Analysis of long-term stress reactions in emergency room patients: An initial study

The psychological stress reactions of 44 family medicine patients who were treated in the emergency room were examined approximately a year after the event. Patients were assessed on several psychological measures, including one for posttraumatic stress disorder (PTSD), and on their perception of how stressful the event was initially and now. Results show continuing stress reactions related to the emergency room event. Three patients endorsed symptoms indicating full PTSD and 13 appeared to have at least partial PTSD. Age appeared to be a factor in the presence of stress symptoms and in degree of perceived communication with the physician.     

Three years follow-up of panic disorder patients: A naturalistic study

Forty Danish panic disorder patients participating in a placebo controlled study of alprazolam and imipramine (The Cross National Collaborative Panic Study, Phase II) were followed up by a telephone interview three years later, with essentially the same battery of evaluation procedures applied at baseline, end of study, and follow-up. The main finding was that panic disorder is a chronic disorder, but fluctuating in form and severity in the course of time. Twenty-five percent of the patients no longer fulfilled the DSM-III criteria for panic disorder, but had substantial disability due to a variety of symptoms, including panic attacks at infrequent rate, generalized anxiety symptoms, affective symptoms, and phobic avoidance behavior. Nearly three fourths of the patients were under treatment at follow-up. Benzodiazepines were the drugs most often prescribed, usually in combination with supportive psychotherapy. It was concluded that the different types of treatment offered were insufficient. Variables predicting panic disorder or substantial disability at 3-years follow-up were few.     

Taking an individualized approach to the assessment of self-efficacy and the prediction of alcoholic relapse

The present study reports on a clinical instrument designed for assessing self-efficacy in alcoholics. In contrast to studies that construct general measures, it was proposed that taking an individualized approach to assessment might offer an effective methodology. Thirty-four alcoholics in an outpatient, behaviorally oriented treatment program participated as subjects. During therapy, an Individualized Self-Efficacy Survey (ISS) was developed for each subject. The ISS was developed by (a) administering the Drinking Patterns Questionnaire (DPQ) to identify important problem areas (e.g., work, children, marital) and specific drinking antecedents and (b) constructing a 15-item scale using each drinker's most important cues. The utility of having clients choose their own items was supported by finding a significant relationship between problem areas identified as important on the DPQ and the areas reported as surrounding relapse. ISS ratings were reflective of efficacy changes during treatment, while posttreatment ISS scores were predictive of subsequent relapse. Situation-specific prediction of relapse was not found. The advantages of this methodology for clinical use are discussed, while general directions for future research are suggested.