Post-traumatic stress disorder in Vietnam veterans: Assessment in a forensic setting

The recognition and proper evaluation of Vietnam veterans' demonstrating Post-Traumatic Stress Disorder syndromes is reviewed. The special problems of accurate diagnosis and assessment of former Vietnam combatants is emphasized. The forensic evaluation of Vietnam veterans' raising the Post Traumatic Stress Disorder syndrome in either civil or criminal proceedings is comprehensively discussed. The question “What are the clinical techniques necessary to accomplish a competent forensic evaluation of the Vietnam veterans?” is specifically addressed with special emphasis on legal dispositions and treatment implications. The relationship between the criminal acts of combat veterans and their exposure to the psychological trauma of war is explored.     

Estimating rates of chronic fatigue syndrome from a community-based sample: A pilot study

Most of the Chronic Fatigue Syndrome (CFS) epidemiological studies have relied on physicians who refer patients having at least 6 months of chronic fatigue and other symptoms. However, there are a number of potential problems when using this method to derive prevalence statistics. For example, some individuals with CFS might not have the economic resources to access medical care. Other individuals with CFS might be reluctant to use medical personnel, particularly if they have encountered physicians skeptical of the authenticity of their illness. In addition, physicians that are skeptical of the existence of CFS might not identify cases. In the present pilot study, a random community sample (N=1,031) was interviewed by telephone in order to identify and comprehensively evaluate individuals with symptoms of CFS and those who self-report having CFS. Different definitions of CFS were employed, and higher rates (0.2%) of CFS were found than in previous studies. Methodological benefits in using more rigorous epidemiological methods when estimating CFS prevalence rates are discussed. The authors appreciate the generous financial support of the CFIDS Association and Minnan, Inc. We also are grateful for many helpful suggestions provided by Judith A. Richman, William McCready, Wendell Richmond, and Stephen E. Goldston. Finally, we are very thankful to the many undergraduate volunteers who helped us complete this study, and they include Cheryl Stenzel, Georgina DeLa Torre, Vickie Chrisos, Don Banik, Hillary Loeb, Leslie Ramesack, Ellen Diamond, Rob Bleeker, Gib Garza III, Mindy Silverstein, Kadip Sen, Meredith Lombrazo, Brian Miller, Caroline Marsden, Lorraine Whitmore, Stan Gayot, Karen Costakis, and Dave Sobotka.     

Driving skills after whiplash

Previous studies have shown that some persons with longlasting problems after whiplash have changed eye movements. These changes have been related to disturbance of the posture control system. The question raised in the present study is whether such disturbances can influence daily life functions connected with balance, position and external movements, such as car driving. A group of 23 persons with disturbed eye movements due to whiplash injury, was tested in a driving simulator, together with a closely matched control group. The results revealed significant differences between the two groups with respect to response times to the traffic signs presented, identification of type of sign, as well as steering precision while the subjects’ attention was directed to the process of identifying the signs. Alternative explanations such as driving experience, pain, medication or malingering are at least partly controlled for, but cannot completely be ruled out. A distorted posture control system leading to disturbance of eye movements seems to be the most likely primary causative factor, but these disturbances are most certainly complexly determined. Reduced attention capacity is considered to be a mediating secondary factor. Registration of eye movements may be a useful diagnostic tool to evaluate driving skill after whiplash.     

Selective alexia and agraphia sparing numbers-a case study

We report a patient (MT) with a highly specific alexia affecting the identification of letters and words but not numbers. He shows a corresponding deficit in writing: his letter writing is impaired while number writing and written calculation is spared. He has no aphasia, no visuo-perceptual or -constructional difficulties, or other cognitive deficits. A similar pattern of performance has to our knowledge only been reported once before [Anderson, S. W., Damasio, A. R., & Damasio, H. (1990). Troubled letters but not numbers. Domain specific cognitive impairments following focal damage in frontal cortex. Brain, 113, 749-766]. This study shows that letter and number reading are dependent on dissociable processes. More interestingly, it points to a common mechanism subserving the perception and production of letters. We suggest that a deficit in a visuo-motor network containing knowledge of the physical shape of letters might explain the pattern of performance displayed by MT.     

