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.     

Signs of Resistance: Peer Learning of Sign Languages Within ‘Oral’ Schools for the Deaf

This article explores the role of the Deaf child as peer educator. In schools where sign languages were banned, Deaf children became the educators of their Deaf peers in a number of contexts worldwide. This paper analyses how this peer education of sign language worked in context by drawing on two examples from boarding schools for the deaf in Nicaragua and Thailand. The argument is advanced that these practices constituted a child-led oppositional pedagogy. A connection is drawn to Freire’s (1972) theory of critical pedagogy. Deaf children’s actions as peer educators are framed as an act of resistance towards the oppression of their language and culture. A contrast is drawn between oralist pedagogy that is historically associated with punitive practices and didactic methods and the experiential and dialogic interaction that characterised peer learning of sign languages. The argument is made that the peer teaching and learning processes enabled the self-actualisation of the Deaf children whereas the oralist methods were based on a deficit model that focused on modifying deaf children according to the norms of hearing society. The implications of this for current policy and practice are inferred to be about access to sign languages and the importance of Deaf communities in deaf children’s education. The argument is made that space needs to be created for deaf children to engage in peer learning.     

Women's experience of brain injury: An interpretative phenomenological analysis

Acquired traumatic brain injury (TBI) can leave the survivor with a complex range of psychological sequalae. This study aims to investigate the experience from the perspective of women with acquired TBI. Using a qualitative research method, six women with a TBI were interviewed about their experience, and the interviews were transcribed verbatim and analysed according to Interpretative Phenomenological Analysis (IPA). The major themes that emerged were: awareness of change; the emotional reaction; struggling to make sense; adaptation and acceptance. This article describes the process of adaptation, and the implications for rehabilitation are discussed. It is suggested that an intervention based on these themes might be an effective tool in rehabilitation.     

Paternal Postnatal and Subsequent Mental Health Symptoms and Child Socio‐Emotional and Behavioural Problems at School Entry

Research on the effect of paternal mental health problems, particularly on young children, is based predominantly on clinical levels of depression. Furthermore, potential mediators such as marital discord have often been overlooked. This longitudinal community study assessed the association between paternal mental health symptoms in a community sample (N = 705) assessed at 3 months postnatally (Edinburgh Postnatal Depression Scale) and 36 months (General Health Questionnaire) and children's socio‐emotional and behavioural problems at 51 months (Strengths and Difficulties Questionnaire) as reported by mother, father and teacher. Controlling for socioeconomic status and maternal mental health symptoms at 3 and 36 months, paternal postnatal depressive symptoms predicted more father‐reported child problems at 51 months but, in contrast to previous findings, not mother‐reported problems. Paternal mental health symptoms at 36 months predicted both maternal and paternal reports of child problems at 51 months controlling for both paternal and maternal postnatal symptoms. Paternal mental health symptoms at 3 and 36 months were not significant predictors of teacher‐reported child problems. Postnatal marital discord and paternal mental health problems at 36 months both mediated the relationship between paternal postnatal symptoms and later child emotional and behavioural problems. Child gender did not moderate the relationship. Implications for interventions are discussed. Copyright © 2013 John Wiley & Sons, Ltd.     

The Changing Role of Fatherhood: The Father as a Provider of Selfobject Functions

Fatherhood is evolving. The way that men carry out their paternal role is reflective of the historical time era in which they live, social and cultural forces, both the mother and the father's expectations for fathering behaviors, as well as the father's own innate capabilities, wishes, and desires. Fatherhood is also greatly influenced by men's relationships with their own fathers, the quality of that relationship, and the extent to which the father was emotionally available. The ever-changing role of fathers has been a challenge for the psychoanalytic literature. There is no comprehensive theoretical body of knowledge about fatherhood that takes into account the changing nature of fathering, especially considering men's desires to be emotionally responsive and nurturing parents. This article examines the changing role of the father and suggests a model of paternal involvement that expands the nurturing and available father role to include the father as a selfobject. It discusses the importance of understanding men's relationships with their fathers, a central dynamic in shaping fathers’ involvement with their children. The residual impact of paternal deprivation is explored, followed by two clinical vignettes that symbolize the search for missing selfobject functions. This article concludes by outlining clinical implications and questions to pose to assess the selfobject relationship with one's father.     

