and the Anxiety Sensitivity Index. Panic attacks were experienced by 77% of participants during their trauma, and 47% reported recurrent panic attacks post-trauma. ASD participants demonstrated more panic symptoms during and after their trauma than non-ASD participants. Posttraumatic panic was most strongly associated with anxiety sensitivity. These findings are discussed in terms of cognitive factors that may mediate posttrauma panic and treatment implications for managing posttraumatic anxiety.There is increasing evidence that panic attacks play a role in psychopathological response to trauma. A significant proportion of people with panic disorder report a history of trauma (). Moreover, two-thirds of trauma survivors report panic attacks within the previous 2 weeks (). There is also evidence that people with posttraumatic stress disorder (PTSD) display elevated levels of anxiety sensitivity (). Recent attention has focused on acute panic reactions because of proposals that panic during trauma may condition trauma-related cues to subsequent panic (). There is evidence that panic attacks occur in 53-90% of trauma survivors during the traumatic experience (). Further, people with acute stress disorder (ASD) are more likely to report peritraumatic panic attacks than non-ASD individuals. ASD is a useful framework in which to investigate the role of panic in posttraumatic stress because ASD describes acute responses to trauma that are strongly predictive of chronic PTSD ().This study investigated the relationship between peritraumatic panic and ongoing panic attacks following trauma. Specifically, we indexed panic attacks during trauma and subsequent to trauma in trauma survivors with and without ASD. We also indexed the extent to which distorted interpretations about somatic sensations may be associated with panic attacks following trauma. We considered that the strong evidence that maladaptive appraisals of somatic sensations mediate panic () is directly relevant to posttraumatic panic. We hypothesized that ASD participants would report more peritraumatic and persistent panic than non-ASD participants, and that this panic would be associated with dysfunctional interpretations about somatic stimuli.     

Acute stress reactions: can biological responses predict posttraumatic stress disorder?

What biological responses characterize those acute trauma reactions that develop into chronic psychiatric disorder? The need to understand the genesis of posttraumatic psychological disorders has resulted in much attention on biological reactions in the initial aftermath of trauma exposure. This review outlines the prevailing biological models of acute stress reaction and critiques the available evidence concerning biological responses to trauma that are associated with subsequent psychological disorder. The roles of peritraumatic dissociation and vulnerability factors for acute stress reaction are also reviewed. The major challenges for research on psychobiological responses to trauma are highlighted.     

Memory on the beach: an Australian memory (and hypnosis) laboratory

The memory (and hypnosis) lab at the University of New South Wales investigates a broad range of memory topics. We try to find innovative methods from cognitive and clinical psychology to address theoretical and empirical questions about memory. We aso use hypnosis as one major methodological tool in our investigations of memory (as well as other cognitive processes). In this paper, we review the projects currently underway in our memory (and hypnosis) lab.     

Processing of disyllabic compound words in Chinese aphasia: evidence for the processing limitations account

The current study addresses the debate between so-called 'structural' and 'processing limitation' accounts of aphasia, i.e., whether language impairments reflect the 'loss' of linguistic knowledge or its representations, or instead reflect a limitation in processing resources. Confrontation-naming task and category-judgment tasks were used to examine and compare the performance of non-fluent and fluent aphasics on different compound types of nouns and verbs. We demonstrate that aphasic patients' performance is modulated by the canonicity of the particular compound type, a result that holds true even for the category in which patients show a 'selective category deficit.' These findings weigh against the 'loss' of linguistic representations as the underlying cause of noun-verb deficits, instead supporting a 'processing limitations' approach.     

Hypnotically induced emotional numbing: a real-simulating analysis

This study compared 20 real, hypnotized and 20 simulating, unhypnotized participants who were administered a hypnotic induction and then presented with emotionally distressing and neutral visual images. Half were administered a hypnotic suggestion for emotional numbing. Reals and simulators who received the emotional numbing suggestion reported comparably less responsivity to distressing stimuli than others. Whereas emotionally numb reals displayed little change in electromyographic (EMG) activity during the distressing stimuli, simulators displayed marked reduction in EMG activity. Reals (not simulators) displayed a dissociation between their affective response and awareness of the negative content of the stimuli following the numbing suggestion.     

Concurrent validity of the Wechsler abbreviated scale of intelligence and the Kaufman brief intelligence test among psychiatric inpatients

This study examined the convergent and discriminant validity of the Wechsler Abbreviated Scale of Intelligence and the Kaufman Brief Intelligence Test for 85 psychiatric inpatients. The correlation between the WASI Full Scale and K-BIT Composite IQ scores was significant (r = .89, p < .001). Multitrait-multimethod analysis of the subtest scores showed that the K-BIT had higher internal consistency for its two subtests but, therefore, less differentiation of cognitive functioning than the brief Wechsler scale, as would be expected due to the larger number and diversity of the latter subtests. Correlations among the Wechsler scale subtests were lower than among those for the K-BIT, so the former may tap different cognitive functions and yield more clinically useful information than the latter. This brief Wechsler scale appears to be a valid screening measure of verbal, performance. and general intellectual ability for use with an inpatient psychiatric population when considerations of the setting or patient preclude administration of a longer measure of intellectual ability.     

Acute stress disorder: a synthesis and critique

The diagnosis of acute stress disorder (ASD) was introduced to describe initial trauma reactions that predict chronic posttraumatic stress disorder (PTSD). This review outlines and critiques the rationales underpinning the ASD diagnosis and highlights conceptual and empirical problems inherent in this diagnosis. The authors conclude that there is little justification for the ASD diagnosis in its present form. The evidence for and against the current emphasis on peritraumatic dissociation is discussed, and the range of biological and cognitive mechanisms that potentially mediate acute trauma response are reviewed. The available evidence indicates that alternative means of conceptualizing acute trauma reactions and identifying acutely traumatized people who are at risk of developing PTSD need to be considered.     

Asian American college students as model minorities: an examination of their overall competence

Educational success among Asian Americans has led to their being labeled the "model minority." At the University of California, Berkeley (UCB), Asian American students have higher grade point averages (GPAs) than Hispanic and African American but not White students, supporting the notion that Asian Americans are more successful compared with other racial minorities. However, success in the classroom does not implicate effective functioning in life, and nonacademic criteria ought to be considered in assessing the validity of the model minority image. Given the increasing diversification of the United States, cross-racial engagement may be an additional contributor to overall competence. This was empirically tested in a group of 642 undergraduates at UCB, including 291 Asian, 197 White, 20 African American, 67 Hispanic, and 56 multiracial students. Overall competence was operationalized by sense of coherence, that is, the extent to which the world is experienced as comprehensible, manageable, and meaningful (A. Antonovsky, 1979, 1987). As predicted, Asian Americans had significantly fewer numbers of cross-racial groups represented in their friendship network than did students of all other races. Lower cross-racial engagement and being Asian (as compared with White) were related to a lower sense of coherence, whereas lower GPA was not. Within the Asian American subsample, cross-racial engagement was again significantly associated with greater coherence, whereas GPA again was not. Thus, extending the definition of success to overall competence, these findings raise questions about the applicability of the model minority label to Asian Americans, despite their academic achievement. Future studies need to assess the reasons for their limited cross-racial engagement and lower sense of coherence and to examine means to assist the development of these strengths.