Bullying in college by students and teachers

This study explored bullying in college by students and teachers. The reports of a sample of 1,025 undergraduates indicated that 24.7% had seen students bully other students occasionally and 2.8% very frequently, 5% had been bullied by students occasionally and 1.1% very frequently, 12.8% had seen teachers bully students occasionally and 1.9% very frequently, 4.2% had been bullied by teachers occasionally and .5% very frequently, while 3.2% had bullied other students occasionally and 1.9% very frequently. Male students bullied significantly more than females. Student bullying was predicted by having seen other students bully, and by having been bullied by both students and teachers.     

The effects of behavioral skills training on staff implementation of discrete-trial teaching

A behavioral skills training package was used to train 3 teachers to correctly implement discrete-trial teaching. The mean baseline proportion of possible correct teaching responses for Teachers 1, 2, and 3 increased from 43%, 49%, and 43%, respectively, during baseline to 97%, 98%, and 99%, respectively, following training. These data indicate that the training package consisting of instructions, feedback, rehearsal, and modeling produced rapid and large improvements in the teachers' implementation of discrete-trial teaching.     

Psychometric properties of the social phobia inventory: further evaluation

This study investigated the psychometric properties of the Social Phobia Inventory [SPIN; Connor, K. M., Davidson, J. R. T., Churchill, L. E., Sherwood, A., Foa, E., Wesler, R.H., 2000. Psychometric properties of the Social Phobia Inventory (SPIN). British Journal of Psychiatry, 176, 379-386], a measure of severity in social phobia (social anxiety disorder). Participants included 132 participants with social phobia, 57 participants with panic disorder and agoraphobia (PDA), and 62 participants with obsessive-compulsive disorder (OCD). Confirming findings from an initial validation study, the SPIN was found to have excellent internal consistency and good test-retest reliability. It also distinguished well between those with social phobia and those with either PDA or OCD. Good convergent and discriminant validity were established by examining correlations with other conceptually related and unrelated scales. Finally, the SPIN was sensitive to changes in social phobia severity following cognitive behavioral group treatment. In conclusion, the SPIN is both reliable and valid for the measurement of social phobia severity and outcome following psychological treatment.     

Infectious and immune factors in the pathogenesis of neurodevelopmental disorders: epidemiology, hypotheses, and animal models

Both genetic and environmental factors contribute to the pathogenesis of a wide variety of neurodevelopmental disorders, including autism, mental retardation, and schizophrenia. Some heritable disorders approach 100% penetrance; nonetheless, even in these disorders, subtle aspects of clinical disease expression may be influenced by the environment. In other disorders with genetic influences, exogenous factors, and the timepoint(s) during nervous system development at which they are introduced, modulate expression of disease. Elucidation of the mechanisms guiding this intricate interplay between host response genes, environmental agents, and the neurodevelopmental context within which these interactions occur, is necessary to understand the continuum of clinical outcomes. This chapter will review the evidence that infectious and immune factors may contribute to the pathogenesis of neurodevelopmental disorders, describe an animal model of neurodevelopmental disorders based upon viral infection, identify processes by which neural circuitry may be compromised, and outline areas for future research.     

Self-affirmation versus self-consistency: a comparison of two competing self-theories of dissonance phenomena

High or low self-esteem individuals participated in a role-playing paradigm in which a friend stood them up for a dinner date. The participants received either a good explanation from the friend for the missed date (sufficient justification) or a poor explanation (insufficient justification). As predicted by self-affirmation theory (Steele, 1988), but not self-consistency theory (Aronson, 1999), low-esteem participants derogated the friend more than high-esteem participants under both insufficient and sufficient justification. Also supporting self-affirmation theory, sufficient/low-esteem participants reported more offense for being stood-up than sufficient/high-esteem participants. Discussion centers on the role of self-esteem in dissonance processes and on the need for more research that focuses on dissonance/self-threats that result from the behavior of other(s) rather than one’s own behavior.