Practice Effects on Motor Control in Healthy Seniors and Patients with Mild Cognitive Impairment and Alzheimer's Disease

ABSTRACT

This research was designed to test the hypothesis that motor practice can enhance the capabilities of motor control in healthy controls (NC) and patients with a diagnosis of probable Alzheimer's disease (AD) and mild cognitive impairment (MCI), and consequently results in better motor performance. Approximately half of the subjects in the NC (n = 31), AD (n = 28), and MCI (n = 29) either received or did not receive practice on a task of fast and accurate arm movement with a digitizer. Changes in movement time (MT), movement smoothness (jerk), and percentage of primary submovement (PPS) were recorded and compared among the three groups across six blocks of trials (baseline and five training sessions). For all subjects, practice improved motor functions as reflected by faster and smoother motor execution, as well as a greater proportion of programming control. Compared to unaffected matched controls, AD and MCI subjects exhibited a greater reduction in movement jerk due to practice. Movement time and PPS data revealed that motor practice appeared to reduce the use of “on-line” correction adopted by the AD or MCI patients while performing the aiming movements. Evidently, their arm movements were quicker, smoother, and temporally more consistent than their untrained peers. The findings of this study shed light on how MCI and AD may affect motor control mechanisms, and suggest possible therapeutic interventions aimed at improving motor functioning in these impaired individuals.     

Dependence on Visual Feedback During Motor Skill Learning in Alzheimer's Disease

Three experiments examined the role of visual feedback on the performance of a fine motor task, namely the rotary pursuit, in patients with Alzheimer's disease (AD) and healthy older adults. After extensive practice tracking a fully visible target, participants in Experiments 1 and 2 were tested under restricted vision (RV) conditions. In both experiments, the two groups showed a drop in performance when vision was restricted, with AD patients showing a significantly larger decline. Tracking improved significantly in normal controls, but not AD patients across the RV trials after the initial drop. When difficulty of the rotary pursuit task was manipulated in Experiment 3 without restricting vision, AD patients and normal controls showed identical patterns of performance. Consequently, it could be concluded that AD patients in the first two experiments were relying more heavily on visual information for accurate performance of the tracking task than their healthy peers.     

Environmental enrichment results in cortical and subcortical changes in levels of synaptophysin and PSD-95 proteins

Experience-dependent plasticity is thought to involve selective change in pre-existing brain circuits, involving synaptic plasticity. One model for looking at experience-dependent plasticity is environmental enrichment (EE), where animals are exposed to a complex novel environment. Previous studies using electron microscopy showed that EE resulted in synaptic plasticity in the visual cortex and hippocampus. However, the areas in the brain that have been examined following EE have been limited. The present study quantified potential synaptic plasticity throughout the brains of C57BL/6 mice using an enzyme-linked immunosorbent assay (ELISA) for two synaptic proteins, synaptophysin and PSD-95. EE resulted in increased synaptophysin and PSD-95 levels through major brain regions, including anterior and posterior areas of the forebrain, hippocampus, thalamus, and hypothalamus. However, no changes in synaptophysin were detected in the cerebellum. These results demonstrate that EE results in an increase in levels of both pre- and post-synaptic proteins in multiple regions of the brain, and it is possible that such changes represent the underlying synaptic plasticity occurring in EE.     

Why Do Churches Become Empty,While New Age Grows? Secularization and Religious Change in the Netherlands

Research from the Netherlands has pointed out that the increased popularity of New Age since the 1960s by no means compensates for the dramatic decline of the Christian churches. From a theoretical point of view, however, it is more important to study why those remarkably divergent developments have occurred in the first place. This article does this by analyzing survey data collected among the Dutch population at large in 1998, focusing on a comparison of the young and the elderly. It is concluded, first, that there are no indications that the decline of the Christian tradition has been caused by a process of rationalization. Second, the decline of the Christian tradition and the growth of nonreligiosity as well as New Age are caused by increased levels of moral individualism (individualization). Implications for the sociological analysis of cultural and religious change are discussed.