A Comparison of Homeless Male Veterans in Metropolitan and Micropolitan Areas in Nebraska: A Methodological Caveat

This study explored differences between homeless male veterans in metropolitan and micropolitan cities in Nebraska on sociodemographic, housing, clinical, and psychosocial characteristics as well as health service use. A convenience sample of 151 homeless male veterans (112 metropolitan, 39 micropolitan) were recruited from Veterans Affairs facilities and area shelters in Omaha, Lincoln, Grand Island, and Hastings in Nebraska. Research staff conducted structured interviews with homeless veterans. Results showed that compared to homeless veterans in metropolitans, those in micropolitans were more likely to be White, unmarried, living in transitional settings, and were far more transient but reported greater social support and housing satisfaction. Veterans in micropolitans also reported more medical problems, diagnoses of anxiety and personality disorders, and unexpectedly, were more likely to report using various health services and less travel time for services. Together, these findings suggest access to homeless and health services for veterans in micropolitan areas may be facilitated through Veterans Affairs facilities and community providers that work in close proximity to one another. Many homeless veterans in these areas are transient, making them a difficult population to study and serve. Innovative ways to provide outreach to homeless veterans in micropolitan and more rural areas are needed.     

Athletes trained using stable compared to unstable surfaces exhibit distinct postural control profiles when assessed by traditional and nonlinear measures

Athletes are assumed to exhibit better balance than non-athletes; however, few studies have examined the role of different types of sports on balance measures. Two athlete groups that experience divergent sport-specific balance training are stable- (i.e. basketball) and unstable-surface athletes (i.e. surfers). The purpose of this study was to quantify the effect of stable- compared to unstable-surface sports on postural stability.MethodsEight non-athletes (NON), eight stable-surface athletes (SSA) and eight unstable-surface athletes (USA) performed five 20-s quiet standing trials while ground reaction forces were recorded. Approximate entropy (ApEn), total excursion and root mean square distances (RMS) of the center of pressure position were calculated. Univariate ANOVAs with post hoc tests were conducted for each variable.ResultsApEn values were lower in SSA compared to NON in the ML direction (p = 0.012) and USA had lower ApEn values compared to SSA in the AP direction (p = 0.036). The USA had smaller AP RMS compared to SSA (p = 0.002) while the USA had greater ML RMS (p = 0.008) and resultant RMS values compared to SSA (p = 0.025).DiscussionThese data suggest that USA and SSA may exhibit direction-specific differences in balance strategy due to feedback paradigm.     

Fragile self-esteem and affective instability in posttraumatic stress disorder

Temporal fluctuations in self-esteem and affect are prominent features of several clinical conditions (e.g., depression), but there is an absence of empirical work examining their role in posttraumatic stress disorder (PTSD). Individuals who experience large fluctuations in self-evaluations and affect are considered more vulnerable to psychopathology than individuals able to adequately modulate their self-image and emotional responses. We examined the relevance of self-esteem and affective instability to PTSD. Veterans with and without PTSD completed 14 daily ratings of self-esteem, positive affect, negative affect, and gratitude. Compared to veterans without PTSD, veterans with PTSD exhibited more temporal fluctuations in self-esteem, negative affect, and gratitude, with a smaller effect for positive affect. For all veterans, self-esteem and negative affective instability was associated with diminished well-being. Except for self-esteem instability, most findings were substantially reduced after accounting for variance attributable to PTSD diagnoses and mean intensity levels over the 14-day monitoring period. These data suggest self-esteem instability is important in understanding the lives of veterans with and without PTSD.     

A randomized pilot study of anger treatment for Iraq and Afghanistan veterans

Objective

Anger and aggression are serious problems for a significant proportion of veterans who have served in combat. While prior research has suggested that cognitive behavioral treatments may be effective for anger problems, there are few controlled studies of anger treatment in veterans and no studies of anger treatment focusing exclusively on veterans from the Iraq and Afghanistan wars. This randomized pilot study compared an adapted cognitive behavioral intervention (CBI) to a supportive intervention (SI) control condition for the treatment of anger problems in veterans returning from deployment in Iraq or Afghanistan.

Methods

25 veterans with warzone trauma, problems with anger, and one or more additional hyperarousal symptoms were randomized and 23 started treatment (CBI, n = 12; SI, n = 11). Outcome measures were administered at pre- and post- treatment and at 3 months post-treatment.

Results

CBI was associated with significantly more improvement than SI on measures of anger and interpersonal functioning. Gains were maintained at follow-up.

Conclusions

Findings suggest that CBI may be more effective than an active control providing psychoeducation, relaxation, and supportive therapy for treating anger problems in returning veterans. The findings need to be replicated in an adequately powered and more diverse sample.     

Recognizing Anxiety Disorders in the Aftermath of the World Trade Center Crisis

This article seeks to educate the reader on how to recognize the presence of anxiety disorders as they occur in the church community. The author uses medical information, Scriptural wisdom and a case illustration to help concerned Christians to assist sufferers in getting appropriate care. Anxiety disorders in the aftermath of the World Trade Center trajedy will be on the rise and the paper addresses this matter particularly for clergy, caregivers and professional counselors.     

Assessing the Readability of Mental Health Internet Brochures for Children and Adolescents

We investigated the readability of seven mental health brochures on mental, emotional, and behavioral disorders in children that were selected from a website developed by the Center for Mental Health Services at http://www.mentalhealth.org. The reading grade levels of the brochures ranged from 11.1 to 14.8 (mean 13.23), considerably higher than the 8th grade level recommended for educational material by the U. S. Department of Education (1986). On other readability variables, assessed using the Readability Assessment Instrument (RAIN; Singh, 1994), all brochures met criterion on most variables but failed on those for new words (audience appropriateness) and print size. This is a favorable result in comparison with other studies that have assessed readability of mental health information on the Internet using the RAIN, although less so with reading grade levels.     

A case of subcortical dementia due to sarcoidosis of the hypothalamus and fornices

A patient with sarcoidosis involving predominantly the hypothalamus and fornices was evaluated for dementia. He showed a relative sparing of fund of knowledge and orientation. Memory skills, particularly short-term memory, were severely impaired. Behavioral changes included apathy and a lack of spontaneity. Insight was relatively preserved. The pattern of his deficits showed some similarities to the pattern reported in patients with Huntington's disease and was different from that described in Alzheimer's disease. The dementia caused by subcortical pathology may differ in important respects from that caused by diffuse cortical dysfunction.     

Serial learning: Identification of subjective subsequences

Learning of fixed arbitrary sequences proceeds by idiosyncratic subsequencing and assembly of the resulting subsequences. An error item that just precedes a subjective subsequence is a closely constrained member of that subsequence. Identification and characterization of subjective subsequences were accomplished by analyses of forward serial learning, free recall, and backward serial learning. We conclude that ordinary serial learning cannot be represented by traditional continuous-process theories, but instead must be treated by an organizational model.     

Retrieval of propositional information from long-term memory

Three experiments are reported in which subjects learn propositions like A hippie is in the park. The experiments manipulate the number of such propositions involving a particular person (e.g., hippie) or a particular location (e.g., park). After learning the material, subjects are asked to judge whether particular probe propositions are from the study set. Times to make these judgments about probe propositions increase with the number of study propositions involving the person or location used in the probe proposition. A model is presented which assumes a subject simultaneously accesses memory from all concepts in a probe proposition and serially searches through all study propositions involving each concept. Search of memory terminates as soon as one search process from a concept finds the probe proposition or exhausts the study propositions attached to that concept.